Transurethral Resection of Malignant Lesions of the Prostate Gland

The attending physician may be asked many difficult questions by the patient afflicted with a malignant process of the prostate gland. Because of the nature of the disease, the patient generally is free of symptoms until the lesion is rather well advanced. Often symptoms of urinary obstruction, such as diminution in the size and force of the stream, and urinary frequency or nocturia, are the first indications of the disease. Less frequently pain caused by skeletal metastasis or loss of weight and anemia without the slightest urinary distress are the only signs of the disease. In either case complete surgical extirpation of the lesion is practically always impossible. Until Huggins and his co-workers1discovered that bilateral castration usually would bring about regression of the local malignant process and of generalized metastasis, surgical procedures, if indicated at all, were at best purely palliative for 95 per cent of all patients