Role of the Ground Substance in Atrophy of Normal and Malignant Prostatic Tissue Following Estrogen Administration and Orchiectomy

BEFORE Huggins and his associates (1) made their observations on the effect of estrogen and castration on prostatic cancer, other workers (2, 3) had pointed out the dependence of prostatic size on the presence of a testicular substance. That estrogen, in the intact animal, would inhibit prostatic growth in the immature rat or decrease normal adult prostatic size was reported by Steinach and Kun (4), and Moore and Price (5). Similar observations were made by others (6, 7). The nuclear pyknosis and general loss of cytologic detail in hyperplastic or carcinomatous prostatic epithelium, treated by castration or with estrogens, has been described in detail (8–11); but for the most part, this has been the limit of histologic study. The local mechanism through which this atrophy occurs has not been clearly described. Little consideration has been given to the possibility that structural alterations in the encompassing connective tissue stroma may play an important role in the causation of the changes seen in the prostate after orchiectomy or estrogen therapy. Several workers (12, 13, 14) however, have described “fibrosis” in the prostate after antiandrogen therapy. It is the connective tissue stroma of the prostate with which we are here concerned.