Late endocrine-metabolic complications in survivors of young adult and adult-onset cancers: comprehensive evaluation and strategies for management. An Italian Association of Medical Oncology (AIOM), Italian Association of Medical Diabetologists (AMD), Italian Society of Diabetology (SID), Italian Society of Endocrinology (SIE), Italian Society of Pharmacology (SIF) multidisciplinary critical review

Background: Cancer survivors have been considered individuals who have completed anti-tumor treatment and are in “remission”. However, the definition is increasingly seen as insufficient due to a significant number of patients living with chronic or stable disease, as a result of advanced therapies, and according to a recent definition, “survivors” are all people living with and beyond cancer. Breast, prostate, lung and colorectal cancers are the most frequent tumors diagnosed in Europe with an increasing population of survivors. The longer life expectancy has made it necessary to assess the health status, comorbidities, and complications in cancer patients, mainly in the age range of 20–50 years. In particular, the long-lasting hormonal therapies in hormone-sensitive tumors and the immunotherapies, that are changing the cancer clinical scenario, have opened a broad landscape of late endocrine/metabolic toxicities. Purpose: The aim of the present manuscript is to evaluate the late endocrine-metabolic complications in survivors of young adult or adult-onset cancers in the most prevalent tumors, analyzing risk factors for endocrine/metabolic disease, attempting to provide a indications for long-term surveillance and treatment strategies. Conclusions: This paper highlights the importance of recognizing endocrine and metabolic complications, as well as identifying key risk factors that can suggest a more effective surveillance and management.