Worried for my sons

Hi
I am very worried. My dad is waiting to get a biopsy to diagnose/ruleout potential for Prostate cancer. Last year his PSA level was 3 and this year the 2 latest PSA levels are 6.9 and then 6.5. His specialist didn't feel any enlargement in his prostate. My dad's brother has prostate cancer. We don't know the history before that generations cause my grandmother's generation consist of 2 girls and noone knows how my great grandfather died.

I am desparately worried cause I have 2 sons. This whole hereditary thing just keeps crossing my mind.

Worried

worried_mom,

People who have become familiar with prostate cancer have become familiar with the name "Dr Michael Kattan." Dr Kattan, now at Memorial Sloan Kettering, developed what is now known as the "Kattan nomograms" which are used on a daily basis by urologists to provide guidance to prostate cancer patients on probabilities of various outcomes. He is world-renowned in his knowledge of PC outcomes.

Dr Kattan wrote in the Journal of Urology that "Age, fitness, and body weight have a far bigger effect on survival than PSA, Gleason score, or any type of treatment."

Age, you can do nothing about. There is a saying that the only way to avoid prostate cancer is to die young...nobody wants that. The reality is that the percentage of men with PC is roughly equivalent to the number of decades that they have lived. So, roughly 50% of 50-year olds (40% of 40-years old, 60% of 60-year olds, etc) have PC, although very few of them know they have it, very few will ever know they have it, and most will die of something else without knowing they had it.

Fitness and body weight are completely within one's control. There are known cancer fighting foods, and known cancer fueling foods...another factor completely within one's control. Lifestyle choices (diet, exercise and stress reduction) have been shown to reduce PSA as a marker for PC progression in men with biopsy-confirmed PC. These are the facts you need to help you sons get intimate with.

As Graham Nash wrote, "Teach your children well..."

Thank you. I am still super worried. I don't know statistics if it was my dad and the odds with slipping generations. I am just worrying so much and this disease is so foreign to me.

Worried Mom,

I have had the same worries for my son and grandson. My grandfather had PC but died from other causes so he died with it, not from it. My father has suffered with an enlarged prostate since he was in his 40's and at age 85 his URO thinks he might now have a low grade PC that most likely will go untreated at his age. My son is 36 and had his first PSA test last year after I was diagnosed so he now has a baseline for going forward. With all the new research and treatments on the horizon I hope that by the time my son or grandson is ever diagnosed with PC there will be a simple non evasive treatment to cure cancer other than surgery and radiation. So I am not as worried about this as I was before I knew much about this cancer.

Terry

Hi I am back
It turns out that my uncle has had high PSA reading for over 10 years. Not sure in the level though but all his biopsies is negative. The results for my dads biopsy last year was negative but this year his psa remains high or have slightly gone up so the specialist called him to go in again.

I am just such a worried mom for my children. Sigh I can't talk to anyone cause they say I am over reacting and people in my family is so secretive about their history or even health history

Totally a worried mom

Hi worried mom,

Have you told us yet how old your sons are? Generally speaking, it is VERY rare for a man to develop prostate cancer much before the age of 50.

With that said, I'll tell you what my local urologist told me in 2009 -- which was 2 years before I was Dx'd with PC. I had a PSA that was a bit higher than normal, but I also had a significant case of BPH, a benign condition of prostate enlargement.

BPH can account for a higher PSA reading. But the uro also cautioned me that this meant it could also be masking the presence of PC. He told me this in 2009 and, when I finally agreed to let him do a biopsy in 2011, PC was found.

Anyway, he asked in 2009 if I had any family history of PC. I advised him that my Father had PC in his early 70s. The doctor replied that this made me TWICE as likely than normal to get it also.

When I further told him that one of my Dad's brothers also had PC, the doctor said I was then THREE times more likely to get it. He urged me to do the biopsy, but I chickened out.

But when my PSA spiked by almost 2 points from 2009 to 2011, I finally agreed to the biopsy and, soon after, I was diagnosed.

So your sons DO have a significantly greater risk of eventually developing PC as the get older. If any other close family members had PC, their chances go up even higher.

So, as they enter their 40s (assuming they are younger than this now), they should have the doctor include a PSA check in their standard, annual physical bloodwork. Then they can begin a tracking history of their PSA and be able to watch it from year to year.

As others have noted, by the time they might develop the disease, medical science may have a much easier cure. The trick, of course, is to stay on top of it and not let it get away by not monitoring.

Good luck to them -- and to your dad!
Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1. PSA tests now annual.
Semi-firm erections now happening 14 months post-op & VERY slowly getting a bit stronger.

Hello, worriedmom. Glad you stopped back in and glad your uncle and dad ended up with negative biopsies. Hopefully this will bode well for your sons and your worries will be unfounded. Based on what you now know about your family history it would appear that your sons have no significant hereditary issues that you know about. Good luck and please try not to be overly concerned. How old are your sons now? The answer to that question will help us give you our thoughts about testing and discussions with their physicians.

Jim

Sons are 3 and 6
Dad is 63
Uncle is 65

Thank you I think I just need that. I am trying to come to grip with it. I know it is a little crazy cause even my dad and uncle isn't diagnosed yet or maybe won't.