Der Urologe

, 50:1271 | Cite as

Primärprävention urologischer Tumore: Prostatakarzinom

  • B.J. Schmitz-Dräger
  • G. Lümmen
  • E. Bismarck
  • C. Fischer
  • Mitglieder des Arbeitskreises Prävention, Umwelt und Komplementärmedizin (PUK)
Leitthema

Zusammenfassung

In den vergangenen 10 Jahren hat sich die Bewertung der Rolle von Vitaminen und Spurenelementen in der Primärprävention des Prostatakarzinoms (PCA) gravierend verändert. Es ist bislang nicht gelungen, den Nachweis für die Wirksamkeit einer Einzelsubstanz zu erbringen. Entsprechende Empfehlungen sollten daher heute nicht mehr gegeben werden. Es bleibt sogar zu diskutieren, ob weitere aufwändige Interventionsstudien in diese Richtung sinnhaft sind. Demgegenüber scheinen Lifestyle-Modifikationen nach wie vor sinnvoll zu sein. Es gibt weiterhin gute Hinweise darauf, dass maßvolle Ernährung, eine Reduktion des Verzehrs von Milchprodukten, eine asiatische oder mediterrane Ernährung neben Effekten auf den allgemeinen Gesundheitszustand auch der Entstehung von Prostatakrebs vorbeugt. Hier sollte auch der Schwerpunkt weiterer epidemiologischer Studien liegen. Es darf daher durchaus von einem Paradigmenwechsel in der Prävention des PCA gesprochen werden. Demgegenüber ist die Datenlage für die Chemoprävention mit 5α-Reduktasehemmern eindeutig: sowohl die Einnahme von Finasterid als auch von Dutasterid korreliert mit dem signifikant verminderten Nachweis eines PCA. Die Umsetzung dieses Ergebnisses in die urologische Praxis bleibt Gegenstand einer breiten, kontrovers geführten Diskussion.

Schlüsselbegriffe

Prostatakarzinom Prävention 5a-Reduktasehemmer Vitamine Ernährung 

Primary prevention of urologic tumors: prostate cancer

Abstract

Assessment of the role of vitamins and micronutrients in the primary prevention of prostate cancer has changed dramatically in the past 10 years. Efforts to confirm the efficacy of a single substance have not yet succeeded. Therefore, such recommendations should at present no longer be given. Consideration could even be given to discussing whether additional large-scale interventional studies are expedient in this regard. There is still solid evidence that a well-balanced moderate diet, reduced consumption of milk products, and an Asian or Mediterranean diet are not only beneficial for general good health but can also prevent the development of prostate cancer. This should be the focus of further epidemiological studies. Thus, one can certainly speak of a paradigm shift in the prevention of prostate cancer. In contrast, available data on chemoprevention with 5α-reductase inhibitors is unequivocal: intake of finasteride as well as dutasteride correlates with significantly decreased evidence for prostate cancer. Converting this result into urologic practice remains the topic of extensive controversy.

Keywords

Prostate cancer Prevention 5α-reductase inhibitors Vitamins Nutrition 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • B.J. Schmitz-Dräger
    • 1
  • G. Lümmen
    • 2
  • E. Bismarck
    • 1
  • C. Fischer
    • 3
  • Mitglieder des Arbeitskreises Prävention, Umwelt und Komplementärmedizin (PUK)
  1. 1.UrologieEuromedClinicFürthDeutschland
  2. 2.Klinik für UrologieSt.Josef-Hospital TroisdorfTroisdorfDeutschland
  3. 3.Urologische KlinikKlinikum Hohe WarteBayreuthDeutschland

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