The Dihydrotestosterone Hypothesis of Prostate Cancer and Its Therapeutic Implications

The document from 1986 supports the hypothesis that dihydrotestosterone (DHT) is the primary androgen responsible for the growth of prostate cancer, rather than testosterone (T). It suggests that androgen ablative therapy should focus on eliminating DHT while retaining circulating T, which could be achieved by using a 5α-reductase inhibitor like 6-methyleneprogesterone (6-MP). This approach is expected to serve as a prophylactic against prostate cancer, provide palliative treatment for hormone-responsive disease, and be compatible with other therapies. The document reviews the role of androgens in prostate cancer, the impact of newer knowledge on palliative therapy, and the importance of DHT in prostate growth. It also discusses current treatments and proposes that 5α-reductase inhibitors could be an effective therapy for prostate cancer with minimal side effects. The full impact of these new therapeutic approaches was yet to be determined at the time of publication. Specific data on the number of subjects involved in the studies referenced is not provided, so the strength of the conclusions cannot be assessed from this summary.