Skip to main content
SpringerLink
Log in

Nachsorge im Erwachsenenalter

Entwicklung neuer interdisziplinärer Strategien

Long-term follow-up in adulthood

Development of new interdisciplinary treatment strategies

  • Leitthema
  • Published:
Monatsschrift Kinderheilkunde Aims and scope Submit manuscript

Zusammenfassung

Krebserkrankungen und ihre Therapie können viele Jahre nach Therapieende zu chronischen oder spät auftretenden Problemen führen. Die bisher bekannten wichtigsten Spätfolgen im Erwachsenenalter sind durch Radio- und Chemotherapie mit Alkylanzien bedingte Zweittumoren, endokrinologische Spätfolgen sowie kardiovaskuläre Probleme, die durch eine häufig auftretende Adipositas und konsekutives metabolisches Syndrom verstärkt werden. Das Wissen um die Spätfolgen im Erwachsenenalter geht mit neuen Aufgaben einher, die nur in Zusammenarbeit von pädiatrischen Onkologen und Erwachsenenspezialisten verschiedener Disziplinen angegangen werden können. Dafür benötigen wir wissenschaftlich erhobene Daten als Grundlagen, andererseits müssen wir neue Betreuungsmodelle entwickeln, die prinzipiell die gleichen Aufgaben haben, aber in ihrer Detailstruktur sehr ortsabhängig sind. Als wesentliche Grundlage für eine gute Versorgung im Erwachsenenalter hat sich eine gute Information der Patienten selbst und der sie betreuenden Hausärzte erwiesen.

Abstract

Cancer and its treatment can lead to chronic or late occurring problems many years after therapy. The most important known late effects include second primary malignancies, caused by radiotherapy or alkylating agents, cardiomyopathy, endocrine late effects, and cardiovascular problems which are often exacerbated by obesity and subsequent metabolic syndrome. Knowledge about late effects in adulthood brings new problems, which can only be addressed in cooperation between pediatric oncologists and adult specialists in various disciplines. While scientifically gathered information is required to form a basis, we also need to develop new treatment models, which in principal have the same goals, but which are wholly location-specific. Ensuring that both patients and their treating physicians are well informed has been proven to form a strong basis for good treatment in adulthood.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Blaawbroek R, Tuinier W, Meyboom-de Jong B et al (2008) Shared care by pediatric oncologists and family doctors for long-term follow-up of adult childhood cancer survivors: a pilot study. Lancet Oncol 9(3):232–238

    Article  Google Scholar 

  2. Blacklay A, Eiser C, Ellis A (1998) Development and evaluation of an information booklet for adult survivors of childhood cancer. Arch Dis Child 78:340–344

    Article  PubMed  CAS  Google Scholar 

  3. Blatt J (1999) Pregnancy outcome in long-term survivors of childhood cancer. Med Pediatr Oncol [Suppl] 33:29–33

    Google Scholar 

  4. Bowers DC, McNeil DE, Liu Y et al (2005) Stroke as a late treatment effect of Hodgkin’s disease: a report from the Childhood Cancer Survivor Study. J Clin Oncol 23(27):6508–6515

    Article  PubMed  Google Scholar 

  5. Bowers DC, Liu Y, Leisenring W et al (2006) Late-occurring stroke among long-term survivors of childhood leukemia and brain tumors: a report from the Childhood Cancer Survivor Study. J Clin Oncol 24(33):5277–5282

    Article  PubMed  Google Scholar 

  6. Byrne J (1999) Infertility and premature menopause in childhood cancer survivors. Med Pediatr Oncol [Suppl] 33:24–28

    Google Scholar 

  7. Calaminus G, Kaatsch P (2007) Positionspapier der Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH) zu (Langzeit-)Nachbeobachtung, (Langzeit-)Nachsorge und Spätfolgenerhebung bei pädiatrisch-onkologischen Patienten. Klin Padiatr 219(3):173–178

    Article  PubMed  CAS  Google Scholar 

  8. Clerici CA, Fossati-Bellani F, Lepera P et al (2008) Psychological assessment of women on an early breast screening program after radiotherapy of the chest wall for childhood cancer. Tumori 94(4):568–573

    PubMed  Google Scholar 

  9. Darzy KH, Shalet SM (2003) Radiation-induced growth hormone deficiency. Horm Res 59:1–11

    Article  PubMed  CAS  Google Scholar 

  10. Diller L, Nancarrow CM, Shaffer K et al (2002) Breast cancer screening in women previously treated for Hodgkin’s disease: a prospective cohort study. J Clin Oncol 20:2085–2091

    Article  PubMed  Google Scholar 

  11. Friedman DL, Freyer DR, Gill AL (2006) Models of care for survivors of childhood cancer. Pediatr Blood Cancer 46:159–168

    Article  PubMed  Google Scholar 

  12. Frobisher C, Winter DL, Lancashire ER et al (2008) Extent of smoking and age at initiation of smoking among adult survivors of childhood cancer in Britain. J Natl Cancer Inst 100(15):1068–1081

    Article  PubMed  Google Scholar 

  13. Ganz PA (2001) The role of hormones in breast carcinogenesis: issues of relevance to female childhood cancer survivors. Med Pediatr Oncol [Suppl] 36:514–518

    Google Scholar 

  14. Garmey EG, Liu Q, Sklar CA et al (2008) Longitudinal changes in obesity and body mass index among adult survivors of childhod acute lymphoblastic leukemia: a report from the childhood cancer survivor study. J Clin Oncol 26(28):4639–4645

    Article  PubMed  Google Scholar 

  15. Green DM, Fiorello A, Zevon MA et al (1997) Birth defect and childhood cancer in offspring of survivors of childhood cancer. Arch Pediatr Adolesc Med 151:379–383

    PubMed  CAS  Google Scholar 

  16. Gustavson A, Eskilsson J, Landberg T et al (1990) Late cardiac effects after mantle radiotherapy in patients with Hodgkin’s disease. Ann Oncol 1:355–363

    Google Scholar 

  17. Haddy TB, Mosher RB, Reaman GH (2001) Osteoporosis in survivors of acute lymphoblastic leukemia. Oncologist 6:278–285

    Article  PubMed  CAS  Google Scholar 

  18. Hancock SL, Tucker MA, Hoppe RT (1993) Factors affecting late mortality from heart disease after treatment of Hodgkin’s disease. JAMA 270:1949–1955

    Article  PubMed  CAS  Google Scholar 

  19. Haupt R, Byrne J, Connelly RR et al (1992) Smoking habits in survivors of childhood and adolescent cancer. Med Pediatr Oncol [Suppl] 20:301–306

    Google Scholar 

  20. Hudson MM, Hester A, Sweeney et al (2004) A model of care for childhood cancer survivors that facilitates research. J Pediatr Oncol Nurs 21(3):170–174

    Article  PubMed  Google Scholar 

  21. Kash KM, Dabney MK (2001) Psychological aspects of cancer screening in high-risk populations. Med Pediatr Oncol [Suppl] 36:519–524

    Google Scholar 

  22. Kaste SC, Hudson MM, Jones DJ et al (1998) Breast masses in women treated for childhood cancer: incidence and screening guidelines. Cancer 82:784–792

    Article  PubMed  CAS  Google Scholar 

  23. Kaste SC, Jones-Wallace D, Rose SR et al (2001) Bone mineral decrements in survivors of childhood acute lymphoblastic leukemia: frequency of occurrence and risk factors for their development. Leukemia 15:728–734

    Article  PubMed  CAS  Google Scholar 

  24. Kazak AE, Simms S, Barakat L et al (1999) Surviving Cancer Competently Intervention Program (SCCIP): a cognitive-behavioral and family therapy intervention for adolescent survivors of childhood cancer and their families. Fam Process 38:175–191

    Article  PubMed  CAS  Google Scholar 

  25. Konsler GK, Jones GR (1993) Transition issues for survivors of childhood cancer and their healthcare providers. Cancer Pract 1:319–324

    PubMed  CAS  Google Scholar 

  26. Meeske KA, Ruccione K, Globe DR, Stuber ML (2001) Posttraumatic stress, quality of life, and psychological distress in young adult survivors of childhood cancer. Oncol Nurs Forum 28:481–489

    PubMed  CAS  Google Scholar 

  27. Müller HL, Bueb K, Bartels U et al (2001) Obesity after childhood craniopharyngeoma – German multicenter study on pre-operative risk factors and quality of life. Klin Pädiatr 213:244–249

    Article  PubMed  Google Scholar 

  28. Nagarajan R, Neglia JP, Clohisy DR, Robison LL (2002) Limb salvage and amputation in survivors of pediatric lower-extremity bone tumors: What are the long-term implications? J Clin Oncol 20:4493–4501

    Article  PubMed  Google Scholar 

  29. Oeffinger KC, Buchanan GR, Eshelman DA et al (2001) Cardiovascular risk factors in young adult survivors of childhood acute lymphoblastic leukemia. J Pediatr Hematol Oncol 23(7):424–430

    Article  PubMed  CAS  Google Scholar 

  30. Oeffinger KC, Mertens AC, Sklar CA et al ( 2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355:1572–1582

    Article  PubMed  CAS  Google Scholar 

  31. Robien K, Ness KK, Klesges LM et al (2008) Poor adherence to dietary guidelines among adult survivors of childhood acute lymphoblastic leukemia. J Pediatr Hematol Oncol 30(11):815–822

    Article  PubMed  Google Scholar 

  32. Wallace WHB, Blacklay A, Eiser C et al (2005) Developing strategies for long term follow up of survivors of childhood cancer. BMJ 323:271–274

    Article  Google Scholar 

Download references

Interessenskonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. St. Anna Kinderspital, Kinderspitalgasse 6, A-1090, Wien, Österreich

    E. Frey & H. Gadner

  2. Medizinische Klinik III, Allgemeines Krankenhaus, Medizinische Universität Wien, Wien, Österreich

    A. Gessl, M. Riedel & A. Luger

Authors
  1. E. Frey
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Gessl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Riedel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Luger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H. Gadner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Frey.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Frey, E., Gessl, A., Riedel, M. et al. Nachsorge im Erwachsenenalter. Monatsschr Kinderheilkd 157, 339–345 (2009). https://doi.org/10.1007/s00112-008-1863-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00112-008-1863-z

Schlüsselwörter

Keywords

Search

Navigation