Zusammenfassung
Mit 48 650 Neuerkrankungen im Jahr 2002 ist Prostatakrebs in Deutschland die häufigste
Tumorerkrankung und die dritthäufigste tumorbedingte Todesursache des Mannes.
Neben genetischen Faktoren spielen Ernährungsgewohnheiten und körperliche Aktivität
eine bedeutende Rolle bei der Primärprävention. Adipositas, hohe Verzehrsmengen
an Fett, gesättigten Fetten, Fleisch, Milchprodukten und Calcium sind mit
einem erhöhten Erkrankungsrisiko assoziiert. Eine hohe Aufnahme an Tomaten- und
Sojaprodukten, Lycopin, Selen, marinen Omega-3-Fettsäuren und bei Rauchern Vitamin
E können dagegen das Risiko senken. Dies gilt insbesondere für fortgeschrittene
und aggressive Formen von Prostatakrebs. Einen biochemischen (Anstieg des Prostata
spezifischen Antigens) oder klinischen Progress der Erkrankung bzw. ein erhöhtes
Rezidiv- oder Mortalitätsrisiko konnte durch eine Adipositas sowie eine hohe Fettzufuhr
beobachtet werden. Hinweise auf eine Progressionsverzögerung liegen aus Supplementierungsstudien
mit Tomatenprodukten und Selen vor. Experimentelle Studien deuten darüber hinaus
darauf hin, dass die Toxizität einer Chemo- bzw. Radiotherapie durch die gleichzeitige
Gabe von Natriumselenit verringert sowie die Wirkung der antitumoralen Standardtherapie
verbessert wird.
Abschließend werden Empfehlungen für die Beratung von Prostatakrebserkrankten
in der Arztpraxis gegeben, die auch das Bedürfnis von kompetenten Patienten nach
Selbsthilfe und ihrem eigenen individuellen Weg im Umgang mit der Erkrankung berücksichtigen.
Die Umstellung der Ernährung und zusätzlich die Einnahme von Nährstoffsupplementen
sind dabei für viele Patienten essenzielle Bausteine eines Selbsthilfekonzepts,
das Ärzte in der Betreuung von Krebspatienten respektieren sollten.
Summary
Prostate cancer is the most frequently occurring form of cancer in German men
with an incidence rate of 48 650 in the year 2002. Evidence comes from epidemiological
studies that apart from genetic susceptibility diet and physical activity may
play major roles in both incidence and progression of the disease. Obesity may
increase the primary risk. Among individual food groups/nutrients a high consumption
of total fat, saturated fats, meat, dairy, and calcium are related to an increased
risk. Tomato products, soy, lycopene, selenium, marine omega-3-fatty acids and
vitamin E in smokers may inversely be associated with prostate cancer.
Obesity and a high intake of fat are also directly associated with biochemical
(increase in prostate specific antigen) or clinical recurrence. Interventional
studies with supplemental tomato products and selenium suggest a delay of progression.
There is evidence from experimental studies that application of selenium during
chemotherapy or radiotherapy may decrease therapy related toxicities and increases
the effect of the standard therapy on cancer cells.
Expert patients aim to participate in managing their disease by developing individual
self-help concepts. These often include both changing dietary habits and taking
dietary supplements. Physicians should consider these needs when they counsel
cancer patients.
Schlüsselwörter
Prostatakrebs - Prävention - Rezidive - Ernährung - Fett - Adipositas - Mikronährstoffe
- Lycopin - Selen - Patientenkompetenz
Keywords
Prostatic Neoplasms - Prevention, primary - Neoplasm recurrence, local - Diet - Dietary
Fats - Obesity - Micronutrients - Lycopene, Selenium - Expert patient
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Korrespondenzadresse
Steffen Theobald
Dipl. Oecotrophologe
Geschäftsführer der Wissenschaftlichen Gesellschaft zur Förderung der
Patientenkompetenz e.V.
Talstr. 1
79102 Freiburg
Email: s.theobald@patientenkompetenz.org
