Endocrine Side Effects

21.03.2024

ENDOCRINE SYSTEM SIDE EFFECTS IN CANCER TREATMENT

The endocrine system regulates many different functions through the body's hormones. Some methods used in cancer treatment, especially chemotherapy and radiotherapy, can affect the endocrine system and cause various side effects. These treatments can affect the pituitary gland, thyroid, adrenal glands, and sex hormones. For example, chemotherapy can sometimes suppress pituitary gland function, reducing the production of important hormones such as growth hormone or gonadotropins. This can lead to a decrease in energy levels, loss of libido, or menopause-like symptoms. Radiotherapy, especially when applied to the head and neck area, can damage the thyroid gland and cause thyroid diseases such as hypothyroidism. This can lead to a decrease in metabolic rate, weight gain and fatigue. Additionally, some cancer treatments can affect cortisol production by the adrenal glands, creating effects on stress and metabolism. All these side effects highlight the complexity of cancer treatment and the need for a holistic approach for patients. To manage these side effects, oncology physicians should communicate closely with patients and consult with endocrinologists if necessary.

Image 1: Functional disorders may occur in hormone-secreting organs in the body due to cancer or cancer treatment.

Drugs that cause endocrine system side effects in cancer treatment include:

Surgical Interventions: Surgical procedures performed to remove cancerous tissue may lead to the removal of endocrine glands or disruption of their functions.

Chemotherapy and Radiotherapy: These treatments may directly or indirectly affect the functions of the endocrine glands. Radiotherapy, especially applied to the brain, neck and pelvic areas, can damage the endocrine glands in these areas. Some chemotherapeutic agents can cause changes in hormone levels.

Hormonal Treatments: Hormonal treatments used especially in breast and prostate cancers may have an effect on the endocrine system.

Immunotherapies: Some immunotherapy drugs can cause endocrine side effects such as thyroiditis (inflammation of the thyroid gland).

Steroids: Long-term steroid use can affect the body's hormonal functions.

Targeted Therapies: In particular, tyrosine kinase inhibitors may cause changes in the endocrine system.

It is important to closely monitor endocrine system functions during the use of these drugs and apply appropriate treatment methods if necessary. Side effects seen in the endocrine system during cancer treatment may vary depending on the treatment methods and the individual characteristics of the patient. Details of these side effects and treatment methods are explained in detail below.

SIDE EFFECTS ON THE ENDOCRINE SYSTEM

Pituitary Gland Disorders: Deficiency of growth hormone or other pituitary hormones may occur. Symptoms such as fatigue, muscle weakness, loss of libido, and infertility may be observed.

Thyroid Function Disorders: Hypothyroidism or hyperthyroidism may occur. Symptoms such as fatigue, weight changes, intolerance to cold or heat, and changes in heart rate may occur.

Adrenal Gland Affect: A decrease or increase in the production of cortisol and other adrenal hormones may be detected. Fatigue, dizziness and changes in blood pressure may occur.

Calcium Metabolism Disorders: A decrease in bone density and an increased risk of osteoporosis may occur. Bone pain and an increased risk of fracture may occur.

Side Effects Seen in the Reproductive System: In men, a decrease in testosterone production and impairment in sperm production may occur. Sexual dysfunctions, loss of libido, infertility and decrease in muscle mass may be detected. In women, a decrease in estrogen and progesterone production and disruptions in the menstrual cycle may occur. Menopausal symptoms, vaginal dryness, hot flashes, and infertility may occur.

Image 2: During cancer treatment, young patients may experience menopause-related symptoms due to menstrual cessation.

TREATMENTS AND MANAGEMENT STRATEGIES

Drug Dosage: The dose of the drug causing side effects can be reduced and the drug can be discontinued.

Hormone Replacement Therapy: Hormone replacement therapy can be used to replace missing hormones.

Medical Treatment: Medication may be prescribed for thyroid and adrenal dysfunction. Medications such as bisphosphonates may be used to maintain bone density.

Lifestyle Changes:Healthy nutrition, regular exercise and weight management should be done. It is necessary to avoid smoking and alcohol consumption.

Reproductive Health Consultancy:Counseling should be sought on reproductive health and fertility options. Fertility preserving treatments and techniques can be applied.

Psychological support:Emotional and psychological support should be provided. Stress management and relaxation techniques can be applied

Regular Medical Follow-up: Hormone levels and reproductive health may need to be monitored regularly.

Affecting the endocrine system during cancer treatment may be a necessary condition resulting from the nature of the treatment. However, various treatment and support methods are available to manage and alleviate these side effects. A multidisciplinary approach and individual treatment plans are required for patients to cope with these side effects.

Image 3: Hormonal changes that occur in the body due to cancer or during cancer treatment can be detected by blood tests.

HORMONAL SIDE EFFECTS RELATED TO IMMUNOTHERAPY

Immunotherapy is an innovative treatment method used especially in cancer treatment. Various side effects may occur in the endocrine system associated with immunotherapy. These side effects and treatment methods are explained in detail below:

Endocrine System Side Effects

Pituitary gland: It is inflammation of the pituitary gland. Symptoms such as headache, vision changes, fatigue and hormone deficiencies may occur.

Thyroiditis:Inflammation of the thyroid gland may result in hypothyroidism or hyperthyroidism. Symptoms: Complaints such as fatigue, weight change, hair loss and changes in heart rate may occur.

Adrenalitis: Inflammation of the adrenal glands often leads to cortisol deficiency. Fatigue, muscle weakness, low blood pressure and hypoglycemia may be detected.

Diabetes: Immunotherapy may trigger diabetes by affecting insulin production or effectiveness. Complaints such as frequent urination, extreme thirst, rapid weight loss and fatigue may be observed.

TREATMENTS

Drug Dosages: Doses of drugs used in cancer treatment may be adjusted or the drug may be discontinued.

Hormone Replacement Therapy: Missing hormones (thyroid hormone, cortisol, sex hormones) may need to be replaced.

Steroid Treatment: Corticosteroid use may be required in the treatment of hypophysitis and adrenalitis.

Medication: Thyroid hormone replacement may be required for hypothyroidism. Insulin or other diabetes medications may be needed to manage diabetes.

Regular Monitoring: Regular monitoring of hormone levels, blood sugar and thyroid functions is necessary.

Lifestyle Changes: Diet and exercise changes are necessary for diabetes management. Smoking and alcohol consumption should be avoided.

Education and Awareness Raising: Patients and their caregivers need to be educated about endocrine side effects associated with immunotherapy.

Multidisciplinary Approach: Endocrinologist, oncologist and other healthcare personnel should provide holistic patient care in collaboration.

Endocrine system side effects associated with immunotherapy can sometimes complicate treatment and require special attention in patient management. Therefore, it is important to monitor patients receiving immunotherapy regularly for endocrine function and to intervene early when necessary.