Chemoprävention des Prostatakarzinoms – Ein Plädoyer

Zusammenfassung

Eine hohe Prävalenz, das bevorzugte Auftreten in höherem Alter, eine häufig langsame Progression und hohe Behandlungskosten machen die Diagnostik und Therapie des Prostatakarzinoms zu einer besonderen Herausforderung. Eine wirksame Prävention könnte etliche der genannten Probleme bessern. Zwei randomisierte, kontrollierte Studien belegen, dass eine wirksame Chemoprävention des Prostatakarzinoms mit einem 5α-Reduktase Hemmer (Finasterid, Dutasterid) tatsächlich möglich ist. Daneben existieren auch Evidenzen für weitere Substanzen aus der Gruppe der selektiven Östrogenrezeptor Modulatoren (SERMs), NSAIDs und Statine. Die vorliegende Übersicht untersucht die Risiken und Vorteile einer Chemoprävention nicht zuletzt auch unter gesundheitsökonomischen Aspekten. Die Autoren kommen zu dem Schluss, dass die Optionen einer Chemoprävention ergebnisoffen geprüft werden sollten.

Abstract

The high disease prevalence, the presentation in older age, a frequently slowly progressing course of disease, and high costs make the diagnosis of and therapy for prostate cancer a special challenge for urologists. Effective prevention of the disease may help to improve some of the problems mentioned above. Two randomised, controlled studies have proved that effective chemoprevention of prostate cancer is viable using 5α−reductase inhibitors (finasteride, dutasteride). Furthermore, there is increasing evidence that other compounds, e. g., selective oestrogen receptor modulators (SERMs), NSAIDs and statins might also be effective. This review investigates potential risks and benefits of chemoprevention including a consideration of health economical aspects. The authors conclude that the options of chemoprevention should be investigated in an open and unbiased way.

Schlüsselwörter

Chemoprävention - Prostatakarzinom - 5α-Reduktasehemmer

Key words

chemoprevention - prostate cancer - 5α-reductase inhibitor

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