Although screening for prostate cancer is supposed to begin at age 40, many men don’t begin thinking about prostate cancer until they’re well into their forties; in fact, until a few years ago, most men did not get their first PSA test until age 50 or afterward. The average age of diagnosis is 69. In short — prostate cancer is generally regarded as a disease of older men.

And yet, some men die of prostate cancer in their thirties; others are lucky enough to be diagnosed with it, and to receive curative treatment. Fortunately, men in this age group are fairly rare — but this also means that much less is known about their cancer, and how well they fare after treatment.

“ These young men are very curable, and are definitely going to live long enough to be cured.”

“There have been few studies of men in their thirties with prostate cancer,” says Patrick C. Walsh, M.D., University Distinguished Service Professor of Urology. “Most studies of younger men have no men younger than age 40.” What sparse medical literature there was suggested that men in their thirties had more aggressive cancer. “We wanted to find out if this was true.”

Walsh and colleagues Stacy Loeb, David Hernandez, Leslie Mangold, Elizabeth Humphreys, Marilyn Agro, Alan Partin, and Misop Han recently looked at the records of men who underwent radical prostatectomy at Johns Hopkins from 1975 to 2007. Of these, 42 were in their thirties; 893 were in their forties; 4,085 were in their fifties; 3,766 were in their sixties, and 182 were over age 70.

The news was good for young men: Of the men in their thirties, 81 percent had organ-confined disease, as opposed to 62 percent of men over 40. At an average follow-up period of five years, fewer than 5 percent of the men in their thirties had a detectable PSA, compared to about 16 percent of men over age 40.

“These men had a lower risk of progression of cancer,” Walsh notes, “and these results suggest that early aggressive treatment is ideal, because these young men are very curable, and are definitely going to live long enough to be cured.”