Father With Prostate C. - What Age Should Son Have PSA Test?

lauram

I have recently started posting on this forum about my father's prostate cancer. He was 75 when it was diagnosed.

One thing that occured to me during my research into P.C. is that it may be hereditary. We know little of my father's family history, as he was adopted when he was 2 months old.

My brother will soon be 43 years old. Just in case there is a family link from our father, what age should my brother start having PSA tests? I am probably worrying unnecessarily, but half the battle with P.C. seems to be to catch it early.

Many thanks for any advice on this question, and my previous ones.

Laura

Replicant · Moderator Joined: 01 Nov 2006 Posts: 273

He should start being tested now. That will establish a baseline. If all is good, he won't have to be test annually for a while, at least according to a leading urologist.

Having a father who had PCa isn't all that much of a risk factor, but having a father and a brother is.

Dr. Walsh, on p. 134 of his book, says a man should have a DRE and PSA at age 40. If the PSA is lower than 0.6, have the next exam at 45.
If the PSA is higher than 0.6, begin screening every two years.
If the rectal exam is abnormal, have a biopsy even if PSA is low.

If the rectal exam is normal, and PSA is > 2.5 and the man's age is 45-59, a biopsy is in order. Likewise for PSA >3.0 and age 50-59, and PSA >5 and age 60+.

This is all from Walsh--sounds like good advice to me.

He should also eat sensibly, watch his weight, and make sure he's getting plenty of antioxidants in his diet.

Best wishes.
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T3a, N0M0, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 <0.1, 12/07 <0.1, 4/08 <0.1, 11/08 <0.1
http://pcabefore50.blogspot.com

johnw100

It does seem logical that lifestyle and diet has a large influence.

Men on traditional Japanese and Asian diets are affected by relatively low rates of PC (and some other diseases).
Interestingly when Japanese men move to USA, and adopt a western diets their PC rates become similar to USA figures in a couple of generations.

Even if we don't know the exact influence of various diets on PC it is obviously good advice to improve diet and lifestyle where possible.

lauram

Many thanks. I showed this forum to my brother, and he has made an appointment with his doctor for next week. I'm sure it will be fine.

Laura

Beth56 · Regular Joined: 30 Mar 2008 Posts: 30 Location: California

There are some guidelines that should be followed for a PSA test. Often times the doctors will not tell you about this.

The blood test should not be taken sooner than 24 hours after orgasm (48 is better), and it should be taken before the rectal exam. In fact, your brother should insist the doctor take blood before the rectal exam.

I can't remember if there is anything else. Perhaps Replicant will confirm this for me or give additional information. Very Happy

Replicant · Moderator Joined: 01 Nov 2006 Posts: 273

Beth is right.

You'll read some places that you should even avoid bike riding before the blood is drawn, but the studies I've seen say there's no correlation.

A vigorous prostate exam will elevate PSA, and so will ejaculation, so make sure your brother is at least aware.

BTW, recommendations on starting PSA screening vary. The American Cancer Society says:

The American Cancer Society believes that health care professionals should offer the prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) yearly, beginning at age 50, to men who have at least a 10-year life expectancy. Men at high risk, such as African Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65), should begin testing at age 45.

Men at even higher risk (because they have several first-degree relatives who had prostate cancer at an early age) could begin testing at age 40. Depending on the results of this initial test, further testing might not be needed until age 45.

Health care professionals should give men the chance to openly discuss the benefits and limitations of testing at yearly checkups. Men should actively take part in the decision by learning about prostate cancer and the pros and cons of early detection and treatment of prostate cancer.
http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_Can_prostate_cancer_be_found_early_36.asp

The American Urological Society--now these are the guys whose bread and butter comes from DREs and PSA tests--is basically waiting for results of screening trials in the U.S. and Europe. There are some indications that PSA screening lowers deaths--recently from Austria, for example--but no large scale, randomized, controlled trial results are in yet. I would expect some concrete guidelines before long, but for now the AUA is hinting that the future guidelines will likely lower the recommended age for screening to 40, and a continuum of PSA ranges and risk is being considered. In addition, the AUA is looking closely at using PSA velocity rather than straight numbers, and they may recommend testing for African American men at a younger age than for other groups.
http://www.medicalnewstoday.com/articles/111877.php

To me, 43 sounds like a reasonable age to get tested. It's when I was diagnosed!
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T3a, N0M0, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 <0.1, 12/07 <0.1, 4/08 <0.1, 11/08 <0.1
http://pcabefore50.blogspot.com

lauram

Thanks for all the info.

My brother had his PSA test, all is well. Thank god!

How often should he have a PSA test from now on (he's 43)?

Laura

Beth56 · Regular Joined: 30 Mar 2008 Posts: 30 Location: California

If it was my brother, I would tell him annually. It's a small thing to do for yourself and piece of mind. Very Happy

I'm so glad his PSA results were OK.

Otago · Regular Joined: 20 Jan 2008 Posts: 28

[quote="lauram"]Thanks for all the info.

My brother had his PSA test, all is well. Thank god!

How often should he have a PSA test from now on (he's 43)?

Laura[/quote]

Laura, what does "all is well" mean? Did he tell you what his test result was? I ask because I've often seen doctors report anything under 4.0 as "good results"....

He needs to get the specific test result number. It would be interesting if you reported it back here so we could see what some doctors in various countries are labeling as "all is well"....

Otago

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