Endocrine System

Endocrine System

Summarize

Testicles and ovaries

 

 

        For information on the long-term effects of the testes and ovaries, see the Reproductive system section.

 

 

 

 metabolism syndrome

 

 

1. Definitions

 

        Metabolic syndrome is a group of conditions that include excess abdominal fat and at least two of the following:

 

 

 

 hypertension

 

High levels of triglycerides and low levels of high density lipoprotein (HDL) cholesterol

High blood sugar (glucose) levels

 

 weight

 

 

 definition

 

        Being underweight, overweight or obese is a long-term effect that is more likely to occur after treatment for certain childhood cancers.

 

 

Epidemiological

 not have

Etiology & Risk Factors

 thyroid gland

Other risk factors

 

 

 

 

 femininity

They were younger when they received treatment

The radiation dose is high

The time to diagnosis and treatment is longer

Possible health problems

 

Hypothyroidism (insufficient thyroid hormone): This is the most common long-term effect of thyroid disease. It usually occurs 2 to 5 years after treatment, but can occur later. It is more common in girls than in boys.

 

Hyperthyroidism (too much thyroid hormone): Usually develops 3 to 5 years after treatment.

 

Goiter (enlarged thyroid gland).

 

Goiter: Usually occurs 10 years or more after treatment. More common in girls than boys. These growths can be benign (non-cancerous) or malignant (cancerous).

 

 

 metabolism syndrome

 risk factor

 

Cancerous tumors

 

 

 

 

50. Acute lymphoblastic leukemia (ALL)
50. Cancer treated with stem cell transplants
50. Cancer that is treated with radiation to the abdomen, such as Wilms' tumor or neuroblastoma

Classification & Staging

 thyroid gland

Cancer types

 

 

 

 

50. Acute lymphoblastic leukemia (ALL)
50.  cerebroma
50. Head and neck cancer
50.  hodgkin lymphoma
50.  neuroblastoma
50. Cancer treated with stem cell transplants

 

 

 hypophysis cerebri

Cancer types

 

 

 

 

50. Brain and spinal cord tumors
50. Acute lymphoblastic leukemia (ALL)
50.  nasopharyngeal darcinoma
50. Cancer treated with whole body irradiation (TBI) prior to stem cell transplantation

 

 weight

Cancer types

 

 

 

 

50. Acute lymphoblastic leukemia (ALL)
50. Brain tumors, especially indications
50. Cancers treated with radiation to the brain, including whole body irradiation (TBI) as part of a stem cell transplant

 

 

 

 

Clinical Manifestations

 thyroid gland

 S&S

 

        3.1 Hypothyroidism (too little thyroid hormone)

 

 

 

 

50. Feeling tired or weak
50. More sensitive to cold
50. Pale, dry skin
50. Rough and sparse hair
50. Fragile nails
50. A raspy voice
50. Swollen face
50. Muscle and joint pain and stiffness
50.  astriction
50. The menstrual period is heavier than normal
50. The cause of the weight gain is unknown
50. Depression, memory impairment or difficulty concentrating
50. In a few cases, hypothyroidism does not cause any symptoms

 

 

        3.2 Hyperthyroidism (excess thyroid hormone)

 

 

 

 

50. Feel tense, anxious or moody
50.  sleep problems
50. Feeling tired or weak
50. My hands were shaking badly
50. The heart rate is fast
50. The skin can be red and warm and may itch
50. There is thin, soft hair that is falling out
50. Frequent or loose stools
50. The reason for the weight loss is unknown
50. If your child has any of the above concerns, please consult your child's doctor

Clinical Department

 not have

Examination & Diagnosis

 thyroid gland

 test mode

 

 

50. Physical exam and medical history: A general physical examination of the body's signs of health, including checking for signs of disease, such as lumps or other unusual things. Learn about the patient's health habits and past illnesses and treatments.

 

 

 

50. Hormone tests: Blood samples are examined to check the amount of certain hormones released into the blood by organs and tissues. Abnormal results (higher or lower than normal) may indicate problems with the relevant organ or tissue. Abnormal levels of thyroid-stimulating hormone (TSH) or free thyroxine (T4) can be detected in the blood.

 

 

50. Ultrasound: This test shows the size of the thyroid gland and whether there are nodules on it.

 

 

Talk to your child's doctor about whether your child needs a test and examination to determine signs of thyroid long-term effects. If a test is needed, find out how often it will be done.

 

 hypophysis cerebri

 test mode

 

50. Physical exam and medical history: A general physical examination of the body's signs of health, including checking for signs of disease, such as lumps or other unusual things. Learn about the patient's health habits and past illnesses and treatments.

 

 

50. Blood biochemical tests: Tests of blood samples to check the amount of certain substances (such as glucose) released into the blood by organs and tissues in the body. Abnormal results (higher or lower than normal) may indicate problems with the relevant organ or tissue.

 

 

 

50. Hormone tests: Blood samples are examined to check the amount of certain hormones released into the blood by organs and tissues in the body. Abnormal levels of follicle-stimulating hormone, luteinizing hormone, estradiol, testosterone, cortisol or free thyroxine (T4) can be detected in the blood.

 

 

 

50. Blood tests: Blood samples are examined for triglycerides, cholesterol and the levels of low and high density lipoprotein cholesterol in the blood.

       

 

Talk to your child's doctor about whether your child needs a test and examination to check for long-term effects of neuroendocrine issues. If a test is needed, find out how often it will be done.

 

 metabolism syndrome

 test mode

 

50. Physical exam and medical history: A general physical examination of the body's signs of general health, including checking for signs of disease, such as lumps or other unusual things. Learn about the patient's health habits and past illnesses and treatments.

 

 

 

50. Blood biochemical tests: Tests of blood samples to check the amount of certain substances (such as glucose) released into the blood by organs and tissues in the body. Abnormal results (higher or lower than normal) may indicate problems with the relevant organ or tissue.

 

 

 

50. Blood tests: Blood samples are examined for triglycerides, cholesterol and the levels of low and high density lipoprotein cholesterol in the blood.

 

 

Talk to your child's doctor about whether your child needs a checkup and tests for signs of metabolic syndrome. If so, find out how often the tests are scheduled.

 weight

 test mode

 

 

50. Physical examination and medical history: Examine general signs of physical health, including weight or other unusual signs. Learn about the patient's health habits and past illnesses and treatments.

 

 

 

50. Blood biochemical tests: Tests of blood samples to check the amount of certain substances (such as glucose) released into the blood by organs and tissues in the body. Abnormal results (higher or lower than normal) may indicate problems with the relevant organ or tissue.

 

 

50. Blood tests: Blood samples are examined to measure triglycerides, cholesterol and the levels of low and high density lipoprotein cholesterol in the blood.

 

 

Weight, body mass index, percentage body fat or size of the abdomen (abdominal fat).

 

 

        Talk to your child's doctor about whether your child needs a checkup and tests to check for signs of weight gain. If a checkup is needed, find out how often it will be done.

Clinical Management

 thyroid gland

 therapeutic tool

 

 

 

 

50. Radiation therapy for the thyroid is part of radiation therapy for the head and neck or the pituitary gland at the base of the brain.
50. Whole body irradiation (TBI) as part of stem cell transplantation.
50. MIBG (radioactive iodine) treatment for neuroblastoma.

 

 hypophysis cerebri

 therapeutic tool

 

 

 

 

50. Radiation therapy to the brain in the hypothalamus area is used to treat cancer near the hypothalamus, or for whole-body irradiation before stem cell transplantation
50. (TBI)

 

 

 

 

Possible health problems, signs and symptoms, and treatments

 

        Some hormone levels may be low in children who have recovered from cancer with advanced neuroendocrine disease. These hormones are produced in the pituitary gland and released into the bloodstream:

 

 

 

 growth hormone deficiency

 

 

 

        Low levels of growth hormone are a common long-term effect of radiation to the brain in children who have recovered from cancer. The higher the radiation dose and the longer the time after treatment, the greater the risk of this long-term effect. Low levels of growth hormone can also occur in patients with acute lymphoblastic leukemia (ALL) and those who have undergone stem cell transplants involving radiation therapy and/or chemotherapy to the brain and spinal cord.

 

 

 

        Children with low levels of growth hormone are shorter than normal as adults.

 

 

 

        If the child's bones have not fully developed, growth hormone replacement therapy can be used to treat low levels of growth hormone for up to one year after treatment.

 

       

 

A deficiency of adrenocorticotropic hormone

 

 

 

        Low levels of ACTH is an uncommon long-term effect. It may occur in children who have recovered from brain tumours, those with low levels of growth hormone or who have recovered from central hypothyroidism, or after brain radiotherapy.

 

      

 

         Symptoms of adrenal insufficiency may be mild or go unnoticed. Symptoms and signs of adrenal insufficiency include:

 

 

 

 

Unexplained weight loss

 

50. I don't feel hungry
50.  feel like vomiting
50.  vomit
50.  hypopiesia
50. Feeling tired

 

 

        Low levels of adrenal corticosteroids can be treated with hydrocortisone.

 

      

 

 hyperprolactinemia

 

  

 

High levels of prolactin may occur after high-dose radiation to the brain or surgery that affects part of the pituitary gland. High concentrations of prolactin can cause:

 

 

 

 

50. Adolescence is later than normal
50. Women who are not pregnant or nursing produce milk
50. No menstruation, low menstrual frequency, or very light menstrual flow
50. Hot flashes (women)
50. Can't get pregnant
50. Sexual intercourse is impossible
50. Lower libido (in both men and women)
50. Osteopenia (low bone density)

 

 

        Sometimes there are no signs or symptoms. Rarely does it require treatment.

 

 

 

Thyroid-stimulating hormone deficiency (central hypothyroidism)

 

        

 

        Thyroid hormone levels will gradually decrease over time after radiation therapy to the brain.

 

 

 

        Sometimes the symptoms of a lack of thyroid-stimulating hormone go unnoticed. Low thyroid hormone levels can cause slow growth, delayed puberty and other symptoms.

 

 

 

        Low levels of thyroid hormone can be treated with thyroid hormone replacement therapy.

 

 

 

Lack of luteinizing hormone or follicle-stimulating hormone

 

 

 

        Low levels of these hormones can lead to different health problems depending on the dose of radiation.

 

 

 

        Children who have recovered from cancer and receive low-dose brain radiation therapy may develop central precocious puberty, which can cause girls to start puberty before age 8 and boys before age 9. This condition can be treated with gonadotropin-releasing hormone (GnRH) agonists to delay puberty and support the child's growth. Hydrocephalus may also increase the risk of such long-term effects.

 

 

 

        Children who have recovered from cancer treated with high-dose radiation therapy may have low levels of luteinizing hormone or follicle-stimulating hormone. This condition can be treated with sex hormone replacement therapy, depending on the child's age and whether they are in puberty.

 

      

 

 central diabetes insipidus

 

 

 

Central diabetes insipidus may be due to a deficiency or low levels of all hormones secreted and released into the blood by the anterior pituitary gland. It may occur in children who have recovered from cancer and are undergoing surgery for the hypothalamus or pituitary gland. The signs and symptoms of central diabetes insipidus include:

 

        

 

 

50. Large amounts of urine or wet diapers
50. I feel very thirsty
50.  headache
50. Vision difficulties
50. Growth and development delayed
50. Unexplained weight loss

 

 

        Treatments may include antidiuretic hormone replacement therapy, a hormone that controls the amount of urine produced by the body.

 

Testicles and ovaries

 therapeutic tool

 

 

 

 

50. Radiation therapy to the brain or abdomen.
50. Whole body irradiation (TBI) as part of stem cell transplantation.

 

 metabolism syndrome

 therapeutic tool

 

 

 

 

Radiation therapy to the brain or abdomen.

Whole body irradiation (TBI) as part of stem cell transplantation.

 

 

 weight

 therapeutic tool

 

 

 

        2.2.1 The following therapeutic approaches may increase the risk of underweight:

 

 

 

 

Whole-body irradiation (TBI) for women; abdominal radiotherapy for men; certain types of chemotherapy (alkylating agents and anthracyclines).

 

 

 

        2.2.2 The following treatments may increase the risk of obesity:

 

 

 

        Radiation therapy to the brain; surgery to damage the hypothalamus or pituitary gland, such as craniopharyngioma or brain tumor resection. ​

 

 

 

        2.2.3 Other factors that may increase the risk of obesity:

 

 

 

 

50. He was diagnosed with cancer between the ages of five and nine
50.  femininity
50. There is a deficiency or low level of growth hormone or leptin
50. Not doing enough physical activity to maintain a healthy weight
50. Take the antidepressant paroxetine

 

 

        Children who recover from cancer have a lower risk of becoming obese if they exercise enough and have a good mental outlook.

 

 weight

 therapeutic tool

 

 

 

        2.2.1 The following therapeutic approaches may increase the risk of underweight:

 

 

 

 

Whole-body irradiation (TBI) for women; abdominal radiotherapy for men; certain types of chemotherapy (alkylating agents and anthracyclines).

 

 

 

        2.2.2 The following treatments may increase the risk of obesity:

 

 

 

        Radiation therapy to the brain; surgery to damage the hypothalamus or pituitary gland, such as craniopharyngioma or brain tumor resection. ​

 

 

 

        2.2.3 Other factors that may increase the risk of obesity:

 

 

 

 

50. He was diagnosed with cancer between the ages of five and nine
50.  femininity
50. There is a deficiency or low level of growth hormone or leptin
50. Not doing enough physical activity to maintain a healthy weight
50. Take the antidepressant paroxetine

 

 

        Children who recover from cancer have a lower risk of becoming obese if they exercise enough and have a good mental outlook.

Prognosis

 not have

Follow-up & Review

 not have

Daily Care

 metabolism syndrome

Prevention and health care

 

 

50. Have a healthy weight.

 

50. Eating for heart health.

 

50. Regular exercise.

 

50.  Smoking 。

Cutting-edge therapeutic and clinical Trials

 not have

References

 data source ：

 

PDQ® Pediatric Treatment Editorial Board. PDQ Late Effects of Treatment for Childhood Cancer. Bethesda, MD: National Cancer Institute. Website: https://www.cancer.gov/types/childhood-cancers/late-effects-pdq. Date accessed: July 24,2018. [PMID: 26389365]

 

 

 

        Translated by Qian Yueping (Senior Manager, Medical Device Industry, Medical Clinical Affairs Department, PhD in Biology)

Audit specialists

 not have