Younger men = more aggressive PC?

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JerseyG
Regular Member


Date Joined Feb 2009
Total Posts : 65
   Posted 3/28/2009 1:19 PM (GMT -6)   
Is there any truth or scientific evidence that younger men tend to have more aggressive PC?
Age now 44 (43 when dx)
 
Pre-op PSA:  0.9
Biopsy: 3/12 cores pos  20% 30% 50%
Gleason 3+3=6
Robotic RP:   Aug 08 1 day hospital stay, cath out on 8th day.
Post Surgery Pathology Report: Gleason 6, pT2c, tumor 10% contained in prostate gland, all margins negative. Negative lymph nodes
Post Op PSA: Dec 08 <0.1
Post Op PSA: Mar 06 <0.1


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 3/28/2009 2:58 PM (GMT -6)   
Last year maybe..this year the opinion is different!!

Truth is probably more likely that younger men will no doubt spread if left untreated for long. Also, younger men aren't tested early enough to catch earlier stage cancers still. The most Agressive types may have a genetic link.

I've often wondered if our younger men presenting with cancers are part of the chemical / hormone (especially hormones) additive generation. The 30-40 somethings would be in that first generation of heavily produced preservative, chemical and horomone enhanced products.

swim
 


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 3/28/2009 3:47 PM (GMT -6)   
Don't know about the agression part, but my doc said that with our family history (my Dad and 2 of his brothers and now me) our son should begin PSA testing at 35.  I think its more of a heredity thing rather than agression.  David

Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
Great wife and family who take very good care of me


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2457
   Posted 3/28/2009 5:17 PM (GMT -6)   
JerseyG, If that was the case then why do I have aggressive PCa at the age of 67? I agree that gennes has something to do with that. My father had PC and my brother also did although he died of a heart attack and not PCa.
Age: 67
Retired in 2001 and living in Austin TX.
PSA 3.5 free PSA 11%
Dx 12/30/08
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
Post op Pathology report:
Prostate weighed 57 grams
size:5.2 x 5.0 x 4.9 cm
10-20% involved
Bilateral
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
Lymph nodes: not dissected
seminal vesicles clean


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 672
   Posted 3/28/2009 5:22 PM (GMT -6)   

 

So far, my son age 42 has not inherited my high blood pressure, high cholesterol, or prostate cancer.  However he has inherited my good looks. smilewinkgrin


AndrewJ
Regular Member


Date Joined Jul 2007
Total Posts : 25
   Posted 3/29/2009 3:23 AM (GMT -6)   
Thnking again about what I want to post it seems a very unlikely explanation, but one urologist I saw told me that PCa in younger guys is often aggressive because a less aggressive cancer would have been "dealt with" by the body. It made sense to me at the time, but now it sounds strange. I never heard of the body blocking out a weak cancer. In any case, mine started off with low PSAs and a mid-range Gleason, but the pathology said it had reached to less than 1mm from the capsule by the time it was removed, so I eternally grateful that it was found when it was.
46 years old (45 at diagnosis), Australian living in Germany
PSA: started around 3.5 in 2005, 6.1 at time of surgery
Biopsy: nothing found in 2006, 3 May 2007 3 of 24 cores positive, Gleason 3+3 or 3+4 depending on pathologist
RPE in Munich, Germany on 22 June 2007
Post surgery pathology: organ confined but less than 1mm from margins, Gleason 3+3, pT2c, Lymph nodes removed and clear
First post-surgery PSA 31 July 2007: 0.01 Confirmed every 3 months since. Fully continent immediately after removal of catheter on Day 8.
No potency issues but still taking small doses of generic Levitra "as required" as my security blanket.
This man knows he has been VERY lucky.


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4823
   Posted 3/29/2009 4:58 AM (GMT -6)   
I've seen a few articles that state breast cancer in 30'ish women tends to be very aggressive cancer.
Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
 
06/25/08 - Da Vinci robotic laparoscopy
Catheter in for five weeks.
Dry after 3 months.
 
10/03/08 - 1st Quarter PSA -> less then .01
01/16/09 - 2nd Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.
 


DJBearGuy
Veteran Member


Date Joined Dec 2008
Total Posts : 714
   Posted 3/29/2009 8:54 AM (GMT -6)   
I've also heard that for cancer in general, cancer in younger people tends to be more aggressive.
Diagnosis at age 53. PSA 2007 about 2; PSA 2008 4.3
Biopsy September 2008: 6 of 12 cores positive; Gleason 4+3 = 7
CT and Bone scan negative
Da Vinci surgery at City of Hope December 8, 2008
Radical prostatectomy and lymph node dissection
Catheter out on 7th day, replaced on 8th day, out again 14th day following negative cystogram
Pathology: pT2c; lymph nodes negative; margins involved; 41 grams, 8% involved by tumor; same Gleason 4+3=7
PSA 1/22/08 non-detectable! 8-)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/29/2009 5:54 PM (GMT -6)   

Special thanks to Gordon McCleod on the PPML for this info...This is what I understood as well.  Why it seems like younger guys get more aggressive disease may be due to only being screened when symptoms are present.  Just my thought. 

 

Of men dignosed with prostate cancer...

 

Sources: NPCR and SEER

 

76% of white men between 40 and 49 have stage I or II cancers.

75% of white men between 50 and 59 have stage I or II cancers.

73% of white men between 60 and 69 have stage I or II cancers.

68% of white men between 70 and 79 have stage I or II cancers.

53% of white men between 80 and 89 have stage I or II cancers.

 

21% of white men between 40 and 49 have stage III cancers.

21% of white men between 50 and 59 have stage III cancers.

23% of white men between 60 and 69 have stage III cancers.

25% of white men between 70 and 79 have stage III cancers.

35% of white men between 80 and 89 have stage III cancers.

 

A smaller percentage of men had stage IV cancers (eg. 456 per 100,000 aged 50-59)

 

Tony

 


Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 3/29/2009 6:18 PM (GMT -6)   
Tony, This is very interesting data that you bring up... Breast cancer among younger women is often thought to be more agressive than the cancer after menopause. My mother died of breast cancer at 50..... Pete, my husband, who is a scientist, believes that his cancer, found earlier than his father's. (who died at 95) of something else, may have something to do with Vitamin D3.... The main thinking in this family is: No one as yet, knows why, how, or what started the cancer.....AND we are hoping for genetic science to bring more light to this cancer, and how to treat it at each stage. African American men in the northern climates often have higher incidences of cancer maybe because of Vitamin D ....The skin does not assimilate Vit D....The farther north ..the more incidence of prostate AND breast cancer....Vitamin D is a hormone....not just a vitamin, and the 400 units that the government regulated was because of rickets in children in much earlier years....I dont say this is the reason for prostate or breast cancer, I am just suggesting that it should be looked at as a possible contributor.....By the way, we are taking over 2000 units a day......Diane
Husband Pete
dx Jan 2001 gleason 4 + 3 PSA 16.5
Seed implant and conformal radiation and Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06 Dr. Eastham
Fistula operation 2/07 MSK Dr. Wong
Many cystoscopies and ER visits with strictures
Catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/08
AUS Operation at MSK Sept 8 2008 Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK
Some difficulty with AUS arising Nov 10 2008
Meeting with Dr. Sandhu to discuss AUS problems and new PSA test Dec 11, 2008
PSA .6 12/08
AUS improving..only 2 pads a day and one at night
Complete hip replacement surgery Dr. Waters Gainesville, FL 1/9/09
Hip replacement total success..pain gone!!
PSA .7 2/10/09


Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 5/17/2009 3:26 PM (GMT -6)   
JerseyG

What prompted you to get a biopsy for PC? I would think a .9 psa wouldn't have indicated cancer in a 40 year old.

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4188
   Posted 5/17/2009 6:21 PM (GMT -6)   
I don't think that there is any hard evidence to support that younger men get more aggressive cancer. Aggressive cancer is about 20-30% of all PC and 70% -80% cure rates and the 30% reoccurrance rates are in this range. I don't think think is a difference in either cure rates or reoccurrance rates between younger or older men.
The data Tony posted is in this range, but from the data it seems that in the above 80 group the cancer has gotten more aggressive most likely because it has been around a lot longer, 20-30 years.
JT

64 years old.

I had an initial PSA test in 1999 of 4.4. PSA increased every 6 months reaching 40 in 5-08. PSA free ranged from 16% to 10%. Over this time period I had a total of 13 biopsies and an endorectal MRIS all negative and have seen doctors at Long Beach, UCLA, UCSF and UCI. DX has always been BPH and continue to get biopsies every year.

In 10-08 I had a 25 core biopsy that showed 2 cores positive, gleason 6 at less than 5%. Surgery was recommended and I was in the process of interviewing surgeons when my wife's oncologist recommended I get a 2nd opinion from a prostate oncologist.

I saw Dr Sholtz, in Marina Del Rey, and he said that the path reports indicated no tumor, but indolant cancer clusters that didn't need any treatment. He was concerned that my PSA history indicated that I had a large amount of PC somewhere that had yet to be uncovered and put me through several more tests.

A color doppler targeted biopsy in 11-08 found a large tumor in the transition zone, gleason 6 and 7. Because of my high PSA Dr. suspected lymph node involvement, 30% chance, and sent me to Holland for a Combidex MRI, even though bone and CT scans were clear.

Combidex MRI showed clear lymph nodes and a 2,5 cm tumor in the anterior. I was his 1st patient to come up clear on the Combidex which has a 96% accuracy,

I've been on a no meat and dairy diet since 12-08 and PSA reduce to 30 while I awaited the Combidex MRI.

The location of the tumor in the anterior apex next to the urethea makes a good surgical margin very unlikely. Currently on Casodex and Proscar for 8 weeks to shrink my 60 mm prostate. Treatment will be seeds followed by 5 weeks of IMRT while continuing on Casodex and Proscar. So far no side affects from the Casodex.

As of April 10 and 7 weeks on Casodex and Proscar PSA has gone from 30 to 0.62 and protate from 60mm to 32mm. Very minor side affects. Doc says all this indicates tumor is not aggessive

Awaiting schedule for seed impants

 


Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 5/17/2009 6:46 PM (GMT -6)   

When I was diagnosed last year my first doc said I was one of the "young guys" so he found that strange.  I guess the rumor persists that this is the "old man's disease."  However, since I came to this site I see a lot of men younger than me who are getting this disease.  So I'm wondering what prompted them to get tested?  Was it found during routine DRE's or were there symptoms?  I had symptoms of BPH (Thank you, Flomax) and it snowballed from there.  I also wonder how many "young" guys have gotten this in relation to men my age?  Since we only have the members of the folks who have found this site, we may never know.  I gotta stop thinking so much.

 

Bob


 AGE:57
 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T1c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci Jan. 19th, No lymph node involvement, all margins clear.
 8 week PSa <0.01
 Gleason downgraded to (3+4)7
 Fully continent...ED progressing as expected.


JerseyG
Regular Member


Date Joined Feb 2009
Total Posts : 65
   Posted 5/17/2009 11:15 PM (GMT -6)   
Squirm,
 
No symptoms, during my annual physical the doc felt "something" while performing DRE. That led to a biopsy. Biopsy was positive in 3 of 12 cores.  Gleason 6.

Age now 44 (43 when dx)
 
Pre-op PSA:  0.9
Biopsy: 3/12 cores pos  20% 30% 50%
Gleason 3+3=6
Robotic RP:   Aug 08 1 day hospital stay, cath out on 8th day.
Post Surgery Pathology Report: Gleason 6, pT2c, tumor 10% contained in prostate gland, all margins negative. Negative lymph nodes
Post Op PSA: Dec 08 <0.1
Post Op PSA: Mar 06 <0.1

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