Growth Hormone Deficiency

Some survivors of childhood cancer may develop growth problems as a result of their cancer treatments.

Growth problems can happen because certain glands in the endocrine system do not produce enough hormones.

Learn More About the Endocrine System

Causes of growth hormone deficiency

• Radiation to the:
  • Head/brain
  • Total body irradiation (TBI)
• Surgery to the brain, particularly the central (suprasellar) region, where the pituitary gland is located
• Tumor growth in the brain that directly damages the pituitary gland

Signs and symptoms of growth hormone deficiency

In children, the most obvious sign of deficiency is the slowing of growth or height.

Other signs include:

• Growing more slowly than normal for age, usually fewer than 2 inches a year.
• Being smaller and younger-looking than children of the same age but with normal body proportions

Adults with growth and hormone deficiency may experience:

• Thinning of the bones
• Decreased muscle strength
• Increased body fat
• High blood cholesterol levels
• Feeling tired, anxious, irritable, gloomy, unmotivated
• Decreased interest in sex

What survivors can do

Know your risk and monitor your health

Ask your oncologist about your risks of developing late effects.

Inform your primary health care provider about your risks. Share a copy of your Survivorship Care Plan, which includes a treatment summary. The summary includes details about you cancer treatment and information about health problems that may occur because of treatment.

Have a yearly physical examination. The exam should include checking:

• Height, weight, and growth
• Stage of puberty
• Nutritional status
• Stamina and overall well-being

Patients at risk for growth hormone deficiency should have this screening every six months until growth is completed.

If patients have signs and symptoms of poor growth, the health care provider may:

• Order an X-ray on the wrist to assess the maturity of the skeleton "bone age."
• Check for possible causes of growth problems, such as low thyroid function or issues with puberty.
• Refer the survivor to an endocrinologist.

Treatment

Treatment usually involves taking a synthetic growth hormone over several years. It is given by injection. The endocrinologist can provide information about how much growth is possible.