Androgen deprivation
therapy for
prostate cancer was pioneered by Charles Huggins, laureate of the Nobel Prize in Medicine in 1966. The authors tried to understand the scientific context and how previous findings paved Huggins way to his discoveries. With the help of summary or review articles on
androgen deprivation
therapy, the authors identified key publications and used his Nobel Prize speech as a basis to understand his discoveries. Furthermore, they used a recording of the laboratory-talk interview he gave about his findings to guide them to relevant publications. The authors found that the basis for Huggins' discoveries was the isolation of
testosterone in 1935, not long before Huggins' 1941 hallmark publication. Huggins' work follows major experiments in the 19th century in
orchiectomy done as a treatment for prostate
hypertrophy. Researching the etiology of idiopathic hydrocele, Huggins analyzed the composition of prostate fluid. Further research led to the discovery of the influence of
castration,
testosterone, and
estrogen on
acid phosphatase. Recently developed methods facilitated the measurement of the
phosphatases. He, therefore, had a
biomarker for metastatic
prostate cancer to measure treatment response. Very early on, he reported clinical improvements after
castration in metastatic patients. Although the effect of
orchiectomy on prostate
hypertrophy was already known, Huggins was the first to show that
testosterone stimulated and
estrogen decreased the activity of
prostate cancer. Huggins also established
phosphatases as a
tumor marker to measure disease response.