About the Endocrine Late Effects after Cancer Therapy (ELECT) Program

Cancer treatments in children, including chemotherapy, radiation, and immunotherapy, can cause endocrine problems in over half of patients. These problems include growth disorders, difficulties with puberty, thyroid issues, development of diabetes mellitus, and poor bone health. Endocrine disorders due to cancer therapy can occur any time, from immediately to many years later. As cancer survival rates have improved, treatment-related endocrine disorders have become even more common.

The Endocrine Late Effects after Cancer Therapy (ELECT) Program at Children's Hospital of Philadelphia (CHOP) is a team with expertise in identifying and treating endocrine disorders due to cancer therapy. Children who develop endocrine complications following cancer treatment are not the same as children with other endocrine problems, and so CHOP has an endocrine team with expertise in this unique patient population.

Many factors influence endocrine late effects, including whether the child was treated with radiation, and their age at the time of diagnosis. Some endocrine late effects are more prevalent in males and some in females. Endocrine complications can occur at different times related to diagnosis and treatment. Some patients, such as those treated for brain tumors, might experience problems with growth or early puberty at the time of cancer diagnosis, or shortly following treatment. In other patients, hormonal problems may not manifest for several years after treatment. Some treatments, such as a bone marrow transplant, include total body irradiation and high-dose alkylating chemotherapy, leading to gonadal failure (deficiencies of estrogen in girls and testosterone in boys), poor bone health, and future risk for diabetes mellitus. The ELECT Program has the breadth and depth of expertise to anticipate, evaluate and manage every patient’s unique journey.

Subsequent Malignancies

Some cancer treatments can also increase risk for subsequent malignancies in endocrine organs, notably in the thyroid gland. CHOP houses one of the premier childhood cancer programs in the world to address thyroid cancer or other secondary cancers. The ELECT program partners with the CHOP Thyroid Center, the largest program in North America, to ensure state of the art thyroid surveillance and treatment of thyroid cancer in survivors at risk due to prior treatment history such as radiation exposure to the thyroid gland.