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A history of prostate cancer treatment

Abstract

The increased incidence of prostate cancer has led to remarkable changes in diagnosis and treatment over the past century. What were the first ways in which prostate cancer was treated, and how did these evolve into the variety of therapeutic strategies from which patients have to choose today?

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Figure 1: Prostate cancer research pioneers.

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Correspondence to Samuel R. Denmeade.

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DATABASES

Cancer.gov

prostate cancer

LocusLink

PSA

Medscape DrugInfo

bicalutamide

cetrorelix

cytoxan

docetaxel

doxorubicin

estramustine

etoposide

finasteride

5-fluorouracil

flutamide

goserelin

ketoconazole

leuprolide

mitoxantrone

nafarelin

nilutamide

paclitaxel

vincristine

FURTHER INFORMATION

Andrew Schally — Nobel Prize

The Brady Urological Institute at Johns Hopkins University

Charles Huggins — Nobel Prize

The Prostate Cancer Research Institute

The University of Pennsylvania's Oncolink site for prostate cancer

Glossary

BILATERAL ADRENALECTOMY

Surgical removal of both adrenal glands to eliminate production of adrenal androgens.

BRACHYTHERAPY

Radiation therapy applied inside the patient by means of radioactive seeds that are implanted into the prostate gland. These seeds deliver radiation over a very short distance, thereby minimizing the amount of radiation that is delivered to normal tissue.

EXTERNAL BEAM RADIOTHERAPY

Radiation therapy applied from outside of the patient to a defined area of the body (such as the prostate gland).

GLEASON GRADING SYSTEM

The 'gold standard' for grading prostate cancer, used by pathologists worldwide. This system involves assessing both the predominant and secondary pattern of gland formation within a prostate sample. The sample is scored to create a Gleason 'sum', ranging from 2 to 10, with the highest number indicating the most aggressive cancer. Patients with a Gleason sum of less than 6 typically respond well to therapy, whereas patients with a Gleason sum greater than 7 usually have poor outcomes.

HAEMATOCRIT

Percentage of the blood that is red blood cells, normally between 40–52% in men and 36–46% in women.

HYPOPHYSECTOMY

Surgical removal of the pituitary gland. The pituitary gland produces hormones that stimulate the secretion of several hormones that include cortisol, thyroid hormone and testosterone.

ORCHIECTOMY

Surgical removal of the testicles.

RADICAL PERINEAL PROSTATECTOMY

Surgical removal of the prostate by means of a perineal approach. The perineum is the area between the base of the penis and the anus.

RADICAL RETROPUBIC PROSTATECTOMY

Surgical removal of the prostate by means of a retropubic approach in which the surgeon enters the pelvis above the pubic bone in front of the bladder to visualize the prostate and remove it.

TRANSURETHRAL PROSTATIC RESECTION

(TURP). Removal of prostatic tissue by means of the urethra under direct visualization using electrocautery to relieve symptoms of urinary outflow obstruction.

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Denmeade, S., Isaacs, J. A history of prostate cancer treatment. Nat Rev Cancer 2, 389–396 (2002). https://doi.org/10.1038/nrc801

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