Harvard Perspectives on Prostate Disease

Strong bones, healthy heart

Advice for men considering hormone therapy for prostate cancer

For more than a century, doctors have known that hormones play a role in prostate health. But they didn't understand the link between the two until 1941, when Dr. Charles Huggins demonstrated the healthy prostate's dependence on the male sex hormones testosterone and dihydrotestosterone for growth. He also proved that shutting off the production of these hormones — either with surgical castration or with the drug diethylstilbestrol (DES) — would tamp down the growth of prostate tumors. Since then, hormone therapy has been the mainstay of treatment for men with advanced prostate cancer.

Although surgical removal of the testicles, or orchiectomy, is a relatively simple operation, most men wanted to avoid the procedure — and the psychological impact that can accompany castration. Instead, they opted for DES, a form of estrogen. Trials launched by the Veterans Administration Cooperative Urological Research Group (VACURG) in the 1960s supported its use: there was no statistically significant difference in survival rates between patients taking the drug and those undergoing orchiectomy.

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