An historical perspective of the pathology and treatment

There are inner and outer gland groups in the human prostate. Benign nodular hyperplasia develops from the inner group of glands. Carcinomas arise in the outer glands and spread beyond the prostate at an early stage in the disease. The biological malignancy of prostatic cancer varies from patient to patient and from part to part of the same tumour. Some tumours remain biologically inactive or latent so that there must be some naturally occurring mechanism that controls tumour growth in some cases. This phenomenon is not confined to the prostate but can be found in many other organs, although not so frequently. It may represent a stage in tumour progression or reflect the balance between growth stimulating and inhibiting factors (Franks, 1956b). Our new knowledge of these factors suggests that this may be an area well worth looking at again. Prostatic cancer patients may be divided into groups that differ in their response to endocrine treatment. These differences may be due to changes in the tumour cells or in the host. A temporary state of tumour retardation or latency follows endocrine treatment in about 70-80% of all cases, but whatever form of treatment is used, about 75% of all patients die within 3 years. Even in tumours that show a marked response, endocrine treatment does not destroy all the tumour cells. Hormone sensitivity is not a property of the tumour as a whole but may vary from part to part of the same tumour.(ABSTRACT TRUNCATED AT 250 WORDS)