Many children diagnosed with neuroblastoma, a cancerous tumor of the nerve tissue, receive chemotherapy. A team of Belgian paediatricians have now investigated the long-term toxic effects of the treatment on the endocrine system. While doing so, they discovered an unexpected impact on the survivors’ final height.
By Claire Geurten, Marie Geurten, Claire Hoyoux & Marie-Christine Lebrethon
Neuroblastoma is a form of cancer which originates in the neuronal tissue outside the brain. It exclusively affects children – about one in 100,000 – and mostly toddlers. New treatments have made it possible to cure about 80% of cases. Nevertheless, treatments such as chemotherapy, radiation therapy, surgery and nuclear therapy are known to affect the patients’ health during therapy and in the years after. Overall, up to one childhood cancer survivor out of two suffers from a chronic condition due to therapy.
In particular, radiation therapy to control the growth of inoperable tumors has been shown to impact fertility and the secretion of growth hormones. What is more, a Belgian team of pediatricians have now discovered that children undergoing chemotherapy without radiation are also at a higher risk of developing hypothyroidism (an underactive thyroid) and dysfunctions of the reproductive glands (the testicles and ovaries), potentially affecting their fertility.
An unexpected outcome
On top of that, the researchers discovered that adult neuroblastoma survivors treated with chemotherapy at some point in the last 20 years were shorter than expected, independent of any other comorbidities or growth hormone deficiencies. The Belgian researchers believe a chemotherapy-induced premature closure of the bones to be the cause for this. The study, recently published in the Journal of Pediatric Endocrinology and Metabolism, is the first to report differences in body height due to receiving chemotherapy alone in childhood.
According to the paediatricians the study will lead the way to further investigations as to how exactly chemotherapy affects bone growth, so ultimately treatments can be adapted to prevent small height in cancer patients without affecting their chances of survival.
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