Der Urologe

, Volume 51, Issue 5, pp 727–736 | Cite as

Prävention uroonkologischer Erkrankungen

  • B.J. Schmitz-Dräger
  • G. Lümmen
  • E. Bismarck
  • C. Fischer
  • Mitglieder des Arbeitskreises Prävention, Umwelt und Komplementärmedizin (PUK) der Deutschen Gesellschaft für Urologie e. V. (DGU)*
CME Zertifizierte Fortbildung

Zusammenfassung

In den vergangenen 10 Jahren hat sich die Bewertung der Rolle von Vitaminen und Spurenelementen in der Primärprävention urologischer Tumoren 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. Demgegenüber scheinen Lifestyle-Modifikationen nach wie vor sinnvoll zu sein: Neuere Untersuchungen weisen darauf hin, dass Rauchen nicht nur die Entstehung von Harnblasentumoren, sondern auch des Prostata- und Nierenkarzinoms beeinflusst. Es gibt weiterhin gute Hinweise darauf, dass maßvolle Ernährung, eine Reduktion des Verzehrs von Milchprodukten sowie eine asiatische oder mediterrane Ernährung neben Effekten auf den allgemeinen Gesundheitszustand auch der Entstehung von Prostatakrebs (PCA) vorbeugen. 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-Reduktase-Hemmern 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 5α-Reduktase-Hemmer Vitamine Ernährung 

Prevention of uro-oncological diseases

Abstract

During the last decade consideration of the role of vitamins and minerals in primary prevention of genitourinary tumors has changed dramatically. Despite all efforts the efficacy of a specific compound has not yet been proven and as a consequence recommendations for the use of vitamins or other supplements for tumor prevention should no longer be given. In contrast life style modification might be helpful as recent investigations suggested that smoking not only promotes the development of bladder cancer but is also involved in prostate and renal cell carcinogenesis. In addition there is some evidence that moderate food consumption, reduction of dairy product consumption and an Asian or Mediterranean diet can prevent prostate cancer and also harbor additional beneficial effects for general health. These observations should be the starting point of future epidemiological research. This may be considered as a change of paradigm in prostate cancer prevention. In contrast there is clear evidence of the efficacy of chemoprevention using 5α-reductase inhibitors as the use of finasteride and dutasteride significantly reduces the detection of prostate cancer. However, translation of these findings into urological practice remains a matter of controversial discussion.

Keywords

Prostatic neoplasms Prevention 5α-reductase inhibitors Vitamins Nutrition 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag 2012

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) der Deutschen Gesellschaft für Urologie e. V. (DGU)*
    • 4
  1. 1.UrologieEuromedClinicFürthDeutschland
  2. 2.Urologische AbteilungSt. Josef-HospitalTroisdorfDeutschland
  3. 3.Urologische KlinikKlinikum Hohe WarteBayreuthDeutschland
  4. 4.DüsseldorfDeutschland

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