Metabolic syndrome
This page is part of the PanCare PLAIN summaries about late effects and recommendations for long-term follow-up care for survivors of childhood, adolescent, and young adult cancer. Click here, for more information on the PLAIN summaries.
PLAIN version 4: 01/04/2026
This PLAIN summary is based on the PanCareFollowUp guideline about “Metbolic syndrome” [1], which is which is itself based on the corresponding IGHG* guideline [2].
Metabolic syndrome
Metabolic syndrome isn’t a single disease. It’s a group of health problems that happen together and increase your risk of developing more serious diseases later in life such as strokes, heart problems and diabetes. For more information on these health problems please read: Stroke, Heart problems and Impaired glucose metabolism and diabetes.
To be diagnosed with metabolic syndrome at least three of the following health problems need to be present:
- Overweight or obesity, where your BMI is 25 or higher. For more information on being overweight or obese, please read: Overweight and obesity.
- Elevated triglyceride levels, where your blood triglyceride levels are too high. For more information on abnormal lipid levels, please read: Dyslipidemia.
- Reduced HDL cholesterol levels, where your blood HDL cholesterol levels are too low. For more information on abnormal lipid levels, please read: Dyslipidemia.
- Hypertension, where your blood pressure is too high. For more information on high blood pressure, please read: Hypertension.
- Hyperglycemia, where your blood glucose levels are too high. For more information on impaired glucose metabolism and diabetes, please read: Impaired glucose metabolism and diabetes.
Most survivors do not develop metabolic syndrome. There are a number of things anyone can do to lower your risk of developing metabolic syndrome, such as exercising regularly and adopting or maintaining a healthy diet and weight.
mmHg
With every beat of your heart, blood is pushed through the blood vessels. The blood pressure measures the pressure of the blood against the walls of blood vessels.
There are two types of blood pressures: systolic and diastolic blood pressure. Systolic blood pressure refers to the pressure in the moment your heart beats. Diastolic blood pressure refers to the pressure between your heart beats.
Both systolic and diastolic blood pressure are important to consider. That is why when talking about blood pressure, you will usually find two numbers with the first one referring to the systolic pressure and the second one referring to the diastolic blood pressure.
- The Ideal blood pressure: between 90/60mmHg and 120/80mmHg
- High blood pressure: higher than 140/90 mmHg
- Low blood pressure: below 90/60mmHg
Healthy lifestyle
- Having a healthy diet
- Drinking less (or no) alcohol
- Exercising regularly
- Quitting smoking (if you smoke)
Your follow-up care specialist or general practitioner may give you additional advice tailored to your individual situation for maintaining a healthy lifestyle. For more information on taking up a healthier lifestyle, please read: Health promotion.
Am I at higher risk of metabolic syndrome?
Anyone, including people who have never had cancer treatment, may develop metabolic syndrome. However, there are some treatments that may increase the risk of having metabolic syndrome.
The following treatments can increase the risk of metabolic syndrome:
- Radiotherapy to the brain or an area including the brain
- Radiotherapy to the entire body, also known as total body irradiation (TBI)
You can find out if you had any of these treatments by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.
If you experience metabolic syndrome, it does not always mean that it is caused by your cancer treatment. Metabolic syndrome may have other causes, such as an unhealthy diet, being overweight or little exercise.
Radiotherapy
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, do contact your treating hospital.
Radiotherapy is a treatment for cancer which uses high-energy radiation to destroy cancer cells and to shrink tumours. The radiation comes from a machine outside the body (external beam radiotherapy) or occasionally from radioactive material that is placed in the body near cancer cells (intracavitary or interstitial radiotherapy). The aim of radiotherapy is to treat only one area of the body, around and near the cancer or where the cancer was before it was removed by surgery and as far as possible to protect unaffected areas. For example, if you have cancer in your lung, you will have radiation only to your chest, not to your whole body.
External beam radiotherapy is painless and takes only a few minutes. It is given once or occasionally twice a day often for several weeks. A radiation beam is like an invisible light beam. The machines which produce the radiation beam can be moved so that the beam enters the body from different directions, ‘spotlighting’ on the area to be treated. This means that the tumour is given a high dose whilst normal areas get either a lower or no dose at all.
Since the early 1980’s computers and other technical advances have improved radiotherapy. Before this there were not many ways to protect normal tissues which were in the path of a radiation beam. Even now, whilst modern techniques allow doctors to target the cancer cells more precisely than older techniques, healthy cells may still get damaged. This can result in some of the late effects covered in the PLAIN summaries. It will help you and your follow up specialist to know what long term effects there might be after your radiotherapy if you and they have your treatment summary.
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, please contact your treating hospital.
What are the symptoms and signs of metabolic syndrome?
There are symptoms and signs that can tell you if you might have metabolic syndrome. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.
For more information on symptoms and signs of the individual conditions that make up metabolic syndrome, please read the symptoms and signs section in the following PLAIN language summaries: Overweight and obesity, Dyslipidemia, Hypertension and Impaired glucose metabolism and diabetes.
If you recognise any of these symptoms or signs in yourself, please contact a general practitioner or follow-up care specialist.
Symptoms and signs
I am at higher risk of metabolic syndrome. What tests should I have and when?
If you are at higher risk of metabolic syndrome, it is advised to:
- Have your height, weight, BMI and blood pressure measured. You can do it as well at home. If you see your general practitioner or follow-up care specialist more often, it is best to measure your height, weight and BMI at each visit.
- Have a blood test to measure your glucose and lipid levels in the blood. This blood test is usually done in the morning, before you eat breakfast.
How often you should do this depends on the type of radiotherapy you received:
- Radiotherapy to the entire body, also known as TBI: At least every 2 years starting at entry into long-term follow-up (LTFU).
- Radiotherapy to the brain or spinal cord or an area including the brain or spinal cord:
- Have your height, weight, BMI and blood pressure measure at least every 2 years starting at entry into long term follow-up.
- Have a blood test to measure your glucose and lipid levels in the blood at least every 5 years starting no later than the age of 40 years.
Long-term follow-up (LTFU)
In LTFU, you will be monitored and tested for potential late effects according to your Survivorship Care Plan If you don’t have one, contact your LTFU specialist or GP. For more information about the survivorship care plan click here.
What happens if I have metabolic syndrome?
If you have metabolic syndrome, your general practitioner or follow-up care specialist will probably refer you to a specialist. Depending on the symptoms and/or signs you experience, you may be referred to an:
- Cardiologist (physician specialised in cardiovascular diseases)
- Endocrinologist (physician specialised in hormones and metabolism)
- Dietician or nutritionist (specialists who advise on eating habits and lifestyle)
The specialist may discuss different treatment options with you.
If you have metabolic syndrome, your physician may also test for other health problems related to metabolic syndrome, such as being overweight or obese, having high blood pressure, having high blood glucose (sugar) levels or having abnormal blood lipid levels. For more information on these health problems please read: Overweight and obesity, Hypertension, Impaired glucose metabolism and diabetes and Dyslipidaemia.
Hormone
What else can I do?
Knowing that you may be at increased risk of metabolic syndrome can be difficult. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.
To lower your risk of metabolic syndrome, adopting or maintaining a healthy lifestyle is extremely important. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.
It is important that you are aware of the possibility of developing metabolic syndrome and that you know the symptoms and signs. If you have any further questions or if the information in this brochure concerns you, please contact your general practitioner or follow-up care specialist.
Where can I find more information?
You may find more information about metabolic syndrome online. However, it is important to be aware that this information is not always up to date or accurate.
On this website, you can also find more information related to this topic:
Please note
This PLAIN summary is based on the PanCareFollowUp guideline about “Metbolic syndrome” [1], which is which is itself based on the corresponding IGHG* guideline [2].
While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.
Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.
No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.
The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.
*International Guideline Harmonization Group for Late Effects of Childhood Cancer
[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext.
[2] van den Oever, SR et al. (2025) Metabolic syndrome in childhood, adolescent, and young adult cancer survivors: recommendations for surveillance from the International Late Effects of Childhood Cancer Guideline Harmonization Group. European journal of endocrinology. Available at: https://academic.oup.com/ejendo/article-abstract/192/4/S27/8086479?redirectedFrom=fulltext&login=false#google_vignette
PanCareFollowUp has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 824982. The material presented and views expressed here are the responsibility of the author(s) only. The EU Commission takes no responsibility for any use made of the information set out.
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