RE: Is PCa more aggressive in younger men?

[Guest guest]

There seems to be a lack of clarity in my original post which I regret. I

was not suggesting that young men were never diagnosed with an aggressive

form of the disease. I know only too well that they are - and that those

young men who are unfortunate enough to have this type of diagnosis die far

too soon. The point I was trying to develop was that many young men were

NOT diagnosed with aggressive forms of the disease and that, compared to

older men, there was a significantly lower number of younger men with

aggressive disease.

A poster on one site suggested that a study published in July of this year

might be useful. The study was Cancer. 2009 Jul 1;115(13):2863-71.

Treatment and survival outcomes in young men diagnosed with prostate cancer:

a Population-based Cohort Study. PMID: 19466697

There are two relevant points in the Abstract for this study (I have not had

an opportunity of reading the entire document):

1. Younger men were less likely to be diagnosed with high-grade cancer, and,

as a group, to have better overall and equivalent cancer-specific survival

at 10 years compared with older men. The diagnostic point is what the data

from my site seems to demonstrate. The site has not been running long enough

to demonstrate any survival rates.

2. Among men with high grade and locally advanced prostate cancer, the

youngest men had a particularly poor prognosis compared with older men. This

seems in line with the Albersen paper - Competing risk analysis of men aged

55 to 74 years at diagnosis managed conservatively for clinically localized

prostate cancer. JAMA 1998 Sep 16;280(11):975-80 -which also found that

young men with low grade disease had a better survival rate than older men

with the same grade, but that the position was reversed when the disease was

high grade. In those cases the young men had a poorer outcome.

I hope this helps to make clear my intention in my original post.

But I also think it is important to get the values of these percentages into

focus. According to the latest figures I could find for the US (for 2005)

28,905 men died of PCa. That is an awful number to contemplate, but the

total number of male deaths from all causes was said to be 1,207,675. This

means that the percentage of men who died from PCa was about 2.4% of the

total number of male deaths - or put another way 97.6% of the men who died,

died from something other than PCa.

When we look at a breakdown of those PCa deaths we see this from the SEER

statistics from 2002 - 2006:

1. The median age at death for cancer of the prostate was 80 years of age -

so half the men who died were over the age of 80

2. Statistically, there were no PCa deaths of men under the age of 35

3. 0.1% of the deaths - about 29 - occurred in men aged between 35 and 44;

4. 1.4% of the deaths - about 405 - occurred in men aged between 45 and 54;

5. 7.2% of the deaths - about 2,081 - occurred in men aged between 55 and

64;

6. 20.1% of the deaths - about 5,810 - occurred in men aged between 65 and

74;

7. 40.9% of the deaths - about 11,822 - occurred in men aged between 75 and

84; and

8. 30.3% of the deaths - about 8,758 - occurred in men aged 85+ years of

age.

About 9.3% ( or 17,288 men) out of the 185,895 men diagnosed with PCa were

under the age of 55: about 1.5% ( or 434 men) out of the of the 28,905 who

died of PCa were under the age of 55.

About 26.1% ( or 48,518 men) out of the 185,895 men diagnosed with PCa were

over the age of 75: about 71.2% ( or 20,580 men) out of the of the 28,905

who died of PCa were over the age of 75.

I'm no statistician, but it seems to me that older men have more aggressive

versions of the disease.

All the best

Terry Herbert

I have no medical qualifications but I was diagnosed in '96: and have

learned a bit since then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr " Snuffy " Myers : " As a physician, I am painfully aware that most

of the decisions we make with regard to prostate cancer are made with

inadequate data "