Endocrinologic Toxicities of Cancer Therapy: Evolving Challenges and Multidisciplinary Approaches
摘要
Modern cancer therapies, particularly immune checkpoint inhibitors (ICIs), have led to a rise in endocrine toxicities such as hypothyroidism, adrenal insufficiency, insulin-dependent diabetes, and hypophysitis. These conditions often present with nonspecific symptoms such as fatigue, which can make timely diagnosis challenging, especially in patients with advanced malignancies. Early recognition is essential, as most endocrinopathies are treatable with hormone replacement and rarely require discontinuation of cancer therapy. This review highlights emerging trends in endocrine toxicities associated with cancer treatment, discusses the challenge of distinguishing symptoms from these toxicities from cancer progression, and examines the shared roles of oncology, endocrinology, and palliative care in patient management from symptom to diagnosis. We propose a multidisciplinary approach to support care across the treatment continuum, with an emphasis on shared decision-making. Continued research is needed to establish standardized clinical guidelines, integrate digital health innovations, and improve long-term outcomes.