A paradoxical, but logical finding, indicates that I am more likely to die from prostate cancer than my fellow pc survivors. In the world of prostate cancer I am a young man. I was diagnosed at 50 years and suffered a recurrence at 55 years, in the prostate cancer world this makes me a young man with advanced prostate cancer.

Research shows that young men with prostate cancer have a low risk of dying early, those with advanced forms of cancer do not live as long as older men with similar forms of the disease. That is the conclusion of a new study published in the July 1, 2009 issue of Cancer, a peer-reviewed journal of the American Cancer Society.

Possibly, there are biological differences between prostate cancers that develop in younger men (me) and those that develop in older men. Using this issue could it be possible to develop screening tools and treatment modalities that recognize and respond to these differences? How important is age in considering the best treatment protocol?

There have been few studies have analyzed the health of younger vs. older men after diagnosis and treatment for prostate cancer. In general, a younger prostate cancer survivor has a better prognosis than an older survivor, but the younger advanced prostate cancer survivor has a worse prognosis.

Daniel Lin, M.D., of the University of Washington and colleagues designed a study to examine the association between age at diagnosis and health outcomes in men diagnosed with prostate cancer in the United States. They extracted data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database, the investigators identified 318,774 men diagnosed with prostate cancer between 1988 and 2003. Men aged 35 to 74 years were stratified by age at the time of diagnosis, and the researchers examined differences in tumor characteristics, treatment, and survival within each age group.

The analysis revealed that, over time, men are being diagnosed with prostate cancer at younger ages, likely due to more extensive screening. Also, younger men are more likely to be treated with prostatectomy, have less aggressive cancers, and have a better chance of survival after 10 years compared with older men. However, among men with advanced prostate cancers, the youngest men (aged 35 to 44 years) have a particularly poor prognosis compared with older men. These young men are more likely to die from cancer or another cause sooner than older men with similar forms of cancer.

The most logical conclusion for this is that young men with advanced prostate cancer may have biologically more aggressive forms of the disease than the forms that are diagnosed in older men. Additional studies are needed to determine what, if any, underlying differences exist between advanced prostate cancer found in young men vs. those found in older men. If these differences can be identified, than perhaps they can be exploited to allow better, more accurate screening and treatment for both younger men and older men

“Treatment and survival outcomes in young men diagnosed with prostate cancer: a population based cohort study.” Daniel W. Lin, Michael Porter, and Bruce Montgomery. CANCER; Published Online: May 22, 2009 (DOI: 10.100224324/cncr.24324); Print Issue Date: July 1, 2009.

Joel T Nowak MA, MSW