Conservative Treatment of Cancer of the Prostate: Some Clinical Observations
MANY statistical reviews have reported the results of various methods used in the treatment of cancer of the prostrate. This report presents some typical cases as well as general observations of the effectiveness of conservative measures in the treatment of prostatic carcinoma. Conservative therapy is mainly hormonal treatment, but it also includes simple orchiectomy (in 20 per cent of patients) and even an occasional transurethral resection for the relief of obstructive urinary symptoms.
It is generally agreed that only about 10 per cent of patients are suitable candidates for so-called “radical prostatectomy.” Thus, the remaining 90 per cent of patients must be treated by conservative measures. Experience also suggests that these measures may give results in the other 10 per cent of patients which compare favorably with those obtained following radical operation.
Diagnosis is first made from digital rectal palpation of the prostate; the experienced finger is remarkably accurate. A roentgenogram of the pelvis is useful to rule out (or in) prostatic calculi. When necessary, we obtain a histologic diagnosis from tissue obtained by needle biopsy. Biopsy occasionally has not been done, as in cases of typical advanced cancer or in certain instances of radiographically demonstrable metastasis.
Categories of Cancer
In reviewing the records of patients with cancer of the prostate, one is impressed by the fact that this is not a uniform disease. Cases may be roughly separated into three groups: (1) slowly growing cancer that runs a chronic course; (2) rapidly growing cancer, often far advanced when . . .