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The Inexorable March of Prostate Cancer Research Testosterone and Beyond (2023)
Kevin R. Loughlin, MD, MBA
INTRODUCTION
Wikipedia defines a generation as being 20 to 30 years.1 Although not strictly proven, it has been suggested that surgeons are at their peak from 35 to 55 years of age.2,3 It therefore should come as no surprise that over the past century or so that, with some noticeable exceptions, major discoveries in prostate cancer treatment have occurred at 20-year intervals.
It can be theorized that each new generation of physicians, surgeons, and nonphysicians alike inherit the knowledge of those who have gone before them. Their own experience accrues, and by the time they reach their professional maturity in their fifties, they have contributed to and added to the knowledge of their field. With this as a construct, the author reviews the history of prostate cancer treatment discoveries over slightly more than the past hundred years.
*THE SURGICAL FOUNDATION: HUGH HAMPTON YOUNG,1904
*THE BRITISH EMPIRE CANCER CAMPAIGN: 1923
*CHARLES HUGGINS: THE TESTOSTERONEPROSTATE CANCER LINK: 1941
*THE VETERANS ADMINISTRATION COOPERATIVE UROLOGICAL RESEARCH GROUP STUDIES 1960-1975
*DONALD GLEASON: PATHOLOGIC SCORING OF PROSTATE CANCER: 1962
*THE IDENTIFICATION OF PROSTATE-SPECIFIC ANTIGEN: 1970
*ANDREW SCHALLY: GONADOTROPINRELEASING HORMONE AGONIST ANALOGUES, 1972-1978
*PATRICK C. WALSH: NERVE-SPARING RADICAL PROSTATECTOMY, 1982
*MALCOLM BAGSHAW AND RADIATION THERAPY FOR PROSTATE CANCER
*WILLET F. WHITMORE AND INTERSTITIAL IMPLANTATION OF IODINE-125
*LAURENCE KLOTZ AND ACTIVE SURVEILLANCE OF PROSTATE CANCER
*LAPAROSCOPIC AND ROBOTIC PROSTATECTOMY
*THE ANTIANDROGENS
*PROSTATE BIOPSY TECHNIQUES
*GENETIC TESTING AND PROSTATE CANCER RISK
*BIOMARKERS
*IMMUNOTHERAPY AND PROSTATE CANCER
*POLY(ADENOSINE DIPHOSPHATE-RIBOSE) POLYMERASE INHIBITORS AND PROSTATE CANCER
PROSTATE CANCER RESEARCH: THE MODERN ERA
It is fair to say that there have been several eras in prostate cancer research. The ground-breaking research of Huggins in the 1940s provided the underpinning for the understanding of the role of testosterone in the development of prostate cancer. The period from 1982 to 2002 may well be considered to be the Localized Prostate Cancer Era. The period from 2002 until now may be considered the Indolent Prostate Cancer Era. Now it would appear that we are entering the Prostate Cancer Genetics and Metastatic Prostate Cancer Era.
The next 20 years hold great promise for prostate cancer treatment. The collaborative research of urologists, radiation oncologists, medical oncologists, endocrinologists, and basic scientists will undoubtedly result in major clinical breakthroughs that will benefit our patients.
Kevin R. Loughlin, MD, MBA
INTRODUCTION
Wikipedia defines a generation as being 20 to 30 years.1 Although not strictly proven, it has been suggested that surgeons are at their peak from 35 to 55 years of age.2,3 It therefore should come as no surprise that over the past century or so that, with some noticeable exceptions, major discoveries in prostate cancer treatment have occurred at 20-year intervals.
It can be theorized that each new generation of physicians, surgeons, and nonphysicians alike inherit the knowledge of those who have gone before them. Their own experience accrues, and by the time they reach their professional maturity in their fifties, they have contributed to and added to the knowledge of their field. With this as a construct, the author reviews the history of prostate cancer treatment discoveries over slightly more than the past hundred years.
*THE SURGICAL FOUNDATION: HUGH HAMPTON YOUNG,1904
*THE BRITISH EMPIRE CANCER CAMPAIGN: 1923
*CHARLES HUGGINS: THE TESTOSTERONEPROSTATE CANCER LINK: 1941
*THE VETERANS ADMINISTRATION COOPERATIVE UROLOGICAL RESEARCH GROUP STUDIES 1960-1975
*DONALD GLEASON: PATHOLOGIC SCORING OF PROSTATE CANCER: 1962
*THE IDENTIFICATION OF PROSTATE-SPECIFIC ANTIGEN: 1970
*ANDREW SCHALLY: GONADOTROPINRELEASING HORMONE AGONIST ANALOGUES, 1972-1978
*PATRICK C. WALSH: NERVE-SPARING RADICAL PROSTATECTOMY, 1982
*MALCOLM BAGSHAW AND RADIATION THERAPY FOR PROSTATE CANCER
*WILLET F. WHITMORE AND INTERSTITIAL IMPLANTATION OF IODINE-125
*LAURENCE KLOTZ AND ACTIVE SURVEILLANCE OF PROSTATE CANCER
*LAPAROSCOPIC AND ROBOTIC PROSTATECTOMY
*THE ANTIANDROGENS
*PROSTATE BIOPSY TECHNIQUES
*GENETIC TESTING AND PROSTATE CANCER RISK
*BIOMARKERS
*IMMUNOTHERAPY AND PROSTATE CANCER
*POLY(ADENOSINE DIPHOSPHATE-RIBOSE) POLYMERASE INHIBITORS AND PROSTATE CANCER
PROSTATE CANCER RESEARCH: THE MODERN ERA
It is fair to say that there have been several eras in prostate cancer research. The ground-breaking research of Huggins in the 1940s provided the underpinning for the understanding of the role of testosterone in the development of prostate cancer. The period from 1982 to 2002 may well be considered to be the Localized Prostate Cancer Era. The period from 2002 until now may be considered the Indolent Prostate Cancer Era. Now it would appear that we are entering the Prostate Cancer Genetics and Metastatic Prostate Cancer Era.
The next 20 years hold great promise for prostate cancer treatment. The collaborative research of urologists, radiation oncologists, medical oncologists, endocrinologists, and basic scientists will undoubtedly result in major clinical breakthroughs that will benefit our patients.
