I may become involved in a child’s care during active cancer treatment — for example, if a medication they are taking affects thyroid function or raises blood sugar, or if their tumor causes early puberty. I may also be involved early in the course of care for children with conditions such as thyroid cancer or Fanconi anemia, or as part of the consultation team for children being considered for surgery or bone marrow transplantation. As a member of the MSK Kids Pediatric Long-Term Follow-Up Program, I see patients one to two years after completing treatment.
I also conduct research. I am evaluating the association between cancer treatment and low testosterone levels (“testicular hypofunction”) in male childhood cancer survivors. My colleagues and I are also studying the association between the dose of radioactive iodine therapy (iodine 131) and long-term outcomes in children who receive this treatment for papillary thyroid cancer.
In addition to my position on the MSK Kids team, I am the Division Chief of Pediatric Endocrinology at Weill Cornell Medicine. I am also the Silo Chair of the Testicular Late Effects Group of the Children’s Oncology Endocrine Late Effects Group.
When I first meet a patient and family, I introduce myself and explain what our team does. We spend about an hour reviewing the child’s treatment history, diagnosis, and any other issues specific to that child’s care. Sometimes we need to discuss sensitive subjects such as puberty, fertility, and height. While I encourage all parents to involve their children in these discussions in an age-appropriate way, I also understand and support requests from parents to have a separate discussion without the child in the room.
I chose the field of endocrinology because it encompasses a large number of conditions that are very relevant to a child’s wellbeing, both in childhood and adulthood. Hormone deficiencies can be safely and effectively treated, with rewarding outcomes. I enjoy working with survivors through the Pediatric Long-Term Follow-Up Program to help them focus on succeeding and thriving in their lives by overcoming the challenges imposed by late effects from their treatment. I also find it rewarding to collaborate with multiple subspecialists and help our patients transition from the completion of therapy to the rest of their lives.
Nearly half of the survivors of childhood cancers will experience at least one hormonal late effect related to their treatment. It is important that these children receive evaluation and care for these conditions in a timely way to maximize their health and wellbeing. Children with rare endocrine conditions benefit from an endocrinologist who is experienced in the treatment of those disorders and is able to communicate and effectively work with other subspecialists to provide the best care. At MSK Kids and Weill Cornell Medicine, we excel in accomplishing this through our collaborative team efforts.
