Prostatic Cancer
There was a kind of grim good news for half the human race last week: adoctor stated flatly that he does not think castration is theinevitable prescription for prostatic cancer.
Wrote Dr. Herman Louis Kretschmer of Chicago's Presbyterian Hospital inthe Journal of the American Medical Association: "There seems tobe a prevailing notion that … all that is necessary to effect a cureis to perform an orchiectomy [castration]. It is extremely unfortunate. . . .Results are . . . anything but desirable."
Men, Lions and Dogs. Enlargement of the prostate gland occurs in mostmen over 50 and about half of them have some prostate trouble. Anestimated 17 to 20% of men past 50 develop prostatic cancer.This also happens to dogs and lions. The dangerous gland, situated atthe lower part of the bladder next to the exit, rarely gives muchwarning until thecancer is beyond surgery.
A lucky few can have gland and cancer completely removed. But all thatcan be done for most patients is to try to make them comfortable andprolong their lives by 1) operations, X-ray or radium treatments; 2)morphine and other pain-killing drugs.
Fashions in Surgery. Castration as a method for checking prostaticcancer is once more in fashion. It was abandoned in the '90s because itdid not cure, revived in the '30s because many doctors believe thetemporary relief it offers is worth while. The operation is oftensupplemented by continuing doses of female sex hormones. Many patientsrefuse the treatment.
Dr. Kretschmer's blunt boo gains force from his experience with elevencastrated patients who had some prostatic tissue cut out besides:"Three of the patients are dead [after] five, eight and eleven months;one patient is bedridden, requiring frequent doses of morphine; threepatients have pain; one patient had painful urination and attacks ofhematuria [bloody urine]; only three say they are improved aftereleven, seven and three months respectively."
Sex Treatment. One hopeful alternative to castration is injections offemale sex hormones .Like castration, female hormones seem to slow down the growth of cancercells. Drs. Charles Cornell Herger and Hans Richard Sauer recentlyreported in the American Journal of Surgery that 30% of their patientsgetting stilbestrol "responded with regressionor softening of the prostate."
The castration argument is not over. Many doctors are castrationzealots. Others, like Dr. Kretschmer, are dead set against it. Drs.Herger and Sauer take the middle ground: they do not invariablycastrate all prostatic-cancer patients, but recommend castration 1) forpatients who do not respond to female sex hormones, 2) to prolong andease the lives of men whose cancers have become widespread.
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