在癌症后治疗更年期
Martha Hickey1, Partha Basu2, Jenifer Sassarini3
1Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and the Royal Women's Hospital, Melbourne, VIC, Australia.
Lancet (London, England)
|March 8, 2024
概括
癌症幸存者通常面临严重的更年期症状, 需要有效的治疗策略,考虑激素治疗的安全性和癌症患者的非激素选择.
科学领域:
- 癌症学
- 妇科医生
- 绝经管理
背景情况:
- 每年有数以百万计的女性被诊断出患有癌症,
- 改善癌症存活率导致更多的妇女经历长期治疗效应,如早产卵巢衰竭 (POI) 或早期更年期.
- 癌症治疗引起的更年期症状往往比自然更年期更严重,可能包括性功能障碍,睡眠,情绪和生活质量受损.
研究的目的:
- 审查癌症幸存者的更年期症状诊断和管理方面的挑战.
- 评估更年期激素治疗 (MHT) 和癌症患者的非激素治疗的疗效和安全性.
- 突出需要改善以患者为中心的护理模式,
主要方法:
- 对癌症幸存者的更年期症状管理的当前文献的综述.
- 对更年期激素治疗 (MHT) 和非激素干预措施的证据分析.
- 对诊断挑战和护理模式进行讨论.
主要成果:
- 在癌症幸存者的更年期症状可能是严重的,并与癌症相关的症状重叠,使诊断复杂化.
- 对于许多癌症患者来说,MHT是有效的血管运动症状,并且通常是安全的.
- 非荷尔蒙和非药物治疗有希望,但证据有限,特别是在年轻女性和非乳腺癌诊断方面. 阴道雌激素对生殖尿路症状是安全的, 但非激素的选择很少.
结论:
- 在癌症后治疗更年期症状需要仔细考虑治疗的安全性和有效性.
- 对于非激素治疗的证据存在重大差距,需要更多的研究.
- 改善,集中和以患者为中心的护理模式对于解决经历更年期的癌症幸存者的未满足需求至关重要.
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