Hormone Therapy in Malignancies
HORMONE therapy in the treatment of cancer is useful for two purposes: (1) as a palliative in incurable cases; (2) for study of the behavior of cancer in an attempt to understand its natural history. It is never curative and for that reason should not be depended upon when surgical removal of the primary lesion can be accomplished before metastases have occurred. There are perhaps some exceptions to this rule; for example, as a therapeutic measure for patients severely ill with some other incurable ailment or in the aged patient whose life expectancy is limited. This therapy may be dangerous if misused. Its action is not well understood. Even though cures are not produced it may, nevertheless, relieve pain, improve health temporarily, and prolong life in some patients.
Hormonal therapy may be regarded solely as hormonal administration or it may be accepted as indicating manipulation or withdrawal of existing hormones in some cases. We shall consider both aspects briefly in relation to breast and prostatic cancer.
Castration and Cancer of the Breast in Women
As early as 1886, Sir George Beatson1 recommended oophorectomy as a treatment for cancer of the female breast. Adair2 has recently estimated that it is useful in 15 to 30 per cent of patients with recurrent or metastatic disease. Little or no response is to be found in lymph gland metastases or in the primary tumor. X-ray castration may be capable of causing definite regression in pulmonary metastases temporarily. A good result brings relief from pain,. . .