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Erfahrungsheilkunde 2003; 52(11): 724-732
DOI: 10.1055/s-2003-44308
Originalia

Karl F. Haug Verlag, in: MVS Medizinverlage Stuttgart GmbH & Co. KG

Präventive Maßnahmen gegen Prostatakrebs

Hoffnung und RealitätKarl-Friedrich Klippel, Ben L. Pfeifer
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Publication History

Publication Date:
19 November 2003 (online)

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Zusammenfassung

Vorbeugung von Prostatakrebs ist ein vordringliches gesundheitspolitisches Problem, da jedes Jahr mehr Männer mit dieser Erkrankung diagnostiziert werden. Die hohe Prävalenz und Inzidenzrate, eine lange Latenzperiode, und die signifikante Morbidität und Mortalität prädestinieren den Prostatakrebs zur Erforschung und Anwendung präventiver Maßnahmen. Voraussetzungen für die Entwicklung rationaler chemopräventiver Strategien gegen Prostatakrebs sind eine ausreichende Kenntnis der Karzinogenese, gut charakterisierte, potentiell präventive biologische und chemische Substanzen, geeignete Patientenkollektive zur Prüfung und verlässliche Biomarker zur Einschätzung des Krebswachstums. Die Wahl eines potentiell präventiven Mittels wird abhängen von experimentellen oder epidemiologischen Untersuchungen mit Effektivitätsnachweis, der Unbedenklichkeit des Mittels auch bei Langzeitanwendung, und einer rationalen Begründung bezüglich der zu erwartenden Aktivität. Berechtigte Hoffnung auf präventive Wirksamkeit bei Prostatakrebs besteht dabei für Antiandrogene und Antiöstrogene, 5-alpha-Reduktase Hemmer, Aromatase Hemmer, Retinoide, Vitamine D und E, Selen, Karotenoide, Soja Isoflavone, 2-Difluoromethylornithine, Lipoxygenase Hemmer, Apoptose Induktoren, und nicht-steroidale anti-entzündliche Medikamente. Einige dieser Substanzen sind gegenwärtig in der klinischen Prüfung Phase I-III.

Abstract

The increasing incidence rate for prostate cancer in the Western World combined with an ageing male population will create an enormous healthcare problem within the next 25 years. With its high prevalence, long latency, high incidence and significant morbidity and mortality, prostate cancer is an ideal target for chemoprevention. Developing rational chemopreventive strategies for prostate cancer requires in-depth knowledge of carcinogenesis, well-characterized agents, suitable cohorts, and reliable biomarkers of cancer. Choice of chemopreventive agent will depend on experimental or epidemiologic data demonstrating efficacy, good safety record with chronic administration, and a rationale for activity. Current promising agents include antiandrogens and antiestrogens, 5-alpha-reductase inhibitors, aromatase inhibitors, retinoids, vitamins D and E, selenium, carotenoids, soy isoflavones, 2-difluoromethylornithine, lipoxygenase inhibitors, apoptosis inducers, and nonsteroidal anti-inflammatory drugs. Several of these agents are now under evaluation in clinical trials phase 1, 2, and 3.

Schlüsselwörter

Chemoprävention - Prostatakrebs - Phytotherapie - Diät - Lebensweise

Keywords

Chemoprevention - prostate cancer - phytotherapy - diet - life style

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Korrespondenzautoren:

Prof. Dr. Dr. med. Ben L. Pfeifer

Direktor für Klinische Forschung
Aeskulap Klinik

Gersauer Strasse 8

CH-6440 Brunnen

Schweiz

Prof. Dr. med. Karl-Friedrich Klippel

Urologische Klinik
Akademisches Lehrkrankenhaus Celle

Deutschland