Prostate cancer on the rise in younger patients: concern over declining age and aggressiveness

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MUMBAI: Eighteen months ago, S Nikhil*, a resident of Marine Drive, got his first full-body check-up after the Covid pandemic because his friends were doing it. His report, however, came back with alarmingly high levels of prostate-specific antigen (PSA) — a tumor marker for Prostate cancer.
“I was then 55 years old, active, played tennis almost every day and had no symptoms to suspect that cancer was growing in my prostate glands,” said the businessman.
Besides being asymptomatic, there was another reason Nikhil didn’t suspect prostate cancer: It’s commonly associated with men in their 70s and 80s. A subsequent biopsy revealed that Nikhil had grade 8 prostate cancer that required immediate surgical attention.
Uro-Oncologists Dr. Anup Ramani and Dr. For Amit Joshi, Nikhil’s case underscores a new downward trend. Age No beginning For prostate cancer. Unfortunately, these are more young men Aggressive A form of cancer. Professor Dr. Tata Memorial Center, Parel. “Until a decade ago, I used to see a prostate cancer patient once a fortnight or a month, but now we see a young patient in every OPD,” said Joshi. and Kharghar.
Dr. Ramani said he noticed this trend about six years ago. “Something has changed. It could be lifestyle factors such as smoking and alcoholism, genetic factors or the widespread availability of PSA testing,” he said. Among the least educated and affluent classes, preventive healthcare practices that include annual PSA testing may account for the high detection rates among young men.
common cancer
Prostate cancer is one of the top 10 male cancers in India’s urban centers such as Mumbai, Delhi and Bengaluru. In Mumbai, it rose from the eighth most common cancer in men in 1990 to the third in 2014.
According to World Health Organization figures released on World Cancer Day on February 4, prostate cancer will affect 37,948 Indian men — about 3% of the 1.4 lakh new cancer cases reported in the country — in 2022. “The biggest problem in India is the high mortality rate. In the US, 80% of prostate cancer patients are diagnosed early and 20% are diagnosed too late. In India the figures are reversed,” said Dr Ramani.

More aggressive
It is said that in many cases prostate cancer develops so slowly that the patient dies of other natural causes before symptoms appear. Cases of prostate cancer starting in the 40s or 50s have a distinct characteristic: they are more aggressive.
“We find that young men with aggressive cancers that have metastasized or spread to other parts of the body when they come to us,” Dr. Joshi said. This is similar to the trend in younger women with more aggressive forms of breast cancer. “Some genetic factors or molecular mechanisms may be at play here, but there are no clear answers yet,” he said.
Meanwhile, to see an increase in the early stages of prostate cancer, Dr. Joshi’s team has started the study at Tata Memorial Centre’s Kharghar branch. However, Dr. Joshi said it may not be advisable for men over 50 to get a PSA test. “Screening is debatable in Indian settings. It is best recommended for those with a family history.”
Global trends
Tata Memorial Center Director (Academic) Dr. Shripad Banali said that cancer cases are increasing all over the world including India. “As a resident taking a medical history, I have never seen a patient answer positively to the question of whether anyone else in their family has cancer. But now every patient has another case of cancer in their family,” he said.
Along with the increasing cases, the cases of early onset cancers including prostate are also on the rise. A study published in September 2023 in the indexed medical journal, BMJ Oncology, found a 79% increase in cancer incidence among those under 50 over 30 years. While 1.8 million cancers were diagnosed in 1990, this number has increased to 3.3 million in 2019.
(*Patient’s name has been changed to protect his identity)


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