1. Information about this Guideline – Psycho-oncology
1.1 Editors
The German Guideline Program in Oncology (GGPO) of the Association of the Scientific Medical Societies in Germany (AWMF), the German Cancer Society (DKG), and the German Cancer Aid Foundation (DKH).
1.2 Leading Scientific Societies
Arbeitsgemeinschaft für Psychoonkologie in der DKG (PSO)
Deutsche Krebsgesellschaft vertreten durch Ihre Arbeitsgemeinschaften (DKG)
1.3 Funding of the Guideline
This guideline was supported by the German Cancer Aid Foundation (DKH) within the framework of the German Guideline Program in Oncology.
1.4 Contact
Office Leitlinienprogramm Onkologie
c/o Deutsche Krebsgesellschaft e. V.
Kuno-Fischer-Straße 8
D-14057 Berlin
leitlinienprogramm@krebsgesellschaft.de
www.leitlinienprogramm-onkologie.de
1.5 How to cite
Leitlinienprogramm-Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): S3-Leitlinie Psycho-oncological Diagnostics, Counseling and Treatment of Adult Cancer Patients, Langversion 2.0, 2023, AWMF-Registernummer 032-051OL, https://www.leitlinienprogramm-onkologie.de/leitlinien/psychoonkologie/
1.6 Previous Changes of Version 2.0
1.7 Special Comment
Medicine is subject to a continuous development process, so that all information, especially in regard to diagnostic and therapeutic procedures, can only correspond to the state of knowledge at the time when the guideline is printed. The greatest possible care has been taken with regard to the recommendations given for therapy and the selection and dosage of medications. Nevertheless, users are urged to consult the manufacturers' package inserts and expert information for verification and, in case of doubt, to consult a specialist. In the general interest, any discrepancies should be reported to the OL editorial office.
The user is responsible for any diagnostic and therapeutic application, medication and dosage.
In this guideline, registered trademarks (protected trade names) are not specially marked.Therefore, the absence of a corresponding reference does not necessarily mean that it is a free trade name.
The work is protected by copyright in all its parts. Any use outside the provisions of copyright law without the written consent of the OL editorial office is prohibited and punishable by law. No part of the work may be reproduced in any form without the written permission of the OL editorial office. This applies in particular to reproductions, translations, microfilming and the storage, use and exploitation in electronic systems, intranets and the Internet.
1.8 Objectives of the GGPO
By establishing the German Guideline Program in Oncology (GGPO), the Association of Scientific Medical Societies (AWMF), the German Cancer Society (DKG) and the German Cancer Aid Foundation have set out to jointly promote and support the development, updating and use of scientifically based and practicable guidelines in oncology. The program is based on the medical-scientific findings of AWMF and the DKG, the consensus of medical experts, users and patients, as well as the set of rules for the development of guidelines put forth by the AWMF, and the professional support and funding by the German Cancer Aid Foundation. In order to reflect the current state of medical knowledge and advances in medicine, guidelines must be reviewed and updated on a regular basis. The implementation of AWMF regulations is intended to provide the basis for the development of high-quality oncological guidelines. Since guidelines are an important instrument of quality assurance and quality management in oncology, they should be introduced into everyday care in a targeted and sustainable manner. Thus, active implementation measures as well as evaluation programs are an important part of promoting the German Guideline Program in Oncology. The aim of the program is to create a professional and financially secure basis for the development and provision of high-quality guidelines in Germany. These high-quality guidelines not only facilitate the structured transfer of knowledge, but can also play a role in shaping structures of the healthcare system. Evidence-based guidelines provide the foundation for the creation and updating of disease management programs. Quality indicators derived from guidelines can be used in the framework of the certification of organ tumor centers.
1.9 Additional Documents relating to this Guideline
This document is the long version of the S3 Guideline on Psycho-oncological Diagnostics, Counseling and Treatment of Adult Cancer Patients.
In addition to the long version, the following supplementary documents for this guideline are available in German:
- Short version of this guideline
- Patient Guideline (lay version)
- Guideline Report on the preparation of this guideline
The guideline and all additional documents are available on the following websites:
- German Guideline Program in Oncology (https://www.leitlinienprogramm-onkologie.de/leitlinien/psychoonkologie/)
- AWMF (https://register.awmf.org/de/leitlinien/detail/032-051OL)
- Guidelines International Network (www.g-i-n.net)
Earlier versions of the guideline as well as the additional documents (guideline report, evidence tables, evidence reports, if applicable) are available in the guideline archive at https://www.leitlinienprogramm-onkologie.de/leitlinien/psychoonkologie/.
The guideline is also included in the German Guideline Program in Oncology app. Further information at: https://www.leitlinienprogramm-onkologie.de/app
1.10 Composition of the Guideline Group
1.10.1 Coordination and Reaction
Project Management
- Prof. Dr. phil. Joachim Weis, Freiburg
- Prof. Dr. phil. Anja Mehnert-Theuerkauf, Leipzig
Coordination and Editing
- Felix Brehm, Freiburg (until April 30th, 2022)
- Dr. Claudia Gebhardt, Leipzig (until June 30th, 2020)
- Julia Hufeld, Leipzig (since July 1st, 2020)
- Jennifer Ryan, Freiburg
- Myriam Albiez, Freiburg
1.10.2 Involved Professional Societies and Organisations
The organizations and respective representatives listed in the following table were involved in the preparation of this guideline.
Table 1: Beteiligte Fachgesellschaften und Organisationen
Beteiligte Fachgesellschaften und Organisationen
| Beteiligte Fachgesellschaften und Organisationen | Mandatsträger/beteiligte Experten |
| Arbeitsgemeinschaft Dermatologische Onkologie in der DKG und DDG (ADO) | Prof. Dr. Carmen Loquai |
| Arbeitsgemeinschaft Gynäkologische Onkologie der DGGG und DKG (AGO) | Prof. Dr. Annette Hasenburg |
| Arbeitsgemeinschaft Urologische Onkologie der Deutschen Krebsgesellschaft (AUO) | Prof. Dr. Chris Protzel |
| Bundesarbeitsgemeinschaft Künstlerische Therapien BAG KT (für BTD, DFKGT, DMtG) | Prof. Dr. Harald Gruber, Prof. Dr. Sabine Koch, Dr. Ruth Hertrampf |
| Bundesarbeitsgemeinschaft Selbsthilfe (BAG) | Manfred Olbrich, Martina Jäger |
| Bundesarbeitsgemeinschaft für ambulante psychosoziale Krebsberatung (BAK) | Gudrun Bruns, Martin Wickert |
| BundesPsychotherapeutenKammer (BPtK) | Dr. Andrea Benecke, Dr. Tina Wessels |
| Berufsverband Deutscher Nervenärzte (BVDN) | Dr. Sabine Köhler |
| Berufsverband Deutscher Psychiater (BVDP) | Dr. Christa Roth-Sackenheim, Dr. Norbert Mayer-Amberg |
| Deutsche Arbeitsgemeinschaft für Psychosoziale Onkologie (dapo) | Dr. Andreas Werner, Dr. Thomas Schopperth |
| Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC) | Prof. Dr. Jens Büntzel, Prof. Dr. Susanne Wiegand |
| Deutsche Fachgesellschaft für tiefenpsychologisch fundierte Psychotherapie / Psychodynamische Psychotherapie (DFT) | Ulrike Dinger-Ehrenthal |
| Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV) | Prof. Dr. Klaus Kramer, Prof. Dr. Wolfgang Thasler |
| Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie (DGHO) | Dr. Pia Heußner, Dr. Carola Riedner |
| Deutsche Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie (DGMKG) | PD Dr. Dr. Majeed Rana |
| Deutsche Gesellschaft für Medizinische Psychologie (DGMP) | Prof. Dr. Anja Mehnert-Theuerkauf |
| Deutsche Gesellschaft für Palliativmedizin (DGP) | Dr. Elisabeth Jentschke, Sandra Mai |
| Deutsche Gesellschaft für Psychologie (DGPs) | Prof. Dr. Tanja Zimmermann, Dr. Jan Christopher Cwik |
| Deutsche Gesellschaft für Psychosomatische Frauenheilkunde und Geburtshilfe (DGPFG) | PD Dr. Friederike Siedentopf, Dr. Susanne Ditz |
| Deutsche Gesellschaft für Psychosomatische Medizin und Ärztliche Psychotherapie (DGPM) | Prof. Dr. Imad Maatouk, Prof. Dr. Martin Teufel |
| Deutsche Gesellschaft für Psychiatrie, Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN) (dgppn) | Prof. Dr. Dr. Klaus Mathiak, Dr. Anna Westermair |
| Deutsche Gesellschaft für Psychoanalyse, Psychotherapie, Psychosomatik und Tiefenpsychologie (DGPT) | Dr. Ingrid Rothe-Kirchberger, Dr. Sabine Riese |
| Deutsche Gesellschaft für Senologie (DGS) | Prof. Dr. Stephan Zipfel, Prof. Dr. Martin Teufel |
| Deutsche Gesellschaft für Urologie (DGU) | PD Dr. Désirée Luise Dräger, Dr. Ulrike Hohenfellner |
| Deutsche Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation (DGVM) | Prof. Dr. Kristin Härtl |
| Deutsche Gesellschaft für Verhaltenstherapie (DGVT) | Dr. Friederike Schulze, Thorsten Kreikenbohm |
| Deutsches Kollegium für Psychosomatische Medizin (DKPM) | Prof. Dr. Martin Teufel, Prof. Dr. Imad Maatouk |
| Deutscher Pflegerat (DPR) | Dr. Sara Marquard |
| Deutsche PsychotherapeutenVereinigung (DPtV) | Dr. Cornelia Rabe-Menssen |
| Deutsche Psychoanalytische Vereinigung (DPV) | Prof. Burkhard Brosig, Prof. Annegret Eckhardt-Henn |
| Deutscher Fachverband für Verhaltenstherapie (DVT) | Dr. Jürgen Tripp |
| Deutscher Verband Ergotherapie (DVE) | Claudia Meiling, Birthe Hucke |
| Deutsche Vereinigung für Soziale Arbeit im Gesundheitswesen (DVSG) | Prof. Dr. Stephan Dettmers, Katrin Blankenburg |
| Gesellschaft für Personzentrierte Psychotherapie und Beratung (GWG) | Thorsten Kreikenbohm, Prof. Dr. Mark Helle |
| Konferenz Onkologischer Kranken- und Kinderkrankenpflege in der DKG (KOK) | Kerstin Paradies |
| Landeskrebsgesellschaft, Sektion A der Deutschen Krebsgesellschaft (DKG) | Hanna Bohnenkamp, Dr. Thomas Schopperth |
| Physio Deutschland - Deutscher Verband für Physiotherapie | Reina Tholen - † |
| Arbeitsgemeinschaft Onkologische Thoraxchirurgie in der DKG (AOT) | Dr. Dietrich Stockhausen |
| Arbeitsgemeinschaft Radiologische Onkologie in der DKG (ARO) | Prof. Dr. Dirk Vordermark |
| Berufsverband Deutscher Psychologinnen und Psychologen (BDP) | Dipl. -Psych. Dr. Rupert Roschmann, Ruth Curio |
| Berufsverband der Niedergelassenen Ärztinnen und Ärzte für Hämatologie und Medizinische Onkologie in Deutschland (BNHO) | Prof. Dr. Rudolf Weide |
| Bundesverband Prostatakrebs Selbsthilfe (BPS) | Manfred Olbrich |
| Deutsche Gesellschaft für Verhaltenstherapie (DGVT) | Dr. Friederike Schulze |
| Arbeitsgemeinschaft für Psychoonkologie in der DKG (PSO) | Gabriele Blettner, PD Dr. Andreas Dinkel |
| Deutsche Gesellschaft für psychologische Schmerztherapie und Forschung (DGPSF) | Dipl.-Psych. Karin Kieseritzky |
| Arbeitsgemeinschaft Dermatologische Onkologie in der DKG und DDG (ADO) | Dr. Frank Meiß |
| Assoziation Chirurgische Onkologie (ACO)_history | Prof. Dr. Wolfgang Thasler |
| Arbeitsgemeinschaft Onkologische Rehabilitation und Sozialmedizin in der DKG (AGORS) | Dr. Monika Steimann, Prof. Dr. Oliver Rick |
| Arbeitsgemeinschaft Palliativmedizin in der DKG (APM) | Dr. Elisabeth Jentschke |
| Arbeitsgemeinschaft Supportive Maßnahmen in der Onkologie in der DKG (AGSMO) | PD Dr. Georgia Schilling, Manfred Gaspar |
| Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) | Dr. Susanne Ditz |
| Deutsche Gesellschaft für Radioonkologie (DEGRO) | Prof. Dr. Pirus Ghadjar |
| Deutsche Gesellschaft für Rehabilitationswissenschaften (DGRW) | Prof. Dr. Anja Mehnert-Theuerkauf, Prof. Dr. Dr. Uwe Koch |
| Deutsche Gesellschaft für Thoraxchirurgie (DGT) | Dr. Dietrich Stockhausen |
| Netzwerk Evidenzbasierte Medizin (EbM-Netzwerk) | PD Dr. Heike Schmidt - as consulting expert |
| Neuroonkologische Arbeitsgemeinschaft in der DKG (NOA) (noa) | Prof. Dr. Dorothee Wiewrodt |
| Pneumologisch-onkologische Arbeitsgemeinschaft in der Deutschen Krebsgesellschaft (POA) | Günter Tessmer, Elisabeth Olive |
| als Experte ad personam | Jennifer Ryan, Dipl. Biologe Gregor Wenzel, Felix Brehm, Dr. Markus Follmann, Dr. Thomas Langer, Prof. Dr. Ina Kopp |
| Deutsche Fatigue Gesellschaft (DFaG) | Dr. Markus Horneber, Prof. Dr. Joachim Weis |
| Arbeitsgemeinschaft Soziale Arbeit in der Onkologie (ASO) in DKG | Dipl. Soz. Päd. Marie Rösler |
| Assoziation Chirurgische Onkologie (ACO)_history | Prof. Dr. Axel Kleespies |
| Arbeitsgemeinschaft Palliativmedizin in der DKG (APM) | Dipl.-Psych. Beate Hornemann |
| Deutscher Verband Ergotherapie (DVE) | Isabel Pech |
| Deutsche Gesellschaft für psychologische Schmerztherapie und Forschung (DGPSF) | Martina Straub |
| Arbeitsgemeinschaft Prävention und integrative Medizin in der Onkologie in der DKG (PRiO) (PRIO) | Prof. Dr. Oliver Micke, Prof. Dr. Jens Büntzel |
| Arbeitsgemeinschaft Soziale Arbeit in der Onkologie (ASO) in DKG | Prof. Dr. Sabine Schneider |
| Deutsche Schmerzgesellschaft | Prof. Dr. Stefan Wirz |
| als Experte ad personam |
In addition, the German Society of General and Family Medicine (DEGAM) and the German Psychoanalytic Society (DPG) were invited to participate in the update of this guideline. However, due to a lack of personnel resources, they did not take part in the guideline update. The House of Cancer Self-help (Haus der Krebsselbsthilfe, https://www.hausderkrebsselbsthilfe.de) was represented by Ms. Jäger and Mr. Olbrich (see above).
1.10.3 Arbeitsgruppen
Within the framework of the update, working groups were formed, which were responsible for editing and updating the individual chapters of the S3 guideline under the leadership of the working group leaders named below.
Table 2: Arbeitsgruppen
|
Arbeitsgruppe |
Mitglieder der Arbeitsgruppe (AG-Leiter fett markiert) |
|
AG M: Patient Guideline (External contract) |
Beate Hornemann, Martina Jäger, Karin Kieseritzky, Imad Maatouk, Manfred Olbrich, Ingrid Rothe-Kirchberger, Joachim Weis |
|
AG L: Quality Indicators (External contract) |
Joachim Weis, Martina Jäger, Thorsten Kreikenbohm, Klaus Mathiak, Manfred Olbrich, Andreas Werner, Anna Westermair |
|
AG Int: Conflicts of Interest |
Markus Follmann, Thorsten Kreikenbohm, Joachim Weis |
|
AG A: Chapter 3 - Definition and Basic Principles of Psycho-oncology; Chapter 4 - Structural Prerequisites of Psycho-oncological Care Settings |
Joachim Weis, Andrea Benecke, Ruth Curio, Stephan Dettmers, Pirus Ghadjar, Ingrid Rothe-Kirchberger, Sabine Köhler, Andreas Werner, Tina Wessels, Martin Wickert |
|
AG B: Chapter 5 - Psychosocial Distress; Chapter 6 - Psychiatric Comorbidity; Chapter 7 - Diagnostics |
Anja Mehnert-Theuerkauf, Julia Hufeld, Jan Christopher Cwik, Stephan Dettmers, Klaus Mathiak, Frank Meiß, Sabine Köhler, Anna Westermair, Tanja Zimmermann, Claudia Gebhardt |
|
AG C: Psycho-oncological Interventions Chapter 8.1 - Concept and General Principles 8.2 - Relaxation and Imaginative Techniques; 8.3 - Psychoeducation; 8.4 - Psycho-Oncology E-Health Interventions; 8.5 - Psychotherapeutic Interventions |
Felix Brehm, Joachim Weis, Kristin Härtl, Elisabeth Jentschke, Karin Kieseritzky, Imad Maatouk, Claudia Meiling, Isabel Pech, Cornelia Rabe-Menssen, Carola Riedner, Heike Schmidt, Friederike Schulze, Reina Tholen, Tanja Zimmermann |
|
AG D: Psycho-oncological Interventions Chapter 8.6 - Psycho.oncological Crisis Intervention; 8.7 - Psychosocial Counseling - |
Gudrun Bruns, Hanna Bohnenkamp, Stephan Dettmers, Imad Maatouk, Claudia Meiling, Isabel Pech, Carola Riedner, Marie Rösler, Günter Tessmer, Anna Westermair, Martin Wickert |
|
AG E: Psycho-Oncological Interventions - Chapter 8.8 Creative Arts Therapies |
Harald Gruber, Sabine Koch, Ruth Hertrampf, Dorothee Wiewrodt, Joachim Weis |
|
AG F: Additional Therapies - Chapter 9.1 Pharmacotherapy |
Klaus Mathiak, Imad Maatouk, Pia Heußner, Anna Westermair |
|
AG G: Additional Therapies - Chapter 9.2 Occupational Therapy |
Claudia Meiling, Isabel Pech, Manfred Gaspar, Georgia Schilling |
|
AG H: Additional Therapies - Physical and Exercise Therapy (no longer included) |
Reina Tholen, Manfred Gaspar, Georgia Schilling |
|
AG I: Chapter 10 Specifics of Individual Diagnostic Groups and Their Treatment |
Friederike Siedentopf, Susanne Ditz, Désirée Luise Dräger, Sara Marquard, Norbert Mayer-Amberg, Dietrich Stockhausen |
|
AG J: Chapter 11 Patient-centered Communication |
Gabriele Blettner, Andreas Dinkel, Annette Hasenburg, Pia Heußner, Martina Jäger, Ingrid Rothe-Kirchberger, Klaus Kramer, Thorsten Kreikenbohm, Sabine Köhler, Carola Riedner, Marie Rösler, Wolfgang Thasler, Günter Tessmer, Rudolf Weide, Joachim Weis |
|
AG K: Quality Assurance |
Joachim Weis, Andrea Benecke, Ruth Curio, Pirus Ghadjar, Thorsten Kreikenbohm, Klaus Mathiak, Andreas Werner, Tina Wessels, Anna Westermair, Martin Wickert, Tanja Zimmermann |
1.10.4 Patient Involvement
The guideline was developed with the direct participation of patient representatives (Manfred Olbrich, Martina Jäger). These representatives were involved in the entire process of updating this guideline and participated in the consensus conferences with voting rights.
1.10.5 Methodological Support
Through the German Guideline Program in Oncology:
- Dr. Markus Follmann, MPH MSc, (DKG), Berlin, Germany.
- Prof. Dr. med. Ina Kopp, (AWMF), (IMWi), Marburg
- Thomas Langer, (DKG), Berlin
- Gregor Wenzel, (DKG), Berlin
- Simone Witzel, (AWMF), Berlin
Through external contractors:
- PD Dr. Simone Wesselmann, MBA; Dr. Johannes Rückher - Update of the Quality Indicators
- Mag. Wolfgang Geissler - Patient Guideline (Gesundheit Österreich GmbH, Vienna)