Largely due to the exposure to radiation therapy, people who have survived cancer in their childhood may be at an increased risk for developing hormones disorders that may lead to thyroid disease, testicular dysfunction and diabetes, later, say experts.

To warn healthcare providers about these risks, the Endocrine Society, an international medical organisation, issued this week a "Clinical Practice Guideline" which was published in The Journal of Clinical Endocrinology and Metabolism (JCEM). "Childhood cancer survivors have a high risk of developing endocrine disorders," said Charles Sklar of the Memorial Sloan Kettering Cancer Centre in New York who chaired the writing committee that developed the guideline.

The endocrine system has eight major glands that make hormones that help control many important body functions including regulation of blood sugar. Childhood cancer is relatively rare, and due to improvements in treatment and patient care, the current five-year survival rates exceed 80 per cent. However, these survivors also face a greater risk of developing sleep problems and daytime sleepiness as adults and hypertension, even decades after cancer treatment ends.

Endocrine disorders are especially prevalent among this population, often as a result of their previous treatments, particularly exposure to radiation therapy. Radiation exposure to key endocrine organs including hypothalamus, pituitary, thyroid, and gonads, places cancer survivors at the highest risk of developing an endocrine abnormality over time.

Recent data shows that almost 50 percent of these survivors will develop an endocrine disorder over their lifetime. These disease can develop decades following cancer treatment, underscoring the importance of lifelong surveillance, said researchers. The guideline provides recommendations on how to diagnose and manage certain endocrine and growth disorders commonly found in childhood cancer survivors.

It recommends long-term screening of childhood cancer survivors for growth disorders, pituitary hormone deficiencies, and early puberty. "Our new guideline addresses the growing risk of endocrine disorders among childhood cancer survivors. It stresses the importance of life-long screening of these survivors for earlier detection and optimal patient care," Sklar noted.