Is PCa more aggressive in younger men? ANS: Yes, see this graph.

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Forgot this. It is the timeline between diagnosis and death (horizotal) versus age (vertical). The data is highly respected, from a well known epidemiological study, and yes Terry, I have indeed read the study. Have you ? Sam.

Is PCa more aggressive in younger men?As I have travelled along this PCa journey of mine (sometimes a bit of arollercoaster, sometimes smooth sailing, sometimes better than I could haveimagined) one of the constantly repeated themes is that younger mendiagnosed with prostate cancer have a more aggressive form of the disease.This is often one of the issues lurking in the background when 'younger' menare diagnosed and are told not to consider Active Surveillance,But how true is this? Is it another 'medical belief' ( that's what I thinkof as those aspects of prostate cancer diagnosis and treatment which are notsupported by scientific data, but are practised anyhow) ? Is it a hangoverfrom pre-PSA testing days when it may well have been true? I had never seenany studies that indicate that the incidence of aggressive, fast growingcancer is greater at any specific age, but was directed to one:J Urol. 2009 Nov;182(5):2242-8. Epub 2009 Sep 16. PMID: 19758616 Men olderthan 70 years have higher risk prostate cancer and poorer survival in theearly and late prostate specific antigen eras. This concluded: Men olderthan 70 years had higher risk disease and poorer survival in the early andlate prostate specific antigen eras. Pathological Gleason sums did notchange between the 2 eras. Patient age was an important variable in prostatespecific antigen screening, biopsy, treatment and prognosis.This doesn't quite address the issue of aggressive disease in younger men,but there is some data in this connection that I can extract from mywebsite, using Gleason Scores as an indicator of aggressiveness. I know thatthis data has no scientific value, being entirely anecdotal, not collated byan expert, not published etc etc, but as a broad indication, here are someextracts from the raw information provided to me by those who contribute tothe site:There are today 132 contributors who were under the age of 50 when they werediagnosed (I think they would qualify as 'young'). There are only 58contributors who were over the age of 70 when they were diagnosed - I thinkthey would qualify as 'old' (only for the purposes of this discussionbecause I realize now that I am almost there that 70 isn't really old atall!!).· Of these young men, 64% had Gleason Scores of 6 or belowwhen diagnosed while only 33% of the older men had this score.· 24% of the younger men had GS 7 (regrettably I cannotdistinguish between 7a (3+4) and 7b (4+3) while 38% of the older men hadthis score· 12% of the young men had GS 8 or higher while 29% of theolder men were in this categoryMost of the contributions on the site are from men diagnosed in their 50s(375 men) and their 60s (257 men). The distribution of Gleason Scoresbetween these two large groups does not differ substantially. 51% are GS6:31% are GS 7: 18% are GS 8 and higher.Of course there are other factors to take into account when estimatingaggressiveness of PCA, and, as I say, I know these are not reliable figures,but I would be very surprised if they did not reflect the reality of thesituation. As you will see twice as many young men have a 'less aggressive'Gleason Score of 6 than older men do. The older men on the other hand havemore than twice the number of 'aggressive' disease as indicated by theGleason Scores of 8 and over. I think this indicates that the view thatyoung men will have a more aggressive form of the disease may not becorrect and may well be a medical belief, unsubstantiated by formal study.All the bestTerry HerbertI have no medical qualifications but I was diagnosed in '96: and havelearned a bit since then.My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.zaDr "Snuffy" Myers : "As a physician, I am painfully aware that mostof the decisions we make with regard to prostate cancer are made withinadequate data"

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