
Venugopal P
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15 Jan 2023 10:47:27 AMP Ca in Young Men an Emerging Challenge
Dear All,
We all presume that P Ca is a disease of old age and the incidence of this disease occurring in men below 55 years have been considered as Young and the incidence is much lower under 55 when compared to older age group.
In an article published in 2015, it is reported that the
literature on prostate cancer contains < 30 reported cases of prostate
cancer among men ≤ 40 years of age. But this figure may not be factual as more
cases have been found in younger than 40 age group. There was an anecdotal case
reported of P Ca in a two years old child long ago. Sahil Gupta* et al (2015) reported a case of P Ca in a 28 years old male.
I have personally treated (not published) a patient of 19 years old with P Ca.
PSA level is generally
lower in these patients due to poorly differentiated adenocarcinoma of
prostate. So in poorly differentiated carcinoma, PSA level is not indicative of
prostate cancer.
Patients
diagnosed with high grade tumours (Gleason score of 8–10) at ages 35–44 are
also at higher odds of succumbing to prostate cancer as compared to patients
aged 65–74 years. Moreover a strong genetic component has been associated with
early onset prostate cancer. Lange
et al (2012) reported that men with early onset prostate cancer are more likely
to have a greater numÂber of genetic variants, which are associated with an
increased risk of prostate cancer, as compared to older patients.
Archie Blayer, Ronald Barr* et al (2020) studied ‘Prostate Cancer in Young Men: An Emerging Young Adult and Older Adolescent Challenge’ and an excerpt is provided below.
(Full article is available but cannot be downloaded)
‘Recent
observations suggest that prostate cancer is increasing among young adults.
This study investigated incidence and survival data among men <40 years of
age with prostate cancer. Recent observations suggest that prostate cancer is
an increasing disease among older adolescents and young adults. The SEER
program and the Institute for Health Metrics and Evaluation Global Burden of
Disease database were used for analysis. The authors found, worldwide, the
incidence of prostate cancer has increased in all groups between ages 15 and 40
years and has increased globally at a steady rate averaging 2% per year since
1990. In the US, this age group was over six times more likely than older men
to have distant disease at diagnosis. The 5-year relative survival rate in the
US for men diagnosed between ages 40 and 80 years was between 95% and 100%. It
was, however, 30% in those ages 15 to 24 years, 50% in those ages 20 to 29
years, and 80% in those ages 25 to 34 years’. The authors conclude that
prostate cancer in older adolescent and young adult men is increasing in
incidence and is more aggressive compared with prostate cancer in older men.
Environmental factors such as obesity, physical inactivity, and substance
exposure may be contributing.
This fact should
be borne in mind when one encounters a patient with LUTS at an younger age
group.
I am sure there
will be many in our group who might have encountered P Ca in very young
patients and it would be worth sharing it with all.
With warm Regards,
Venu
Atul Kumar Khandelwal
29 Jan 2020 09:49:19 PMI have seen two cases of carcinoma prostrate in young patients. Both patients father also had carcinoma prostrate. One patient's brother also had ca prostate managed by radical prostatectomy.