Numerous data show that there are significant differences between men and women also in many oncological diseases regarding incidence, treatment efficacy, and mortality. This has, among other things, immunological, pharmacological, and hormonal causes. Despite increasing awareness in recent years, women are still underrepresented in clinical trials. Modern, individualized oncology therapy will increasingly consider relevant gender differences in everyday clinical practice.

It has long been suspected that, primarily due to lifestyle factors and gender-specific risk behavior, the incidence and mortality of cancers of the larynx, esophagus, bladder, and lung are higher in men than in women. Today, research is increasingly focused on gender-specific biological differences at the hormonal, immunological, and molecular levels that influence tumor development, response rates and tolerability of treatments, and overall survival.

Immune System

The innate and adaptive immune systems show fundamental gender-specific differences. With the increasing importance of immunotherapies in oncology and hematology, this may provide possible explanations for gender-specific differences in treatment efficacy and prognosis. However, these aspects are still the subject of numerous studies.

Hormones

Gender-specific hormonal influences have a significant impact on the development of tumors. The female hormone progesterone has an anti-inflammatory effect. Estrogens, such as estradiol, enhance certain immune responses. Androgens, i.e., male hormones, tend to have an immunosuppressive effect.

It is believed that estrogens, in particular, have a protective effect on the development of tumors. Cancers of the gastrointestinal tract, for example, occur more frequently in women during and after menopause. The influence of hormones in the development of tumors of the genital organs (breast, ovaries, prostate, testes) has been extensively studied and is also taken into account in therapy. Significantly less data is available for tumors in gender-neutral organs. Further studies and findings could open up new treatment options.

Pharmacology

Gender-specific differences in effectiveness and side effects play a major role, especially in oncology, where sometimes stressful chemotherapy and immunotherapy are used. Personalized medicine also means taking these differences into account with regard to the effectiveness of therapy at the right dose while ensuring the best possible quality of life for patients.

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