Aronowitz Robert
Bull Hist Med. 2014 Summer;88(2):287-318. doi: 10.1353/bhm.2014.0037.
Between 1951 and 1966, more than twelve hundred homeless, alcoholic men from New York's skid row were subjected to invasive medical procedures, including open perineal biopsy of the prostate gland. If positive for cancer, men typically underwent prostatectomy, surgical castration, and estrogen treatments. The Bowery series was meant to answer important questions about prostate cancer's diagnosis, natural history, prevention, and treatment. While the Bowery series had little ultimate impact on practice, in part due to ethical problems, its means and goals were prescient. In the ensuing decades, technological tinkering catalyzed the transformation of prostate cancer attitudes and interventions in directions that the Bowery series' promoters had anticipated. These largely forgotten set of practices are a window into how we have come to believe that the screen and radical treatment paradigm in prostate cancer is efficacious and the underlying logic of the twentieth-century American quest to control cancer and our fears of cancer.
在1951年至1966年期间,来自纽约贫民区的1200多名无家可归的酗酒男子接受了侵入性医疗程序,包括开放性前列腺会阴活检。如果前列腺癌检测呈阳性,这些男子通常会接受前列腺切除术、手术去势和雌激素治疗。鲍厄里系列研究旨在回答有关前列腺癌的诊断、自然史、预防和治疗的重要问题。虽然鲍厄里系列研究最终对临床实践影响甚微,部分原因是伦理问题,但其方法和目标具有先见之明。在随后的几十年里,技术改进推动了前列腺癌治疗观念和干预措施朝着鲍厄里系列研究倡导者所预期的方向转变。这些基本上已被遗忘的医疗实践是一扇窗口,让我们得以了解我们是如何开始相信前列腺癌的筛查和根治性治疗模式是有效的,以及20世纪美国控制癌症的追求和我们对癌症的恐惧背后的逻辑。