Prostate cancer in young men: More frequent and more aggressive?

July 15, 2014
Dr. Kathleen Cooney. Credit: University of Michigan Comprehensive Cancer Center

The number of younger men diagnosed with prostate cancer has increased nearly 6-fold in the last 20 years, and the disease is more likely to be aggressive in these younger men, according to a new analysis from researchers at the University of Michigan Comprehensive Cancer Center.

Typically, prostate cancer occurs more frequently as men age into their 70s or 80s. Many are slow-growing and many older men diagnosed with early stage prostate cancer will end up dying from causes other than prostate cancer.

But, the researchers found, when prostate cancer strikes at a younger age, it's likely because the tumor is growing quickly.

"Early onset prostate cancer tends to be aggressive, striking down men in the prime of their life. These fast-growing tumors in might be entirely missed by screening because the timeframe is short before they start to show clinical symptoms," says Kathleen A. Cooney, M.D., professor of internal medicine and urology at the University of Michigan.

Peter Rich was 59 when he was diagnosed with stage 4 prostate cancer. His PSA was only 9, but the disease had already spread to his ribs, spine and lymph nodes.

"To think of mortality was devastating. It was like any major loss – shock and numbness," says Rich, who had to retire from his job as a school social worker because of his cancer treatment.

Rich was diagnosed six years ago. Average survival for stage 4 disease is generally less than three years.

"What we both said when we got the diagnosis was, well, that's not acceptable," Rich says of himself and his wife, Carol. "I'm a fighter."

Cooney and Scott Tomlins, M.D., Ph.D., assistant professor of pathology at U-M, are leading a new study supported by the U.S. Department of Defense to look at DNA of both normal and cancerous prostate tissue of men diagnosed with advanced prostate cancer before age 61. They will be looking at whether these are more likely to have inherited genetic mutations. For more information on this study, contact the U-M Cancer AnswerLine at 800-865-1125.

Men with a family history of prostate cancer have a two- to three-times greater chance of being diagnosed with prostate cancer. That risk increases for young men with multiple affected relatives.

Prostate cancer runs in Rich's family. Like Rich, his brother was diagnosed in his 50s, and a cousin and uncle had prostate cancer as well.

The new analysis, which appears in Nature Reviews: Urology, found that men with prostate cancer had more genetic variants than men diagnosed with prostate cancer at a later age. The researchers suggest that genetic counseling or increased surveillance in younger men with a family history of prostate cancer may be warranted.

American men have a 16 percent risk of developing prostate cancer in their lifetime, but only a 3 percent lifetime risk of dying from it. The challenge, Cooney says, is understanding which subset of prostate cancers are most likely to be aggressive and deadly.

"The unexpectedly poor prognosis of advanced stage early onset prostate cancer supports the idea that a new clinical subtype might exist in the subset of with early onset prostate cancer. This subtype is more aggressive and requires more specialty expertise, including genetic sequencing," Cooney says.

Early Onset Prostate Cancer Statistics

The American Cancer Society estimates 241,740 Americans will be diagnosed with prostate cancer this year; about 10 percent will be early onset disease

Explore further: Depressed men with prostate cancer are diagnosed later stage, get less effective therapies

More information: Nature Reviews: Urology, DOI: 10.1038/nrurol.2014.91

Related Stories

Depressed men with prostate cancer are diagnosed later stage, get less effective therapies

July 10, 2014
Depressed men with localized prostate cancer were more likely to be diagnosed with more aggressive prostate cancer, received less effective treatments and survived for shorter times than prostate cancer patients who were ...

Radiation for prostate cancer linked to secondary cancers, study finds

May 30, 2014
Among men treated for prostate cancer, those who received radiation therapy were more likely to develop bladder or rectal cancer, according to a new study from the University of Michigan Comprehensive Cancer Center.

Vasectomy may increase risk of aggressive prostate cancer

July 9, 2014
Vasectomy was associated with a small increased risk of prostate cancer, and a stronger risk for advanced or lethal prostate cancer according to a new study from Harvard School of Public Health (HSPH). The researchers found ...

Early-onset baldness in African-American men may be linked to prostate cancer

March 26, 2013
Baldness was associated with an increased risk of prostate cancer among African-American men, and risk for advanced prostate cancer increased with younger age and type of baldness, according to data published in Cancer Epidemiology, ...

Study finds prostate cancer tests underestimate disease in half of cases

April 11, 2014
A study published in the British Journal of Cancer suggests that tests to grade and stage prostate cancer underestimated the severity of the disease in half of men whose cancers had been classified as 'slow growing'.

Benefit of aggressive prostate CA Tx weakens as comorbidity rises

May 21, 2014
(HealthDay)—For men with early-stage prostate cancer, the cancer-specific survival benefit associated with aggressive prostate cancer treatment is reduced with increasing comorbidity, according to a study published online ...

Recommended for you

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

Novel CRISPR-Cas9 screening enables discovery of new targets to aid cancer immunotherapy

July 19, 2017
A novel screening method developed by a team at Dana-Farber/Boston Children's Cancer and Blood Disorders Center—using CRISPR-Cas9 genome editing technology to test the function of thousands of tumor genes in mice—has ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.