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Endocrine sequelae of cancer therapy

Radiation may directly impair hypothalamic, pituitary, thyroid, pancreatic and gonadal function, or alternatively it may induce the development of hyperparathyroidism, thyroid adenomas or carcinomas. Cytotoxic chemotherapy may damage the gonad, and both irradiation and cytotoxic chemotherapy may interfere with the normal growth of bone. These complications of treatment may lead to various clinical presentations, including infertility, gynaecomastia, hypogonadism, impaired growth leading to short stature, failure to undergo normal pubertal development, precocious puberty, hyperparathyroidism, hypothyroidism, thyroid tumours, diabetes mellitus (1) and varying degrees of hypopituitarism.

Hypothalamo-pituitary axis: Deficiency of one or more anterior pituitary hormones is now a well-recognized sequela of external radiotherapy to the hypothalamo-pituitary axis. This may occur in patients treated for non-functioning pituitary adenomas, hormone-secreting pituitary adenomas and craniopharyngiomas. Anterior pituitary hormone deficiencies have also been reported when the hypothalamo-pituitary axis falls within the radiation field during the treatment of nasopharyngeal cancer and intracranial tumours distant from the