Der Krebspatient mit intellektueller und/oder Mehrfachbehinderung – eine Herausforderung für die onkologische Therapie?

The percentage of persons with intellectual and/or complex disabilities (PD) suffering from cancer is continuously increasing. Diagnosis, treatment, and care require an individualized approach with regard to the specific needs of this group.

Presentation of specific requirements of PD diagnosed with cancer and examples of patient-centered solutions for care.

Results from a literature search, case studies, and personal experience are presented.

The frequent somatic and psychiatric comorbidities including the atypical course of disease require special attention regarding diagnosis, treatment, and care. The multiprofessional team should be aware of the particularities of pain and symptom perception and communication, the reduced competence to interpret what is happening and the impaired ability to react to the circumstances. Care that takes into account all dimensions (physical, psychological, social, spiritual) requires close involvement of attachment figures and pedagogues. The patient’s right of self-determination must be respected—ideally via advanced care planning with regard to end of life. Three case studies are presented.

Today, the health care system is not adequately prepared to care for PD with cancer. Deficits can be identified in the areas of personnel (lack of competence), organization (lack of time, restricted integration of attachment figures and pedagogues), and structure (limited availability of informations in Easy Read). The implementation of the rights of PD with cancer to obtain maximum attainable health without any discrimination due to their disability still requires considerable effort.