Zusammenfassung
Patienten im jungen Erwachsenenalter trifft die Diagnose Krebs in einer Lebensphase, in der die Erfüllung des eigenen Kinderwunsches eine große Rolle spielt. Um fertilitätserhaltende Maßnahmen durchführen zu können, ist die Aufklärung der Patienten vor Behandlungsbeginn unerlässlich. Ob und wie die Fertilität im Arzt-Patient-Gespräch thematisiert wird, ist Gegenstand dieser Übersichtsarbeit. Hierfür wurde eine Literaturrecherche (Zeitraum 2000 bis 2010) durchgeführt. Eingeschlossen wurden insgesamt 21 Studien, die die Arzt-Patient-Kommunikation aus Sicht der Patienten bzw. des medizinischen Fachpersonals untersucht haben. Es ist noch nicht die Regel, dass Onkologen mit ihren Patienten über Fertilität bzw. deren Beeinträchtigungen durch die onkologische Behandlung sprechen. Sowohl Onkologen als auch die Betroffenen äußerten Kommunikationsschwierigkeiten. Eine Verbesserung des Arzt-Patient-Gesprächs bezüglich der Familienplanung kann durch die Bereitstellung von Richtlinien, die Schulung des medizinischen Personals sowie die Kooperation zwischen Onkologen und Reproduktionsmedizinern erreicht werden. Außerdem sollte auf die Ausbildung der Patientenkompetenz z. B. mithilfe von edukativem Material fokussiert werden.
Abstract
Cancer patients in young adulthood are affected by the cancer diagnosis in a period of life where future parenthood or fulfilling of a potential wish to have children plays an important role. To perform fertility preserving treatment, patients should be fully informed before any treatment is carried out. The following review broaches the issue of whether and how fertility concerns are discussed in the medical consultation. Therefore, relevant papers were identified by a database search between the years 2000 and 2010. A total of 21 studies were included which focussed on physician-patient communication from the point of view of the patients or healthcare professionals. Oncologists do not routinely speak to patients about fertility issues. Both oncologists and patients expressed communication difficulties. An improvement of the medical interview concerning family planning could be achieved by provision of guidelines, training for healthcare professionals, cooperation between oncologists and reproductive medicine and the provision of educational patient material.
Literatur
Achille MA, Rosberger Z, Robitaille R et al (2006) Facilitators and obstacles to sperm banking in young men receiving gonadotoxic chemotherapy for cancer: the perspective of survivors and health care professionals. Hum Reprod 21:3206–3216
Anderson RA, Weddell A, Spoudeas HA et al (2008) Do doctors discuss fertility issues before they treat young patients with cancer? Hum Reprod 23:2246–2251
Bashore L (2007) Semen preservation in male adolescents and young adults with cancer: one institution’s experience. Clin J Oncol Nurs 11:381–386
Berg H van den, Langeveld NE (2008) Parental knowledge of fertility in male childhood cancer survivors. Psychooncology 17:287–291
Chapple A, Salinas M, Ziebland S et al (2007) Fertility issues: the perceptions and experiences of young men recently diagnosed and treated for cancer. J Adolesc Health 40:69–75
Crawshaw M, Glaser A, Hale J, Sloper P (2004) Professionals‘ views on the issues and challenges arising from providing a fertility preservation service through sperm banking to teenage males with cancer. Hum Fertil (Camb) 7:23–30
Duffy CM, Allen SM, Clark MA (2005) Discussions regarding reproductive health for young women with breast cancer undergoing chemotherapy. J Clin Oncol 23:766–773
Felberbaum R (2010) Krebs und Fertilitätsaspekte erfordern einen interdisziplinären Ansatz. Gynakologe 43:445–446
Glaser A, Wilkey O, Greenberg M (2000) Sperm and ova conservation: existing standards of practice in North America. Med Pediatr Oncol Suppl 35:114–118
Goodwin T, Oosterhuis BE, Kiernan M et al (2007) Attitudes and practices of pediatric oncology providers regarding fertility issues. Pediatr Blood Cancer 48:80–85
Hordern A, Graininger M, Hegarty S et al (2009) Discussing sexuality in the clinical setting: the impact of a brief training program for oncology health professionals to enhance communication about sexuality. Asia Pac J Clin Oncol 5:270–277
Jeruss JS, Woodruff TK (2009) Current concepts: preservation of fertility in patients with cancer. N Engl J Med 360:902–911
Karaöz B, Aksu H, Kucuk M (2010) A qualitative study of the information needs of premenopausal women with breast cancer in terms of contraception, sexuality, early menopause, and fertility. Int J Gynaecol Obstet 109:118–120
King L, Quinn GP, Vadaparampil ST et al (2008) Oncology nurses‘ perceptions of barriers to discussion of fertility preservation with patients with cancer. Clin J Oncol Nurs 12:467–476
Lee SJ, Schover LR, Partridge AH et al (2006) American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol 24:2917–2931
Otte S von, Friedrich M, Diedrich K et al (2006) Fertilitätserhalt bei onkologischen Patientinnen: Stand und Perspektiven – Preserving Fertility in Cancer Patients. Dtsch Arztebl 103:A2479
Popovici R, Wolff M von, Strowitzki T (2009) Fertilitätserhalt bei Krebs – Fertility preservation in cancer patients. Gynakologe 7:535–541
Quinn GP, Vadaparampil ST, Gwede CK et al (2007) Discussion of fertility preservation with newly diagnosed patients: oncologists‘ views. J Cancer Surviv 1:146–155
Quinn GP, Vadaparampil ST, Fertility Preservation Research Group (2009a) Fertility preservation and adolescent/young adult cancer patients: physician communication challenges. J Adolesc Health 44:394–400
Quinn GP, Vadaparampil ST, King L et al (2009b) Impact of physicians‘ personal discomfort and patient prognosis on discussion of fertility preservation with young cancer patients. Patient Educ Couns 77:338–343
Quinn GP, Vadaparampil ST, Jacobsen PB et al (2010) Frozen hope: fertility preservation for women with cancer. J Midwifery Womens Health 55:175 180
Reebals JF, Brown R, Buckner EB (2006) Nurse practice issues regarding sperm banking in adolescent male cancer patients. J Pediatr Oncol Nurs 23:182–188
Richter D, Geue K, Matthes A et al (2011) Fertilität und Krebs – Skizzierung des Problemfeldes. Psychother Psychosom Med Psychol 61.06:246–253
Rippy E, Karat I, Kissin M (2009) Pregnancy after breast cancer: the importance of active counselling and planning. Breast 18:345–350
Robert Koch-Institut (2010) Zentrum für Krebsregisterdaten (persönliche Mitteilung)
Schover LR, Brey K, Lichtin A et al (2002) Knowledge and experience regarding cancer, infertility, and sperm banking in younger male survivors. J Clin Oncol 20:1880–1889
Sonmezer M, Oktay K (2006) Fertility preservation in young women undergoing breast cancer therapy. Oncologist 11:422–434
Strong M, Peche W, Scaife C (2007) Incidence of fertility counseling of women of child-bearing age before treatment for colorectal cancer. Am J Surg 194:765–768
Strowitzki T, Germeyer A (2009) Fertilität und Krebs – ein neues Aufgabengebiet für die Reproduktionsmedizin? J Gynakol Endokrinol 19:10–14
Tschudin S, Bitzer J (2009) Psychological aspects of fertility preservation in men and women affected by cancer and other life-threatening diseases. Hum Reprod Update 15:587–597
Vadaparampil ST, Clayton H, Quinn GP et al (2007) Pediatric oncology nurses‘ attitudes related to discussing fertility preservation with pediatric cancer patients and their families. J Pediatr Oncol Nurs 24:255–263
Vadaparampil S, Quinn G, King L et al (2008) Barriers to fertility preservation among pediatric oncologists. Patient Educ Couns 72:402–410
Vries MC de, Bresters D, Engberts DP et al (2009) Attitudes of physicians and parents towards discussing infertility risks and semen cryopreservation with male adolescents diagnosed with cancer. Pediatr Blood Cancer 53:386–391
Wolff M von, Strowitzki T (2007) Fertilitätserhalt bei onkologischen Patientinnen und Patienten. Gynakologe 10:798–806
Danksagung
Die Autoren bedanken sich bei der Deutschen Josè Carreras Leukämie-Stiftung e. V. für ihre Unterstützung.
Interessenkonflikt
Die korrespondierende Autorin gibt an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Geue, K., Richter, D., Leuteritz, K. et al. Familienplanung junger onkologischer Patienten. Psychotherapeut 56, 371–378 (2011). https://doi.org/10.1007/s00278-011-0852-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00278-011-0852-1