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The complex system of glands known as the endocrine system
regulates body functions including growth and puberty. Some treatments for
childhood cancer can damage these glands and cause a variety of problems,
including starting puberty earlier than usually expected (precocious puberty).
Precocious puberty occurs when children have signs of
puberty at a younger age than usually expected. Most doctors agree that
children have the condition if they develop sexual traits (such as pubic hair
or breast growth) before age 8 years in girls and before age 9 years in boys. Usually,
puberty begins between ages 8 and 13 years for girls and 9 and 14 years for
In addition to having early signs of puberty, children with
precocious puberty often have a growth spurt with rapid bone growth. But bones
that mature early have less time to grow, which results in a final adult height
that is actually much shorter than normal.
Radiation to the head or brain (including eyes, ears, nose, or
mouth areas) can damage the hypothalamus and pituitary glands. The damage
causes them to signal the ovaries (in girls) or testicles (in boys) to make
hormones earlier than normal, prompting signs of puberty. In other cases, signs
of puberty occur because of changes in the ovaries, testicles, or adrenal
Other factors that increase risk include female sex, younger
age at cancer treatment, and being overweight.
Your child’s doctor can order tests that will tell if the
cause of precocious puberty is in the brain or another part of the body.
All childhood cancer survivors should have a long-term
follow-up exam at least once a year. This exam should include measurement of
height and weight and assessment of pubertal progress. If signs of fast growth
or early puberty are present, your child’s doctor may order a blood test to
check his or her hormone levels. Some children might also need an x-ray that
measures bone age.
If any hormone problems are found your child will be
referred to a doctor who specializes in hormones (endocrinologist). Medicine is
sometimes used to stop puberty for a while and to decrease how fast bones mature.
It’s also important to talk with your child’s primary doctor
about how you can help manage the emotional effects of beginning puberty too
early. Although children with precocious puberty may look mature, their
thoughts, emotions, and behaviors are still that of their actual age. Your
child’s doctor can recommend a mental health specialist if needed, too.
Read more about Early Puberty...