Hormonal therapy in the management of prostate cancer: An historical overview

This article reviews the history of hormonal therapy for prostate cancer, b eginning with the studies of Huggins and Hedges completed in the 1940s. Alt hough early clinical reports suggested that major improvements and even cur e could be obtained, later randomized investigations showed that hormonal t reatments were palliative rather than curative. Later investigators demonst rated that prostate cancer is under the trophic influence of male hormones and that ablation of androgens could cause cancer regression. More recently , neoadjuvant and adjuvant hormonal therapy has been shown to improve outco mes for higher-risk patients who receive radiation as definitive local ther apy. Numerous studies have attempted to devise hormonal therapy regimens th at decrease the adverse physiologic consequences of the currently existing agents and to define the patient population and stage of prostate cancer th at most benefit from the use of hormonal therapy, either alone or in associ ation with additional agents. New hormonal agents currently in clinical tri als may increase the options available for patients who have metastatic can cer or are at increased risk of recurrence after surgery or radiation.