Hypopituitarism after Childhood Cancer


Some people who were treated for cancer during childhood may develop hormone problems as a result of changes to a complex system of glands known as the endocrine system. These glands include the pituitary, which makes a number of hormones that are needed for your body to function well. Not enough of these hormones can cause various health problems. 

What Is Hypopituitarism?

Hypopitiutarism occurs when the pituitary gland doesn’t make enough of one or more hormones. When three or more hormones are not produced in sufficient amounts, it is called panhypopituitarism. 

Am I at Risk?

Factors related to childhood cancer treatment that raise risk for hypopituitarism include radiation to the brain and removal of the pituitary gland. Other risk factors include infection, severe head trauma, or lack of development of the pituitary gland from birth. 

What Are the Symptoms of Hypopituitarism?

The symptoms of hypopituitarism depend on which hormones are not being produced adequately. One or more of these hormones may be affected: 

  • Growth hormone – This hormone stimulates the growth of bone and other body tissues. It also effects how the body uses fat, makes muscle, and strengthens bones. It effects overall health throughout life, too. For more information about growth hormone problems, see the related Health Link: “Growth Hormone Deficiency after Childhood Cancer.” 
  • Adrenocorticotropic hormone (ACTH) – This hormone stimulates the adrenal gland to produce cortisol. If the pituitary gland doesn’t make enough ACTH, then cortisol will not be made. Cortisol helps keep the body’s blood sugar at normal levels and helps the body deal with physical stress, such as fever and injury. For more information about ACTH deficiency, see the related Health Link: “Central Renal Insufficiency after Childhood Cancer.” 
  • Thyroid stimulating hormone – This hormone stimulates the thyroid gland to produce thyroxin, which is important for brain development, growth, and metabolism. Too little thyroxin can cause many symptoms including tiredness, weight gain, and dry skin. For more information about thyroid problems, see the related Health Link: “Thyroid Problems after Childhood Cancer.” 
  • Reproductive hormones – These stimulate the testes and ovaries to make sex hormones. Not enough of these hormones can cause problems with pubertal development. For more information about hormone problems see the related Health Links: “Male Health Issues after Childhood Cancer Treatment” and “Female Health Issues after Childhood Cancer Treatment.” 
  • Antidiuretic hormone – This hormone helps manage the balance of water in the body by controlling urine output. If the level of this hormone is not normal, you might have a buildup of fluids in the body, excessive amounts of urine, too much salt in your blood, or severe thirst. 
  • Prolactin – This hormone controls milk production in women who are breastfeeding. Too much prolactin can cause problems with the functioning of the ovaries or testicles and cause breast milk production in non-pregnant women and men. For more information about prolactin problems, see the related Health Link: “Hyperprolactinemia after Childhood Cancer.” 

Should I Be Checked for Hypopituitarism?

All childhood cancer survivors should have a long-term follow-up visit every year that includes measurement of your height and weight and assessment of your pubertal status, nutritional status, and overall well-being. 

If you think you have hypopituitarism, ask your doctor to check for it, too. If a problem is found, your doctor may refer you to a doctor who specializes in hormone problems (an endocrinologist).  

What If I Have Hypopituitarism?

Treatment will depend on which hormones are not being made in sufficient amount. Your endocrinologist can work with you to find treatments that are right for you. 

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