Treatment of Carcinoma of the Prostate
With the introduction of estrogen therapy and orchiectomy as supplemental measures in the treatment of cancer of the prostate, new concepts were made available for combating this disease.
Sufficient time has now elapsed to warrant evaluation of the various types of treatment. Opinions of other surgeons and a personal experience with 100 cases forms the basis for such an evaluation.
In 1941 Huggins demonstrated the effect of certain hormones upon carcinoma of the prostate.1 With the advent of this knowledge a new era in the treatment of this disease has been entered.
Various treatments have been recommended: orchiectomy, administration of estrogen substances, and irradiation of the testes. Interesting observations have been made regarding such treatment. Alleviation of pain, pronounced regression of the primary neoplasm, and disappearance of metastasis have occurred in many patients. Some, however, do not respond to treatment satisfactorily; relief of symptoms is transitory, and in a few little benefit is obtained.
Randall in 1942 reported a series of 5 cases in which castration had been performed for carcinoma of the prostate in 1934.2 Transurethral resection was employed to relieve the obstructive symptoms. He stated that the clinical course following surgical castration was similar to that following a transurethral resection alone. This first suggested that the beneficial effects obtained by hormonal therapy would not exert a permanent effect.
A review of the cases of prostatic carcinoma occurring in two successive years is presented to evaluate the various types of treatment employed at the present time, their indications, and. . .