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Onkologie

  • Chapter
Gender Medizin

Auszug

Erfreulicherweise sind in den letzten Jahren sowohl die Erkrankungsfälle als auch die Todesfälle an Krebserkrankungen rückläufig. In der europäischen Union (vor der Erweiterung am 1.5.2004) konnte ein jährlicher Rückgang der Todesfälle um 80 000 pro Jahr verzeichnet werden. Dies ist auf zahlreiche Verbesserung auf allen Ebenen der Grundlagenforschung,

Entwicklung und Verfeinerung therapeutischer Maßnahmen und vor allem auf die bewußtere Lebensführung und die Verbesserung von Umweltbedingungen zurückzuführen. Die bislang unübiiche Perspektive der Genderforschung erlaubt es, bisher wenig beachtete Facetten des Problem der Krebserkrankungen wahrzunehmen und dadurch möglicherweise neue Chancen in der Prävention, Diagnostik und Therapie maligner Erkrankungen zu eröffnen.

Ein kurzer &#00DC;berblick über die epidemiologischen Daten zeigt, dass bei allen tabaksassoziierten Krebserkrankungen die Erkrankungsraten und Sterblichkeitsraten der Frauen in erschreckendem Ausmaß ansteigen, während die Erkrankungs- und Sterblichkeitsraten der Männer rückläufig geworden sind. Bei der Mehrzahl der Tumore, die nicht tabaksassoziiert und nicht durch Geschlechtshormone getriggert werden, sind mit wenigen Ausnahmen die Erkrankungszahlen beider Geschlechter fast ident.

Die Annahme von Gesundenuntersuchungen und Screeninguntersuchungen zur frühen Diagnostik maligner Tumoren durch Frauen ist wesentlich höher als bei Männern. Bei beiden Geschlechtern ist noch viel — auch geschlechtspezifisch unterschiedliche — Überzeugungs- und Aufklärungsarbeit zu leisten. Die Diagnostik von Tumorerkrankungen läuft im Wesentlichen nicht geschlechtsspezifisch unterschiedlich ab. Die Therapien, insbesonders die internistisch onkologischen Therapien mit Zytostatika werden derzeit im Allgemeinen nicht geschlechtsspezifisch moduliert. Die Dosierung der Zytostatika wird nach der Körperoberfläche aus Körpergröße und Körpergewicht berechnet. Bei mehreren Tumorarten, wo die Ergebnisse von Chemotherapiestudien (unüblicherweise) nach Geschlechtern getrennt ausgewertet wurden, zeigte sich ein Trend, dass Frauen zwar häufiger und schwerwiegendere Nebenwirkungen hinnehmen müssen, dafür aber auch längere Überlebenszeiten erreichen (Dickdarmkrebs, Glioblastome). Es wäre interessant, durch geschlechtergetrennte Auswertungen weiterer Therapieschemata, diese Befunde weiter zu untersuchen, um die Therapieergebnisse bei beiden Geschlechtern zu verbessern.

Wesentliche Unterschiede zwischen den Geschlechtern finden sich bei den Änderungen im täglichen Leben, die durch die Tumorerkrankung hervorgerufen werden. Hier spielt die unterschiedliche wirtschaftliche Situation von Männern und Frauen eine große Rolle. Auch bei der seelischen Bewältigung der Tumorerkrankung finden sich geschlechtspezifische Muster, die bei der Planung der Unterstützung der Patienten und ihrer Familien berücksichtigt werden sollten.

Insgesamt wird durch die geschlechtersensitive Betrachtung der Onkologie eine Fülle konkreter und mit dem heutigen Wissen und Können realisierbarer Maßnahmen angeregt, um das Schicksal der Patientinnen mit malignen Tumoren zu erleichtern.

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Authors and Affiliations

  1. Medizinische Unversltät Wien Universitätsklinik für Innere Medizin Währinger Gürtel, 18-20, A-1090, Wien, Austria

    Univ.-Prof. Dr. C. Marosi, Univ.-Doz. Dr. B. Dörner-Fazeny & Univ.-Prof. Dr. C. Zielinski

  2. Medizinische Universität Wien Institut für Krebsforschung Borschkegasse, 8a, A-1090, Wien, Austria

    Univ.-Prof. Dr. C. Vutuc

  3. Univ.-Klinik für Innere Medizin I, AKH Währlnger Gürtel, 18-20, A-1090, Wien, Austria

    Univ.-Prof. Dr. H. T. Greinix

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  1. Univ.-Prof. Dr. C. Marosi
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  3. Univ.-Prof. Dr. H. T. Greinix
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    Anita Rieder

  2. Abteilung für Geschichte, Ethik und Philosophie der Medizin, Medizinische Hochschule Hannover, Deutschland

    Brigitte Lohff

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Marosi, C., Vutuc, C., Greinix, H.T., Dörner-Fazeny, B., Zielinski, C. (2008). Onkologie. In: Rieder, A., Lohff, B. (eds) Gender Medizin. Springer, Vienna. https://doi.org/10.1007/978-3-211-68290-6_10

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