My dad had prostate cancer, what does that mean for my brothers and I?

This is perhaps one of the more common questions that men raise when seeing their GP or Urologist. The answer is really quite complex but can be simplified into a few clear and easy to understand points.

1. The age at which your dad was diagnosed with prostate cancer is relevant to you and when you should start being checked.
   1. If your dad was 85 when diagnosed, your risk is probably not a lot higher than the average Aussie male. On the other hand, if he was 55 when diagnosed, this puts your risk up significantly
   2. As a general rule, you should probably be tested at an age of about 40-45 with your first PSA and digital rectal examination
      • This will give you an idea of your lifetime risk of cancer
      • The higher the starting PSA, the higher the risk
   3. If your dad was very young, say 45, then you might want to do your first PSA when you are 35 (that is, 10 years before his age at diagnosis)
2. The number of first degree relatives diagnosed with cancer is important
   1. If your dad, 3 uncles and your grandad all had prostate cancer, there may be a stronger genetic tendency in your family that raises your risk.
   2. If there is a strong family (female) history of breast cancer, that may also have an impact due to the presence of the BRCA2 gene
3. Put it all in perspective: if you are healthy and at 45 have no major illness or other health problems, then prostate cancer may be of more importance to you as it may be the only health problem you will face in the next 10 years. On the other hand; if you are unfit, obese, diabetic, hypertensive and have had bypass surgery, then prostate cancer is probably the last thing you should be worrying about as it is unlikely to have much of an impact on your health over the short to medium term.
4. Above all else: DISCUSS YOUR CONCERNS WITH YOUR GP and let them advise you on how to proceed with testing. Prostate cancer shouldn’t be ignored, but neither should you be worried about it unnecessarily. A high PSA isn’t a diagnosis of cancer, but not getting tested when you are at risk may not be the best course of action either.

© Perth Urology Clinic 2016