Hormone therapy in young cancer survivors

초록

As the overall survival rates of cancer treatment have increased, the short-and long-term sequelae faced by the growing number of young survivors have become more of a concern. Among these sequelae, hypogonadism is of particular importance and demands specialized medical care. However, a scarcity of evidence leaves no ideal solution. Hypogonadism caused by cancer therapy leads to impairment of pubertal development, hormonal regulation, fertility and sexual function in childhood and adolescent cancer survivors, and produces menopausal symptoms such as vasomotor and urogenital symptoms, and osteoporosis in young adult survivors. In the majority of cases except hormone receptor-positive cancers, hormone therapy is the most effective option for hypogonadism-induced problems and should be age-specific. For the prepubertal survivors, timing of hormone-therapy is crucial to ensure acceptable growth. For the postmenarchal who cease menstruating during or after cancer therapy, monitoring of menstrual resumption for one year is an acceptable management strategy. Those who remain amenorrheic, have symptoms of gonadal failure, or have elevated gonadotropin levels should be offered individualized hormone-therapy options. For the young adult survivors, sparing ovarian reserve and fertility as well as reduction of menopausal symptoms should be the main objectives of hormone therapy. In this review, we focused on effective hormone therapy according to these age groups. © 2015 by Nova Science Publishers, Inc. All rights reserved.