Prostate cancer, aka the “silent killer”, has always been known as an older man’s disease. Being the second most common cancer among men in the United States, prostate cancer occurs mainly in older men. The average age of diagnosis is about 66, and about six in ten prostate cancer cases are diagnosed in men age 65 or older, according to the American Cancer Society. It is the second leading cause of cancer death in American men; about 1 in 38 will die from it. But what many people are unaware of is that prostate cancer is not just an older man’s disease. Men younger than 50 (as young as 40, and sometimes younger) can get prostate cancer too.
The number of younger men diagnosed with prostate cancer has increased nearly six-fold in the last twenty years. Today, over 10 percent of new prostate cancer diagnoses in the US occur in young men younger than 55 years old. What’s more alarming is that for younger men, the disease is often much more aggressive. Prostate cancer typically affects men in their 60s, 70s and older, and is often slow-growing. For this reason, older men are likely to die of causes other than prostate cancer, rather than of prostate cancer. But when younger men are diagnosed with prostate cancer, it is likely because they have developed a tumor that is growing quickly and aggressively.
Because of the current PSA guidelines established by governmental agencies like the US Preventive Services Task Force, many doctors or urologists do not recommend PSA tests until a man is in his 50s. In fact, the USPSTF recommends against PSA screening completely, claiming there is not enough evidence to support the benefits of the test. Other agencies or organizations recommend that men begin testing their PSA at age 50 or 55. However, this is simply not good enough.
What men should know:
1. Get a baseline PSA test starting at age 40. Men should have a baseline PSA test starting at age 40. There is no harm in knowing your numbers. PSA results should be discussed with an experienced specialist who can guide you in the right direction about how to follow up and what to be aware of.
2. Know your family’s medical history for prostate cancer. Knowing your family’s medical history is just as important. Men who have a brother or father with a history of prostate cancer are twice as likely to be diagnosed with the disease. For younger men, the risk is even higher if they have multiple relatives with a history of prostate cancer. This should also be discussed with the same experienced specialist who checks your PSA level.
3. African-American men have the highest risk for prostate cancer. African-American men should especially be aware of prostate cancer. African-American men are 60 percent more likely to develop prostate cancer and are 2.5 times more likely to die from it. African-American men are also diagnosed at a younger age (about 3 years younger) and are more likely to have high-grade or aggressive tumors.
Prostate cancer can truly be a “silent killer.” There are usually no symptoms present until the disease is in an advanced stage. This is why early detection is key. Screening for prostate cancer is essential in order to find the disease early. Detecting prostate cancer early allows men to have more treatment options and more effective treatment in general. When prostate cancer is discovered in the early stages when it is still confined to the prostate gland, the cure rate is almost 100 percent. Early detection methods include a PSA (prostate-specific antigen) blood test, digital rectal exam (DRE), a prostate biopsy, and a PCA3 urine test.