Prostate cancer among young men has increased sixfold in the past 20 years, according to a new University of Michigan analysis. Even scarier, the disease usually spreads faster and is deadlier in guys younger than 55 compared to men in their 70s and 80s.
"The type of prostate cancer younger men get seems to be more aggressive than the 'typical' prostate cancer, which is often slow growing and non-life-threatening," says Dr. Robert Mordkin, chief of urology and director of robotic surgery at Virginia Hospital Center, who was not involved in this research.
Nobody is really sure why prostate cancer is on the rise. "One hypothesis is that we are screening for prostate cancer better than before," says Mordkin, meaning that since more young men are getting PSA screenings, more cancers are being detected at earlier stages. "But this new data suggests screenings are not the reason [for the uptick in cancer cases]—although the researchers aren't sure what is."
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As for why prostate cancer is more aggressive in young men, that has experts puzzled too. "The fact remains that these younger men, which account for 10 percent of all prostate cancer cases, can certainly die from their disease if it is not identified early enough," Mordkin says. "This flies in the face of what has been pushed in the popular press lately — that men don't need to be concerned about prostate cancer. While many older men develop prostate cancer that's not deadly, young men with an aggressive form of the disease need to have it identified early so that doctors can offer interventions that can save their lives."
One thing is for certain: Men with a family history of prostate cancer are at much greater risk of getting the disease themselves. The Michigan researchers say that these men are twice to three times as likely to be diagnosed with prostate cancer, and the risk is even greater for guys with multiple relatives struck by the disease.
"You can't outrun your own genetics," Mordkin says. "Younger men who have a strong history of prostate cancer in their family need to be concerned. Men whose father, brother, or uncle has had prostate cancer should get a baseline PSA blood test and rectal exam at age 40 and then every few years until they hit 50. From there, testing should be done annually."
Mordkin admits that PSA tests aren't perfect — but they can still be life-saving. "Despite the vibrant debate about the PSA test, and its acknowledged shortcomings and inaccuracies, it can still be a helpful test when it's coupled with rectal exam and viewed with a skeptical and educated understanding," he says.