Prostate Cancer: Therapy

General measures

  • Nicotine restriction (refraining from tobacco use) – smoking increases not only the risk of tumor progression (progression of tumor disease) and cancer-related mortality (death rate) but also toxicity to external beam radiation therapy (radiatio)
  • Alcohol restriction (abstaining from alcohol).
  • Normal weight to strive for or maintain!
  • Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis.
    • BMI ≥ 25 → participation in a medically supervised weight loss program.
    • Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
  • Physical activity (see below sports medicine).
  • Review of permanent medication due topossible effect on the existing disease.
  • Avoidance of environmental stress:

Conventional non-surgical therapy methods

  • Hyperthermia (hyperthermia therapy) – Hyperthermia alone should not be used in the primary therapy of localized prostate cancer.
  • High-intensity focused ultrasound (HIFU) therapy – HIFU therapy is an experimental procedure in localized prostate cancer. HIFU therapy should only be used in prospective studies. For more see below the article “High-intensity focused ultrasound (HIFU) “.
  • Irreversible electroporation (IRE) – nonthermal tissue ablation procedure: In this procedure, repetitive high-current pulses of 2,000-3,000 V and 30-50 A in the microsecond range are carried out via needle-shaped electrodes inserted into the target tissue. The resulting electromagnetic field causes an electrical breakdown of the cell membrane in the target area, creating nanopores in the cell membrane. These in turn lead to uncontrolled ion influx as well as loss of macromolecules resulting in disturbed cell homeostasis. The use of IRE as an alternative therapy for the treatment of prostate cancer has not yet been adequately supported by evidence. However, experts agree that the procedure has high potential for the treatment of malignancies.
  • Cryotherapy (cold therapy) – Cryotherapy is not an adequate treatment alternative in the primary therapy of localized prostate carcinoma. There are no study data to justify the use of this procedure in the primary therapy of localized PCa.

Vaccinations

The following vaccinations are advised:

  • Pneumococcal vaccination
  • Flu vaccination

Regular checkups

  • Regular follow-up examinations for early detection of recurrence (recurrence of the disease).

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet, taking into account the general knowledge of nutrition in a tumor disease. This means:
    • Little red meat, i.e. muscle meat of pork, beef, lamb, veal, mutton, horse, sheep, goat – This is classified by the World Health Organization (WHO) as “probably carcinogenic to humans”, i.e. carcinogenic. Meat and sausage products are classified as a so-called “definite group 1 carcinogen” and are thus comparable (qualitatively, but not quantitatively) to the carcinogenic (cancer-causing) effect of tobacco smoking. Meat products include products whose meat component has been preserved or improved in flavor by processing methods such as salting, curing, smoking, or fermenting: Sausages, sausage products, ham, corned beef, jerky, air-dried beef, canned meat.
    • Reduce consumption of smoked and cured foods, because they contain nitrate or nitrite as a component of curing salt. Their preparation produces compounds (nitrosamines), which are risk factors for various tumor diseases.
    • Once or twice a week fresh sea fish, ie fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
    • Refrain from contaminated foods such as offal and wild mushrooms
    • Do not eat moldy food
    • Consume only limited energy-rich foods
    • Moderate total fat intake
    • High-fiber diet (whole grains, vegetables)
  • Observance of the following special dietary recommendations:
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Endurance training (cardio training) and strength training (muscle training).
  • Exercise therapy is highly effective in relieving cancer-associated fatigue in patients with prostate cancer receiving hormone therapy.
  • Walking, cycling (> 20 min/d), and endurance training (> 1 h/week) result in a reduction in all-cause mortality (death rate)and prostate cancer-specific mortality.
  • Regular exercise after cancer diagnosis reduces all-cause mortality (mortality rate) in prostate cancer by relative 30% (tertiary prevention).
  • A Canadian long-term study of 830 men with prostate cancer concluded the following: More than twice as many patients died in the group with the lowest physical activity as in the quartile with the highest physical activity (158 versus 75). By the end of the study, about one-third of the most active participants had died, compared with three-quarters of those with the least exercise. The follow-up duration of survivors was 15.5 years and ranged up to 17 years.
  • Preparation of a fitness or training plan with appropriate sports disciplines based on a medical check (health check or athlete check).
  • Detailed information on sports medicine you will receive from us.

Psychotherapy