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Dr. Huggins and the Nobel Prize

Shahar Madjar, MD

Even if you listened carefully, you could not hear your cells talking. But they do; they converse and instruct each other, their voice is carried not by sound waves but by molecules called hormones. This is a story about a urologist, Charles Brenton Huggins, who did not only listen to the conversation between cells but also chimed into it, and by doing so, was able to extend the lives of his cancer patients, and millions of other cancer patients.

Dr. Huggins, a Canadian-born doctor did not plan to be a urologist. After obtaining a medical degree from Harvard University, he was originally slated to perform thyroid surgery at the Billings Hospital at the University of Chicago. When the need arose, though, for someone to perform cystoscopies (in which a small camera is used to examine the inside of the bladder), he obliged, later to become a leader in the field of urology. As a researcher, his main interest lied in both urological and cancer research.

Dr. Huggins knew that cells talk to each other, and that they do so, among other ways, by using hormones. Cells in the pituitary gland, a pea-size gland at the base of the brain, for example, make a hormone called Luteinizing hormone, then release it to the blood stream. It tells cells in the testicles to produce testosterone. The cells within the testicles oblige, and testosterone is made and released into the blood stream. Testosterone, in turn, instructs different cell groups in different tissues and organs to change. During  puberty in boys, for example, testosterone encourages tissues within the testicles and penis to enlarge, and pubic hair follicles to suddenly grow hair. The voice begins to deepen. Muscle cells grow. Sex drive develops. Testosterone calls almost each and every cell in a boy’s body for change, turning boys into men.

Dr. Huggins knew that prepubertal castration (and thus the elimination of testosterone production) had multiple effects on the body including inhibition of prostate growth. In a series of experiments in dogs, Huggins demonstrated that the male sex hormones stimulated the function and the growth of their prostates while female sex hormones inhibited it.

Are the effects of hormones limited to normal cells? Do cancer cells also ‘listen’ to hormonal messages? And if so, could a change in the hormonal environment halt the proliferation of cancer cells, even kill them? 

Dr. Huggins decided to experiment on a group of men with advanced prostate cancer – some with cancer that had spread to their bones.

I can only imagine the doctor-patient conversations that took place, the explanations that were given to these unfortunate cancer patients about prostate cancer and testosterone, and how changing their hormonal environment may help them to combat cancer. “I am requesting your permission to eliminate the source of testosterone in your body by removing both of your testicles,” Dr. Huggins must have told his patients.” Answering if he has ever tried it before, he must have responded with a sounding ‘No’.

It was in the early 1940s

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