Phytoöstrogenbehandlung als Therapieoption für das fortgeschrittene Prostatakarzinom

Zusammenfassung

Der Einsatz von Phytotherapeutika, insbesondere phytoöstrogenhaltige Pflanzenprodukte, spielt seit langem eine wichtige Rolle in der Behandlung von Prostataerkrankungen. Aufgrund der vielfältigen antiinflammatorischen und antiproliferativen Wirkungen wird ihr Einsatz auch in der Behandlung des Prostatakarzinoms untersucht. Während In-vitro-Daten wie auch tierexperimentelle Befunde den Einsatz in der Krebsprävention und Karzinombehandlung nahe legen, ist die klinische Wirkung beim Menschen erst ansatzweise nachgewiesen. Vieles spricht für eine Kombination mit konventionellen Prostatakarzinommedikamenten im Sinne einer Optimierung: so scheint gerade eine Kombination von Phytoöstrogenen und synthetischem Östrogen besonders wirksam in der Behandlung des hormonrefraktären Prostatakarzinoms zu sein. Die retrospektive Auswertung von 49 Fällen zeigt, dass das Präparat Sitosterol comp. in etwa 60 % eine PSA-Reduktion von mehr als 50 % innerhalb von 3 Monaten erwirkt, verbunden mit einem klinischen Ansprechen. Die mittlere erzielte Behandlungszeit liegt bei über 12 Monaten. Durch ein intensives Patientenmonitoring lassen sich die anfangs gefürchteten Nebenwirkungen synthetischer Östrogene weitgehend vermeiden. Die Behandlungsform stellt zudem eine kostengünstige Alternative dar.

Summary

Phytotherapeutic drugs have been used for long time in the treatment of prostate diseases. Due to their antiinflammatory and antiproliferative effects their influence is also being tested in the treatment of prostate cancer. While in vitro data and animal experiments support their implication in prevention and treatment of this cancer type little is known with regard to their clinical benefit in patients. There is, however, evidence for the combination of these drugs with conventional prostate cancer medication: a specific combination of phytoestrogens and synthetic estrogen proves to be promising in the treatment of hormone-refractory prostate cancer. A retrospective analysis of more than 50 patients reveals that the combination leads to a PSA reduction in approximately 60 % of the cases with more than 50 % reduction accompanied by a clinical response. The mean treatment duration is more than 12 months. Intensive patient monitoring helps to avoid most of the greatly feared side effects of synthetic estrogens. Treatment with this drug combination also proves to be an alternative which is economically attractive.

Schlüsselwörter

Prostatakarzinom - Phytotherapie - Phytoöstrogen - Polyphenole - Prävention - hormonrefraktär - Prostatakrebsbehandung

Keywords

Prostate cancer - phytotherapy - phytoestrogen - polyphenols - prevention - hormone-refractory - prostate cancer treatment

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