Advanced, Incurable Prostate Cancer Is On The Rise – Experts Are Trying To Figure Out Why

NEW YORK (CBSNewYork) -- There has been an alarming spike in the number of men diagnosed with advanced or incurable prostate cancer.

As CBS2's Dr. Max Gomez reported, the vast majority of the 180,000 prostate cancer that will be diagnosed this year will rarely become and issue for the patient.

However, there will still be more than 26,000 deaths from prostate cancer this year.

It's those metastatic cancers that have jumped and doctors are concerned.

Frank Ehrlich, like many men his age, has been keeping an eye on his PSA levels as a possible early warning sign of prostate cancer.

"I had a normal PSA level for many, many years, but in February it went up to three or four," he said.

That's still low enough that Frank had a number of treatment options, but 4 years ago a federal panel advised against the routine use of the PSA blood test to screen for prostate cancer.

Now, a new study in the journal Prostate Cancer And Prostatic Diseases found that new cases of metastatic prostate cancer climbed 72 percent in the past decade, and almost doubled in younger men ages 55 to 69.

"Metastatic disease means cancer that has spread beyond the prostate. There are treatments for that situation, but not curable," Dr. Ketan Badani, Mt. Sinai Health System said.

However, the upward trend in advanced prostate cancer started before the new recommendations, and this cancer is very slow-growing so the effect of those guidelines likely won't be seen for a few more years.

The other theory is that prostate cancer itself is changing.

"The biology of prostate cancer has gotten worse over time. Whereas it used to be a little less of an aggressive disease, over the time it's become worse. Men who have metastatic prostate cancer will have higher PSAs than those who don't, but these men have even higher PSAs than what we typically see which points to a worse biology of cancer," Badani said.

What concerns many urologists is that the biggest spike in advanced prostate cancer was seen in the age group where early detection with a PSA test could lead to curative treatment.

That's why Dr. Badani and other said men should have a frank conversation with their doctors about PSA screening because the test can lead to a lot of unnecessary biopsies that come with costs and infection risks, and even if the biopsies find cancer most will not be aggressive and may not need any treatment.