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March 2, 1957


JAMA. 1957;163(9):709-712. doi:10.1001/jama.1957.02970440005002

• The results of palliative treatment of prostatic carcinoma were observed in 1,249 patients followed for five years or more. The high incidence of this disease makes rectal examinations advisable in all men over 50 years of age. The shortness of life expectancy and the amount of suffering seen when the treatment has been palliative argue in favor of radical prostatectomy. The advent of radical retropubic prostatectomy has made total extirpation more generally available; it has also shed new light on the mode of spread of the growth. Such spread was found in 30 out of 100 patients without elevated acid phosphatase levels in the blood or evidence of bone involvement. Interstitial irradiation with a colloidal form of radiogold (Au198) has been done in 389 patients with prostatic carcinoma that had extended too far locally to be operable but had not yet metastasized to the bones. It has been found possible to avoid radiation injury to the bladder and rectum, and of the first 100 patients in this series 22 are alive without clinical evidence of disease. Endocrine therapy has often given dramatic though temporary improvement, and the relief from pain has in some cases been lasting. The modern treatment of prostatic carcinoma requires the combined resources of surgery, chemistry, endocrinology, and radiology.