The Present Status of Castration for Carcinoma of the Prostate
Abstract
The treatment of carcinoma of the prostate has long been considered a major problem in the practice of urology. Resection of the gland by one technic or another, x-ray therapy, or both have been the chief methods of treatment. However, the condition has been so far advanced when the patient has presented himself that the outlook has been pessimistic. Now and then hope has been offered by some new therapeutic measure, but the proof of time and experience usually has been lacking.
Today castration as a new method of treatment seems to promise gratifying results. This procedure may be compared with oophorectomy for carcinoma of the breast in that both are on a hormonal basis. However, from early conservative reports castration for prostatic carcinoma seems to have a definitely more favorable outlook.
It has been shown that when androgenic hormones are reduced sufficiently, prostatic epithelium undergoes atrophy. Conversely, the injection of adrogens stimulates the growth of prostatic epithelium, and the injection of estrogens retards its growth. Furthermore, eunuchs who are without a primary source of androgens do not develop prostatic hypertrophy.
Carcinoma of the prostate results from overgrowth and invasion of adult epithelial cells. Concrete evidence of this has been shown by phosphatase estimations. Gutman and Gutman1, 2 and Kutscher and Wolbergs3 made extensive studies of the subject. The former examined prostate glands at various ages for acid phosphatase. They observed low values in children, a slight increase through puberty, and high values in adults. The phosphatase values for carcinoma. . .
