MEDICAL MANAGEMENT OF ADRENALECTOMY AND HYPOPHYSECTOMY

Abstract

Bilateral adrenalectomy or hypophysectomy will induce objective remissions in some patients with metastatic breast cancer. It is the purpose of this report to detail our methods for managing patients subjected to these procedures. These methods are based on clinical experience and physiological studies of over 200 patients submitted to either adrenalectomy or hypophysectomy. We shall attempt to describe the general medical management for both procedures and to suggest specific methods for handling the problems peculiar to patients with metastatic disease. Huggins and Scott,¹ in 1945, reported the initial experiences with bilateral adrenalectomy in four patients with advanced prostatic cancer. With the use of desoxycorticosterone and adrenal cortical extract they were unable to maintain life in their patients, although one patient survived almost four months. Subsequently, Green and co-workers² successfully managed adrenalectomy in a diabetic patient with the use of large amounts of adrenal cortical extracts. With the availability