All men need to talk with their male relatives about who has had prostate cancer or who has not. The significance of a strong family history of prostate cancer is powerful in detecting a man’s risk of this potentially deadly disease. Prostate cancer is common among American men. Ranked as the second most common cancer diagnosed in men (skin cancer ranks first), a man must know his grandfather’s, father’s, and any brother’s medical history. But, men rarely discuss their health history with other men in their families. Yet knowing and being aware of medical conditions, both past and present, can save a man’s life. Just like having a family history of type 2 diabetes is a known strong risk factor for developing that disease, family history is a substantial risk factor for prostate cancer. It should not be ignored or deemed unimportant.
It has been known that men with a family history of prostate cancer are at a higher risk of getting it themselves. Just how high that risk is and how likely it is a man with a family history will get a mild or aggressive (fast-growing) type of the disease can be helpful information in counseling men who have prostate cancer in the family. The more information a man has on the risks of getting prostate cancer can help him make his own decisions about testing and treatment.
How strong is having a family history of prostate cancer?
A study conducted in Sweden in which researchers reviewed the medical records of 52,000 men with brothers and fathers who had prostate cancer found the following information:
Men with a brother with prostate cancer have double the risk of being diagnosed as the general population. In addition, they had about a 30% risk of being diagnosed before age 75, compared with about 13% among men with no family history.
Men with a brother with prostate cancer had about a 9% risk of getting an aggressive form of prostate cancer by age 75, compared with about 5% among other men.
Men with a brother and father diagnosed with this disease have almost triple the risk of being diagnosed as the general population. In addition, they had about a 48% chance of getting prostate cancer, compared with about 13% among other men.
In addition, men with a brother and father with prostate cancer had about a 14% chance of getting an aggressive type of prostate cancer by age 75, compared with about 5% among other men.
Other findings from the Swedish study
Also found in this study was that while the number of close relatives with prostate cancer affected the risk, the type of prostate cancer in the family did not have a substantial effect on risk. For example, the risk of aggressive prostate cancer was just as high in men whose brothers had the mildest form of prostate cancer as those whose brothers had an aggressive type.
One thing for men to keep in mind about this study is that it only looked at men living in Sweden. In other areas of the world where prostate cancer screening rates are relatively high, and the populations of people come from similar genetic backgrounds, the results from this study could be similar. However, more research is needed to clarify and understand the relationship between these findings and how they apply to people with different genetic makeups.
None of us can change our family medical history, including men with a family history of prostate cancer. But since it is known that a man inherits multiple genes from both parents, possibly increasing the likelihood of a prostate cancer diagnosis, they can decide the extent of that risk. In addition, an advanced DNA test may help identify gene mutations putting some men at a greater risk of the disease.
A 2016 study published in the New England Journal of Medicine found that a significant proportion of men with advanced prostate cancer are born with DNA repair mutations. Therefore, they believe that genetic testing could be a valuable part of the treatment for advanced prostate cancer. In addition, this genetic testing for these mutations could identify men with advanced prostate cancer who may benefit by being offered drugs such as PARP inhibitors, which are effective in men with these mutations.
In the meantime, despite a man’s family history of prostate cancer, beginning at age 40, all men should have a baseline prostate-specific antigen (PSA) test and then discuss with their doctor what the recommendation should be on the frequency of PSA testing for him. Men should also be aware of other risk factors for prostate cancer. For example, the earlier prostate cancer is diagnosed, the better your chance of beating it back and living a long life.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.