Carcinoma of the Prostate Gland
CONSIDERABLE progress has been made in the treatment of cancer of the prostate in the last decade.1 This advancement is based upon control of the cancer by eliminating the testicular androgenic stimulus for growth and by utilizing the inhibitory action of estrogens. Striking clinical improvement in advanced cases usually results from such hormonal therapy. When the cancer is localized within the prostate it can be removed completely by extirpation of the gland. The pathology, diagnosis, and treatment of prostatic cancer will be discussed herein and the necessity for early, accurate diagnosis stressed before the carcinoma has extended beyond the gland and become widespread.
Incidence. According to a Public Health Report in which figures are standardized for age and sex, carcinoma of the prostate ranks next in frequency to malignancy of the stomach and skin.2 The incidence of cancer of the prostate gland actually is much higher because of the large number of cases unrecognized clinically. Rich3 reported finding cancer in 41 out of 292 prostate glands from consecutive autopsies examined by single section, an incidence of 14 per cent. Moore4 found the incidence to be 21 per cent in the prostate glands of men over 50 years of age in whom the diagnosis was not made clinically or in the gross findings at autopsy. Kahler5 reported an incidence of 17 per cent, and Baron and Angrist6 discovered cancer in 23 of 50 prostate glands examined similarly by serial block examination, an incidence of 46 per cent. These pathologic studies show. . .