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Ausgewählte somatische Aspekte im Rahmen von „cancer survivorship“

Selected somatic aspects of cancer survivorship

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Forum Aims and scope

Zusammenfassung

Hintergrund

Langzeitfolgen stellen einen wesentlichen Bestandteil von „cancer survivorship“ dar. Insbesondere sind dabei die zytostatikainduzierte Polyneuropathie (CIPN), die kognitive Dysfunktion und strahlentherapeutische Folgen zu nennen.

Methoden

Im vorliegenden Beitrag werden die genannten Langzeitfolgen von Krebsüberlebenden dargestellt.

Ergebnisse

Die CIPN ist ein häufiges Problem und hat einen individuell unterschiedlichen Verlauf. Durch aktive Bewegungstherapie und stimulierende Therapien können die Nervenfunktionen in der Regeneration beschleunigt werden. Die Ergebnisse hierfür sind allerdings nicht ausreichend, um klare therapeutische Empfehlungen aussprechen zu können. Die kognitive Dysfunktion stellt ebenfalls eine relevante und lange unterschätzte Langzeitfolge nach Krebserkrankung dar. In der Pathogenese spielt eine depressive Komponente eine wichtige Rolle. Die besten Daten zur Therapie existieren für ein webgestütztes kognitives Trainingsprogramm. Im Laufe der letzten 3 Jahrzehnte sind die Toxizitäten durch Strahlentherapie deutlich zurückgegangen. Insbesondere die mukosalen Folgen sowie Geschmacksstörungen sind für die Patienten oftmals sehr belastend. Die therapeutischen Ansätze beschränken sich auf die Supportivmedizin.

Diskussion

Die CIPN, die kognitive Dysfunktion und die strahlentherapeutischen Folgen sind Aspekte, die bei der Langzeitbetreuung von Krebspatienten eine wesentliche Rolle spielen und in Programmen zu „cancer survivorship“ implementiert werden sollten. Weitere Studien zur Behandlung dieser z. T. multifaktoriellen Funktionsstörungen sind dringend erforderlich, da die Datenlage diesbezüglich noch nicht ausreichend ist, um Therapiestandards zu formulieren.

Abstract

Background

Long-term sequelae play a major role in cancer survivorship. Cytostatic-induced polyneuropathy (CIPN), cognitive dysfunction, and radiotherapy-induced late adverse effects deserve particular mention.

Methods

The following article presents the abovenamed long-term sequelae of cancer survivors.

Results

CIPN is a frequent problem with an individually determined course. Active exercise and stimulation therapies can accelerative nerve function in regeneration, although results are currently insufficient to permit clear treatment recommendations. Cognitive dysfunction is another relevant and long underestimated late effect after cancer treatment. A depressive component plays an important role in pathogenesis. The best data on treatment come from a web-based cognitive training program. Radiotherapy-induced toxicities have decreased significantly during the past three decades. Particularly mucosal sequelae and dysgeusia are often very disturbing for the patient. Therapeutic approaches are limited to supportive medicine.

Conclusion

CIPN, cognitive dysfunction, and radiotherapy-induced late adverse effects are aspects that play an important role in the long-term aftercare of cancer patients and should thus be implemented in cancer survivorship programs. Further studies on treatment of these multifactorial functional disorders are urgently needed, as the current data are insufficient to formulate treatment standards.

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Author information

Authors and Affiliations

  1. Klinik Reinhardshöhe, Quellenstr. 8–12, 34537, Bad Wildungen, Deutschland

    Oliver Rick

  2. Klinik für onkologische Rehabilitation, Strandklinik Boltenhagen, Boltenhagen, Deutschland

    M. Steimann

  3. Klinik für Strahlentherapie, Campus Kiel, Universitätsklinikum Schleswig Holstein, Kiel, Deutschland

    C. Schmalz

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Correspondence to Oliver Rick.

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O. Rick, M. Steimann und C. Schmalz geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Rick, O., Steimann, M. & Schmalz, C. Ausgewählte somatische Aspekte im Rahmen von „cancer survivorship“. Forum 34, 170–174 (2019). https://doi.org/10.1007/s12312-019-0575-8

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