Of all possible hormonal consequences, the so-called hypothalamic syndrome is the most serious. Hypothalamic damage can result from a tumor in (near) this hormone center in the brain, such as craniopharygioma or low-grade glioma. Consequences of hormone deficiency can include children becoming very fat, chronically tired, reaching puberty too early or not at all, or staying very small. This has major consequences for their quality of life.
Prof. Hanneke van Santen is a pediatric endocrinologist at the Princess Máxima Center and the Wilhelmina Children's Hospital, where she is active within the Child Health and Cancer spearheads. She has set up a multidisciplinary team with to guide children with hypothalamic syndrome. In this team, the pediatric endocrinologist, psychologist, pediatric psychiatrist, dietician, physical therapist, neurologist, rehabilitation physician and oncologist work closely together. In addition to hypothalamic damage, Prof. Van Santen also focuses on thyroid carcinoma in childhood. These children are treated in collaboration with the UMC Utrecht endocrine tumors team.
Mirror
Van Santen: ‘Hormones are not only necessary for daily life, but they are like a mirror; they show how you are doing physically. If we deal with them more consciously, we can signal earlier if something is wrong. Hormones sometimes indicate early on that a child is dealing with, for example, an infection or sepsis, such as through an increase in cortisol or glucose or a decrease in thyroid hormone levels.’
Together with her group, Van Santen is developing new tools to better monitor hormonal imbalance during and after cancer treatment, as well as new therapies to prevent hypothalamic damage. For children with thyroid cancer, she looks at how to prevent unpleasant side-effects. And finally, she focuses on the more general care for children with cancer.
Collaboration
Fortunately, hypothalamic syndrome and thyroid cancer are rare. To advance the field, she is therefore looking for international collaboration. ‘Together we can better investigate which approach can help these patients,’ says Van Santen. ‘A lot is happening internationally, but also right here at the Utrecht Science Park. Within the UMC Utrecht, the WKZ and the Princess Máxima Center, we are sharing more and more knowledge and experience with regard to this special group of children and their parents. I cross the bridge from one organization to another several times a day. I hope that this chair will lead to many more collaborations and acceleration in this area.’