Mazurakova Alena, Samec Marek, Koklesova Lenka, Biringer Kamil, Kudela Erik, Al-Ishaq Raghad Khalid, Pec Martin, Giordano Frank A, Büsselberg Dietrich, Kubatka Peter, Golubnitschaja Olga
Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia.
Department of Pathological Physiology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia.
EPMA J. 2022 Jul 8;13(3):461-486. doi: 10.1007/s13167-022-00288-z. eCollection 2022 Sep.
According to the GLOBOCAN 2020, prostate cancer (PCa) is the most often diagnosed male cancer in 112 countries and the leading cancer-related death in 48 countries. Moreover, PCa incidence permanently increases in adolescents and young adults. Also, the rates of metastasising PCa continuously grow up in young populations. Corresponding socio-economic burden is enormous: PCa treatment costs increase more rapidly than for any other cancer. In order to reverse current trends in exploding PCa cases and treatment costs, pragmatic decisions should be made, in favour of advanced populational screening programmes and effective anti-PCa protection at the level of the health-to-disease transition (sub-optimal health conditions) demonstrating the highest cost-efficacy of treatments. For doing this, the paradigm change from reactive treatments of the clinically manifested PCa to the predictive approach and personalised prevention is essential. Phytochemicals are associated with potent anti-cancer activity targeting each stage of carcinogenesis including cell apoptosis and proliferation, cancer invasiveness and metastatic disease. For example, their positive effects are demonstrated for stabilising and restoring mitochondrial health quality, which if compromised is strongly associated with sub-optimal health conditions and strong predisposition to aggressive PCa sub-types. Further, phytochemicals significantly enhance response of cancer cells to anti-cancer therapies including radio- and chemotherapy. Evident plant-based mitigation of negative side-effects frequently observed for conventional anti-cancer therapies has been reported. Finally, dual anti-cancer and anti-viral effects of phytochemicals such as these of silibinin have been demonstrated as being highly relevant for improved PCa management at the level of secondary and tertiary care, for example, under pandemic conditions, since PCa-affected individuals per evidence are highly vulnerable towards COVID-19 infection. Here, we present a comprehensive data analysis towards clinically relevant anti-cancer effects of phytochemicals to be considered for personalised anti-PCa protection in primary care as well as for an advanced disease management at the level of secondary and tertiary care in the framework of predictive, preventive and personalised medicine.
根据《2020年全球癌症报告》，前列腺癌（PCa）是112个国家中最常被诊断出的男性癌症，也是48个国家中与癌症相关的主要死因。此外，青少年和青年男性中前列腺癌的发病率持续上升。而且，年轻人群中转移性前列腺癌的发病率也在不断增长。相应的社会经济负担巨大：前列腺癌的治疗成本增长速度比其他任何癌症都要快。为了扭转当前前列腺癌病例和治疗成本激增的趋势，应做出务实的决策，支持先进的人群筛查计划，并在健康向疾病转变阶段（健康状况欠佳）提供有效的抗前列腺癌保护，因为这一阶段的治疗成本效益最高。为此，从对临床确诊的前列腺癌进行反应性治疗转向预测性方法和个性化预防的模式转变至关重要。植物化学物质具有强大的抗癌活性，可针对致癌作用的各个阶段，包括细胞凋亡和增殖、癌症侵袭和转移性疾病。例如，它们对稳定和恢复线粒体健康质量具有积极作用，而线粒体健康质量受损与健康状况欠佳以及侵袭性前列腺癌亚型的易感性密切相关。此外，植物化学物质可显著增强癌细胞对包括放疗和化疗在内的抗癌疗法的反应。据报道，基于植物的疗法能明显减轻传统抗癌疗法常见的负面副作用。最后，水飞蓟宾等植物化学物质的双重抗癌和抗病毒作用已被证明与改善二级和三级护理水平的前列腺癌管理高度相关，例如在大流行情况下，因为有证据表明前列腺癌患者极易感染COVID-19。在此，我们针对植物化学物质的临床相关抗癌作用进行了全面的数据分析，以便在预测、预防和个性化医学框架下，在初级护理中考虑用于个性化抗前列腺癌保护，并用于二级和三级护理水平的晚期疾病管理。
