Adrenalectomy and Hypophysectomy for Carcinoma of the Prostate

Initial attempts to modify the endocrine status of patients with carcinoma of the prostate resulted from acceptance of the assumptions that this neoplasm usually is hormonally controlled and that the response of the malignant prostate to hormonal stimulation is similar to that of normal prostate.¹⁰ The frequently prompt therapeutic response seen following orchiectomy and estrogen administration reinforced these assumptions. The variability in degree and duration of the response to these initial efforts, coupled with the persistent acceptance of the assumptions on which endocrine therapy is based, prompted a search for sources of endogenous hormones which might serve as a continuing stimulus to prostatic growth. Eventually, this focused attention on the adrenals and pituitary and led to utilization of adrenalectomy and hypophysectomy in treating patients with carcinoma of the prostate.

Evidence indicating that the adrenals might contribute to stimulation of prostatic growth came from two sources. Studies in animals demonstrated