Fertility
Pituitary/Hypothalmic function
Puberty may be absent, delayed or early (precocious) as a result of:
- CNS tumors located in the hypothalamic-pituitary (H-P) region
- Surgical resection in this location
- Cranial RT (radiation therapy) to the anterior pituitary can result in:
- Gonadotrophin (LH, FSH) deficiency causing delayed puberty
- Premature release of GnRH and premature puberty
Low dose cranial RT (<24 Gy)
- Less likely to cause precocious puberty in boys than girls
High dose cranial RT (>24 Gy)
- At risk for Hypogonadotropic hypogonadism – risk increases with dose
As a result of these alterations of pubertal timing, both male and female survivors of childhood cancer may be at risk of:
- Adult short-stature
- Decreased bone-mineral density
- Absent or incomplete sexual development
- Reduced fertility
