William Halsted and Prostate Cancer Progression (European Urology)

For the past 100yr, urologists have viewed prostate cancer through the paradigm attributed to William Halsted that cancers arise at a single location, grow there, and eventually spread to lymph nodes and distant metastatic sites [1]. Early pioneers of prostate cancer therapy such as Barringer and Young advocated for prostate cancer screening in order to find this disease in an early phase to allow treatment before metastases developed. Stamey`s 1987 report of prostate-specific antigen (PSA) followed by Catalona`s 1991 observation that PSA testing could increase the identification of localized cancer was greeted with considerable enthusiasm by US urologists, and led to a dramatic increase in the incidence of this disease and a significant rise in the rate of radical prostatectomy.