- Men with prostate cancer who come from families with a history of prostate cancer are significantly more likely to survive, compared with other men.
- According to the study, men with prostate cancer who also have a first-degree or second-degree relative who has or has had cancer are 15% more likely to survive prostate cancer.
- The authors of the study suggest that this is due to a heightened awareness of cancer risk and more proactive screening among members of such families.
A man’s risk of developing prostate cancer increases if he has a family history of prostate cancer. Research has shown that those with a brother or father who had a prostate cancer diagnosis are twice as likely to receive the same diagnosis themselves as men with no family history of this form of cancer.
However, according to a new study, men with a family history of prostate cancer are more likely to survive the disease than someone from a family with no such history.
The study found that a man with prostate cancer who comes from a family with one first-degree or second-degree relative who has or has had cancer is 15% more likely to survive prostate cancer.
The more extensive a man’s family history of inheritable cancers, the less likely he was to die from prostate cancer. Men with two or more affected family members were 20% more likely to survive.
The study found that men with family histories of cancer were equally less likely to die early of any cause at all.
The findings appear in the journal European Urology.
Prostate cancer statistics
Prostate cancer is the most common cancer in men, with one in eight men likely to develop the disease, according to the American Cancer Society. Roughly 288,300 new cases of prostate cancer are diagnosed each year in the United States.
Prostate cancer outcomes vary, and there are both non-aggressive and aggressive forms of the disease. One out of every 41 men diagnosed with the disease dies from it.
This may be attributable to the later times in life at which prostate cancer often appears. Six in 10 new diagnoses involve men 65 and older.
There are various treatment options available to men with prostate cancer, including “watchful waiting.”
The UK Genetic Prostate Cancer Study
The findings were based on data from the UK Genetic Prostate Cancer Study. This involved an analysis of survival data for 16,340 men with a diagnosis of prostate cancer and was collected from nearly 125 hospitals.
The authors of the study propose that a heightened awareness of cancer risk in families with a history of the disease leads to more diligent, and earlier, cancer screenings.
Dr. Konrad Stopsack, a molecular and clinical epidemiologist with a focus on cancer epidemiology at the Harvard T.H. Chan School of Public Health, who was not involved in the current research, told Medical News Today:
“This is a large study in a well-established and indeed one of the world’s biggest databases of prostate cancer in families. It shows quite conclusively that, in this specific setting in the United Kingdom, men who have a family history of prostate cancer lived longer after prostate cancer diagnosis compared to those who do not have affected family members.”
He noted, however, that in the U.K., prostate-specific antigen (PSA) screening “is not as widely done [as in the U.S.], so the mix of prostate cancers diagnosed is quite different, and tends to be more enriched for more aggressive cancers.”
Dr. Michael O’Callaghan, an associate professor in the College of Medicine and Public Health at Flinders University in Adelaide, Australia, also not involved in the study, added that “[i]n areas where screening is more readily accessible, the effect of family history on survival may be less pronounced if the mechanism of action is indeed through increased screening, as the authors conclude.”
PSA testing in the U.S.
“In some ways, a PSA test is more widely accessible in the U.S. than it is in the U.K.,” Dr. Stopsack also pointed out.
Even so, PSA testing levels in the U.S. have decreased significantly for roughly the last decade. At that time, the U.S. Task Force on Prostate Cancer recommended PSA screenings should not be required at regular medical examinations, according to interventional urologist Dr. S. Adam Ramin, not involved in the current study.
Since that recommendation “[t]here has been an increase in higher-stage prostate cancer. Many of us urologists are advocating a change in that recommendation,” said Dr. Ramin.
The primary reason behind the task force’s recommendation, said Dr. Ramin, was overdiagnosis, and “when there’s an overdiagnosis, there may be overtreatment,” he explained.
“In many instances,” said Dr. Ramin, “patients with prostate cancer don’t necessarily require treatment.”
“We have solid data,” said Dr. Stopsack, “that PSA screening reduces the long-term risk of death from prostate cancer to some degree, but at the expense of a significant burden of PSA tests, prostate biopsies, and therapies such as prostate surgery or radiation with all their potential complications.”
Dr. Ramin described prostate biopsies as “relatively invasive, and the invasive nature of those tests may also cause some morbidity, like prostate infections and sepsis, and bleeding in the bladder.”
Dr. Ramin said that worrying PSA levels lead first to recent, less-invasive tests in his practice. These include magnetic resonance imaging (MRI) scans of the prostate, 4K blood scoring, and urine-based liquid biopsies, where “they’re looking for molecular genetic changes in the urine that may increase the likelihood of having prostate cancer.”
Only after a positive result from such testing is a solid biopsy considered.
Breast cancer and prostate cancer
Breast cancer in a family member is the other form of cancer most highly associated with prostate cancer risk in male kin related by blood.
Dr. Ramin noted that the inheritable breast cancer genes BRCA1 and BRCA2 are common in both breast and prostate cancer.
“A breast cancer family history,” said Dr. Stopsack, “is associated with a moderately elevated risk of aggressive, symptomatic prostate cancer.” It is also linked, he noted, to the risk of other less dangerous types of prostate cancers.
Some of that association may be due to the same heightened awareness of cancer risk the authors of the study credit for greater survival in men with a family history of cancer, said Dr. Stopsack.
“That is,” he said, “having a family member raises awareness and leads one to get screened, which also raises the risk of getting diagnosed with a prostate cancer that may otherwise not have become symptomatic.”
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