Primärprävention urologischer Tumore: Prostatakarzinom

Abstract

Assessment of the role of vitamins and micronutrients in the primary prevention of prostate cancer has changed dramatically in the past 10 years. Efforts to confirm the efficacy of a single substance have not yet succeeded. Therefore, such recommendations should at present no longer be given. Consideration could even be given to discussing whether additional large-scale interventional studies are expedient in this regard. There is still solid evidence that a well-balanced moderate diet, reduced consumption of milk products, and an Asian or Mediterranean diet are not only beneficial for general good health but can also prevent the development of prostate cancer. This should be the focus of further epidemiological studies. Thus, one can certainly speak of a paradigm shift in the prevention of prostate cancer. In contrast, available data on chemoprevention with 5α-reductase inhibitors is unequivocal: intake of finasteride as well as dutasteride correlates with significantly decreased evidence for prostate cancer. Converting this result into urologic practice remains the topic of extensive controversy.

Sekundär- und Tertiärprävention urologischer Tumore

“…Im Rahmen der PCPT-Studie ("prostate cancer prevention trial") konnte der Nachweis einer präventiven Wirkung von Finasterid in der Entstehung eines Prostatakarzinoms erbracht werden [12,13]. Eine später veröffentlichte Subgruppenanalyse von Patienten mit einer bioptisch gesicherten High-grade-PIN zeigte, dass die Gabe von Finasterid in dieser Subgruppe ebenso effektiv war, wie in der Gesamtpopulation [14].…”