Androgen Deficiency and Testosterone Replacement by Wayne J.G. Hellstrom

Author:Wayne J.G. Hellstrom
Language: eng
Format: epub
Publisher: Humana Press, Totowa, NJ

Historical Perspective

There are many available effective treatment options for patients with locally confined prostate cancer including surgical and radiation modalities. The beneficial effects of androgen deprivation on men with prostate cancer were first realized over 70 years ago, and today, it remains a mainstay of treatment for advanced prostate cancer patients [19].

In 1941, Huggins and Hodges established a strong link between prostate cancer and testosterone. Twenty-five years later, they won a Nobel Prize for their groundbreaking work in prostate cancer treatment. They observed increased levels of acid phosphatase in two patients with metastatic prostate cancer who received exogenous testosterone, although one of the patients was already castrated. They also described disease regression in patients with metastatic prostate cancer after the administration of high doses of estrogens or surgical castration. They correlated this with a decrease in acid phosphatase level. Despite the multiple methodological flaws in the study, most notably the small cohort size, they arrived at the conclusion that high levels of serum testosterone were associated with enhanced prostate cancer growth [20]. With these observations, they provided the first scientific basis for advanced prostate cancer treatment.

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