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As I recall you were the third youngest man on the site when you first started posting your story – and I’m very grateful that you have updated that regularly as you head for your ten year anniversary. There are now about thirteen men who were diagnosed after you and at a younger age than you were in 2002.
I find that very sad, but understandable. There has been a consistent thrust ever since the introduction of PSA to reduce the recommended age for PSA testing. The original age was 55, then 50, then 45, then 40 and the latest push that is gathering speed is for men aged 35 and over to be tested. This push for ever younger men being tested has resulted in a reduction of the median age of diagnosis in the USA dropping by about ten years. Prior to PSA testing being introduced the median age was about 75 (so half the men diagnosed were over 75) and it is now about 63 – or was when I last looked. But this reduction in the age of diagnosis has not changed the mortality profile. Most of the men who die from prostate cancer are still dying in their late seventies with the median age for death virtually unchanged at about 83. This means that men are indeed living longer after being diagnosed with PCa, but only because they are being diagnosed earlier.
And as long as there is no differentiation made between the aggressive forms of cancer, which are comparatively rare in these young men, and the indolent forms of the disease, there will sadly be more men diagnosed at ever younger ages and having to live with the regrettable but inevitable side effects for many years longer.
I don’t know how many of you will have seen Dr Jonathan Oppenheimer’s BLOG where he suggests, very sensibly, in my opinion, that
…. that the terms “cancer,” “adenocarcinoma,” “malignancy,” and “tumor” be avoided by on pathology reports unless there exists clear evidence of Gleason pattern 4, more than two cores are involved, or if total lesion length is more than 3mm. The term “tubular neogenesis” followed by an explanation, can better serve the discussion between physician and patient that must follow. As our understanding evolves, criteria for identifying life-threatening prostatic alterations on needle core biopsies in conjunction with serological or urine-based molecular assays, or new non-invading imaging techniques will allow the more aggressive terms to be used without fear of inducing unnecessary medical intervention.
If this distinction were made – and Dr Oppenheimer details why he makes this suggestion, then we would see less men, especially younger men, being rushed into unnecessary treatment.
