Thyroid & Neuroendocrine System

Childhood cancer survivors may have late effects that affect the thyroid.

Thyroid late effects may include the following:

  • Hypothyroidism (not enough thyroid hormone).
  • Hyperthyroidism (too much thyroid hormone).
  • Goiter.
  • Lumps in the thyroid.

Certain factors increase the risk that thyroid problems will occur.

The risk of thyroid late effects may be increased in childhood cancer survivors who received either of the following:

  • Radiation therapy to the head and neck.
  • Total-body irradiation (TBI) as part of a stem cell transplant.

The risk may also be greater in females and may increase as the amount of time since diagnosis gets longer.

Thyroid late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause thyroid late effects:

  • Acute lymphoblastic leukemia (ALL).
  • Brain tumors.
  • Hodgkin lymphoma.
  • Head and neck cancers.

Neuroendocrine system

Childhood cancer survivors may have late effects that affect the neuroendocrine system.

Neuroendocrine late effects may include the following:

  • Low levels of pituitary hormones, including growth hormone.
  • Early puberty (especially in females).
  • Late puberty.
  • Disorders of the hypothalamus.
  • Pituitary gland problems.

Childhood cancer survivors who received a stem cell transplant with total-body irradiation (TBI) have an increased risk of growth disorders.

Their risk is affected as follows:

  • Low levels of growth hormone are more likely if the survivor:
    • is female; or
    • received radiation therapy to the head before the transplant; or
    • received TBI in a single dose instead of divided doses; or
    • had graft-versus-host disease; or
    • received busulfan and cyclophosphamide.
  • Adult height that is shorter than normal is more likely if the survivor:
    • is male; or
    • received the transplant at a young age; or
    • received TBI in a single dose instead of divided doses.

Neuroendocrine late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause neuroendocrine late effects:

  • Acute lymphoblastic leukemia (ALL).
  • Central nervous system (CNS) tumors.
  • Lymphoma.

The Web site of the National Cancer Institute (http://www.cancer.gov)

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