Charles Huggins (Ben May Laboratory for Cancer Research, University of Chicago, Chicago, III.).

In certain patients it is clinically possible to induce a profound regression of widely disseminated cancer even in the terminal stages of the disease by modification of the hormonal status of the host. These witherings of extensive cancer in multiple loci are accompanied pari passu by clinical improvement which lasts for more than a decade in favorable cases, the neoplasm remaining in an atrophic condition or having been destroyed-in whole or in part. Prolonged or worth-while relief has been rendered thereby to many people. It is now certain that steroid hormones are of great significance in the maintenance of three neoplasms. The problem is far from solved, however; many patients do not respond to attempts at hormonal control, and in others the relief is of short duration. It would appear that the control of cancer by steroid modifications is in its incipience-only a crack has developed in the facade of cancer.

The purposes of this communication are to present some of the methods of control and to indicate the theoretical considerations which led to the conception of these modes of treatment as indicated by the discoverers.

The control of cancers, to be designated, by hormonal means rests on two principles (15, 27) of medicine, (a) Cancer is not necessarily autonomous and intrinsically self-perpetuating. Some neoplasms retain sufficient characteristics of the normal cells from which they arose that the tumor cells function like the tissue of origin. When the original cells are dependent upon hormonal support for metabolic activity at a high rate, its cancers can be similarly dependent, and these atrophy when hormonal support is withdrawn by any of a number of means; these cancers are by definition dependent tumors. When normal cells concentrate chemical substances selectively, their neoplasms can have the same property; this explains the carcinocidal action of I131 on certain thyroid cancers. (6) The second principle is that disease (here cancer) can be sustained and propagated by hormonal function that is not abnormal in kind or exaggerated in rate but which is operating at normal or even subnormal levels. It is now appreciated that trace amounts of hormones can drive cancer to such exuberant growth that it causes the death of the host.

* This study was aided by grants from the American Cancer Society, Inc., the Illinois Division of the American Cancer Society, the Jane Coffin Childs Memorial Fund for Medical Research, and the VS. Public Health Service.