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Late Effects of Treatment for Childhood Cancer (PDQ®)

  • Posted: 04/23/2004
  • Updated: 10/27/2014

Table 9. Pituitary Gland Late Effects

Predisposing Therapy Endocrine/Metabolic Effects  Health Screening 
Radiation impacting hypothalamic-pituitary axisGrowth hormone deficiencyAssessment of nutritional status
Height, weight, BMI, Tanner stagea
Radiation impacting hypothalamic-pituitary axisPrecocious pubertyHeight, weight, BMI, Tanner stagea
FSH, LH, estradiol, or testosterone levels
Radiation impacting hypothalamic-pituitary axisGonadotropin deficiencyHistory: puberty, sexual function
Exam: Tanner stagea
FSH, LH, estradiol or testosterone levels
Radiation impacting hypothalamic-pituitary axisCentral adrenal insufficiencyHistory: failure to thrive, anorexia, episodic dehydration, hypoglycemia, lethargy, unexplained hypotension
Endocrine consultation for those with radiation dose ≥30 Gy
Radiation impacting hypothalamic-pituitary axisHyperprolactinemiaHistory/exam: galactorrhea
Prolactin level
Radiation impacting hypothalamic-pituitary axisOverweight/obesityHeight, weight, BMI
Blood pressure
Components of metabolic syndrome (abdominal obesity, hypertension, dyslipidemia, impaired glucose metabolism)Fasting blood glucose level and lipid profile
Radiation impacting hypothalamic-pituitary axisCentral hypothyroidismTSHb free thyroxine (free T4) level

BMI = body mass index; FSH = follicle-stimulating hormone; LH = luteinizing hormone; TSH = thyroid-stimulating hormone.
aTesticular volume measurements are not reliable in the assessment of pubertal development in boys exposed to chemotherapy or direct radiation to the testes.
bAppropriate only at diagnosis. TSH levels are not useful for follow-up during replacement therapy.