Genetic Testing For Prostate Cancer: What You Should Know
Doctors have known for decades that genetics can play a vital role in breast and ovarian cancer. Lately, scientists have begun to realize that many of these same genetic changes may lead to a man’s risk of developing prostate cancer. These findings are leading to earlier identification of men at risk for prostate cancer.
They are also leading to more targeted care options for some men with advanced prostate cancer, says Todd Morgan, M.D., Associate Professor of Urology at the University of Michigan.
This year nearly 165,000 men in the United States will be diagnosed with prostate cancer. More than 29,000 will die from the disease. The risk of prostate cancer is 74 percent higher in blacks than in whites. The reasons for this are still unclear.
Overall, men have a 1 in 9 chance of being diagnosed with prostate cancer. That rises to a 1 in 6 chance for African-American men. Men with a family history of the disease have a 1 in 5 chance of getting the disease themselves.
A man is two to three times more likely to get prostate cancer if his father, brother or son had it. This risk rises with the number of family members who have prostate cancer, breast cancer, and ovarian cancer. The age when a close family member was diagnosed is also a vital factor.
Some genes linked to prostate cancer also can cause breast, ovarian and other cancers. These genes have a 50 percent chance of being passed on to children. The most well-known of these genes are BRCA1 and BRCA2.
Prostate Cancer: A Guide For Aging Men
Prostate cancer is one of the most frequently diagnosed cancers in the world, despite it only being diagnosed in males . In fact, more than 70 percent of men over the age of 80 have some quantity of cancer cells in their prostate.
Its so common that it sometimes doesnt go diagnosed until autopsies are performed, though that doesnt mean the cancer is the cause of death. On the contrary, the overall prognosis for men diagnosed with prostate cancer is as positive as you can get when talking about the dreaded c word. The five-year survival rates for the disease are close to 100 percent, especially when talking about prostate cancer that is caught early on in the processbefore it spreads.
The five-year survival rates for the disease are close to 100 percent, especially when talking about prostate cancer that is caught early on in the processbefore it spreads.
Nevertheless, prostate cancer is serious business, and the best way to handle a diagnosis is to be informed. Lets take a look at the frequency at which its diagnosed, how youre tested for it, how it can affect your daily life, and what we can do to try and prevent the disease.
Average Age of Prostate Cancer Diagnosis
Everyone Older Than 60 Has Cancer
Doctors are finally realizing that most people have cancer in their body. But its latent or hidden cancer. Latent cancers are so well contained by the immune system that they never get large enough to cause problems. As a result, doctors rarely discover them, unless they discover them by accident. Most of the cancers they discovered in this autopsy study were latent cancers. And, as you can see, they are very common.
Autopsy studies on women, for example, show that by the time a woman is 40 years old, the chance of her having a latent breast cancer is 40 percent.
That sounds terrible, doesnt it? Its really not terrible. In fact, the existence of latent cancers is very reassuring. They clearly demonstrate how effective a healthy immune system can be in stopping cancer.
Its so effective that the great majority of latent cancers never go on to become full-blown cancers. Thats good news. When you start to add up all of the various autopsy studies that are published, you soon realize that every single one of us over the age of 60 has cancer. Actually, we have at least two of these cancers already living in our bodies. But the really important thing about latent cancers is that they can teach us a lot.
The first thing they teach us is that by maintaining a healthy immune system, we can dramatically decrease our chances of dying from cancer.
Whats the best way to do this?
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Screening For Prostate Cancer
There are no tests available with sufficient accuracy to screen populations of men for early signs of prostate cancer. However, early detection and treatment can significantly improve prostate cancer survival.
The test most commonly used to aid early detection of prostate cancer is the prostate specific antigen blood test. This is not a diagnostic test as it can only indicate changes in the prostate. If you are concerned about prostate cancer you should talk to your doctor and make an informed choice about whether to have one of the tests designed to find early signs of prostate cancer, in view of the potential risks and benefits.
There are no proven measures to prevent prostate cancer.
Second Cancers After Prostate Cancer
Prostate cancer survivors can be affected by a number of health problems, but often a major concern is facing cancer again. Cancer that comes back after treatment is called a recurrence. But some cancer survivors may develop a new, unrelated cancer later. This is called a second cancer.
Unfortunately, being treated for prostate cancer doesnt mean you cant get another cancer. Men who have had prostate cancer can still get the same types of cancers that other men get. In fact, they might be at higher risk for certain types of cancer.
Men who have had prostate cancer can get any type of second cancer, but they have an increased risk of certain cancers, including:
This risk is probably related to the dose of radiation. Newer methods of giving radiation therapy may have different effects on the risks of a second cancer. Because these methods are newer, the long-term effects have not been studied as well.
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Fewer Men Getting Screened For Prostate Cancer
Prostate cancer is diagnosed in 1 in 7 men in the U.S., and though that is an undeniably high rate, most won’t die from the disease. According to the American Cancer Society, there are approximately 2.9 million men in the country diagnosed with prostate cancer at some point in their life who are still alive today.
In May 2012, the U.S. Preventive Services Task Forcean independent, government-funded panel of volunteer physicians that formulates guidelines for medical screeningsrecommended against using the prostate-specific antigen test for all men. The Task Force assigned the PSA test a letter grade D under the conclusion that the harms of this screening measure far outweigh the benefits.
As a result of these guidelines, rates of PSA testing have dropped significantly in middle-aged men, according to a new study that was published Tuesday in JAMA. The study looked at data from 2000, 2005, 2010 and 2013 gathered in the National Health Interview Survey, taken by 20,757 men overall. The researchers found rates of PSA screening declined most in men aged 50 to 54from 23 percent undergoing PSA screening in 2010 to 18 percent in 2013. In men aged 60 to 64, the rates declined from 45 percent to 35 percent.
Why Is There Increasing Concern At This Time Regarding Erectile Dysfunction Issues Following Radical Prostatectomy
The reality of the recovery process after radical prostatectomy today is that erectile function recovery lags behind functional recovery in other areas. Patients are understandably concerned about this issue and, following months of erectile dysfunction, become skeptical of reassurances that their potency will return.
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Black Men Both Get And Die From Prostate Cancer At A Higher Rate The Reasons Are Complex And Unclear
Black men are 50% more likely to develop prostate cancer in their lifetime and twice as likely to die from the disease, Dr. Kantoff says.
It is difficult to untangle the various factors that might affect the risk and outcome of prostate cancer, Dr. Kantoff explains. Prostate cancer in Blacks tends to have biological characteristics associated with more aggressive disease, he says. There is evidence suggesting that this is partly related to inherited genetic factors.
He points out that in addition to differences in tumor biology, the higher risk may be tied to disparities in environment and behavior. This could include social stress or more exposure to cancer-causing pollutants. Smoking, poor diet, and lack of exercise, which can cause obesity, may also have effects. Disparities in outcome could be affected by differences in when the cancer is diagnosed and how the men are treated after diagnosis.
When Malignant Cancer Cells Form And Grow Within A Person’s Breast Tissue Breast Cancer Occurs
There are a number of different treatments doctors recommend. Your doctor will want to discuss treatment options as well as the prognosis for bladder cancer. A diagnosis of lung cancer naturally causes some overwhelming emotions, but you don’t have to let those emotions get the best of you. Of course, your specialist is the main person whose advice you should follow but it doesn’t do anyone harm. It may grow slowly and it’s typically treatable. Although the percentage of cases in men is much lower than in women, male breast cancer accounts for a por. Breast cancer is the second most common cancer found in women after skin cancer but that doesn’t mean men aren’t at risk as well. Although it is the most commonly diagnosed cancer in american women, breast cancer can impact people of all genders. If breast cancer is diagnosed at an early enough stage, it’s treatable. Information is a powerful weapon against uncertainty and fear, and you can use this to your advantage. Prostate cancer is a common type of cancer in men, according to the mayo clinic. Being armed with information is vital to begin the fight. Prostate cancer is one of the most common types of cancer diagnosed in men.
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What Should I Do If I Think I Have A Prostate Problem
If you notice any of the above symptoms or you think you might have a problem with your prostate, talk to your GP. Prostate cancer can be treated and over 90% of men with the disease survive but the first step is to talk to your GP.
Your GP may want to do a blood test called a PSA blood test and then examine your prostate. This involves inserting a gloved finger into your back passage to feel the size and shape of your prostate.
Risk Factors You Cant Control
Age: The risk of developing prostate cancer increases with age. One in 10,000 men younger than 40 will be diagnosed with prostate cancer, but one in 15 men in their 60s will be diagnosed with the disease.
Family history: Being born with a gene mutation is one of the unavoidable risks of prostate cancer. Two of them include the BRCA1 and BRCA2 gene mutations. BRCA and other inherited mutations, including HOXB13 and DNA mismatch repair genes, may explain why prostate cancer runs in families. Having a father or brother with prostate cancer may double a mans risk, especially if that relative was diagnosed before age 55.
Hormones: The level of male sex hormones, called androgens, may be higher in some men than others. Higher levels of androgensmainly testosteronehave been linked to a higher risk of prostate cancer. Men who use testosterone therapy are at a higher risk of developing prostate cancer, as an increase in testosterone stimulates the growth of the prostate gland.
Prostatic intraepithelial neoplasia : This condition may be associated with increased risk of prostate cancer. PIN is a condition in which prostate gland cells look abnormal when examined with a microscope. Its not necessarily linked with any symptoms. Nearly half of men will be diagnosed with PIN before age 50.
Race: Studies show that African-American men are about 70 percent more likely to develop prostate cancer in their lifetime than Caucasian or Hispanic men.
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Results Could Lead To Earlier Cancer Screening
Finding out you have a genetic mutation linked to prostate cancer benefits the whole family. Other family members also may want to think about testing. This will tell them if they have inherited the same gene.
This is called “cascade testing” and is often offered to family members after a discussion with a genetic counselor. Men who are found to have a genetic mutation should start being screened for prostate cancer at a younger age than men without a family history of the disease.
The first step in screening is a prostate-specific antigen blood test. In general, the higher a man’s PSA level, the more likely he has prostate cancer. If prostate cancer is suspected, the doctor may suggest more tests. This could include a prostate biopsy . In a man with a genetic mutation, the doctor may use a lower PSA score to decide whether a biopsy is needed.
If you have an inherited risk of prostate cancer, your doctor may talk to you about certain lifestyle changes. These can include adding exercise, quitting smoking and keeping a healthy weight, which may lower your risk of cancer.
“Many men are surprised to hear inherited genes can play a major role in prostate cancer,” Dr. Morgan said. “But when I talk with men who may benefit from testing about why they should consider it, they often decide to get tested in order to receive more health information that can help them and their family make vital health decisions.”
Quality Of Life With Advanced Stage Prostate Cancer
Since Huggins and Hodges won a Nobel Prize in 1966 for their work describing the relationship between testosterone and prostate cancer, androgen deprivation has continued to be an important component in the treatment of advanced prostate cancer. It is associated, however, with significant cost in terms of morbidity as well as economics. Side effects of androgen deprivation therapy include hot flashes, osteoporosis, loss of libido or impotence, and psychological effects such as depression, memory difficulties, or emotional lability. Recently Harle and colleagues reported insulin resistance, hyperglycemia, metabolic syndrome, and metabolic complications being associated with castration and thus being responsible for increased cardiovascular mortality in this population.
Because of the palliative nature of androgen ablation, quality of life is an important component of evaluating competing therapies. Intermittent androgen deprivation is one approach to hormonal therapy that has been developed with the aim of minimizing the negative effects of therapy while maximizing clinical benefits and the patients quality of life. It can be used in any clinical situation where continuous androgen deprivation treatment could be applied.
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What Should You Do If Your Partner Has Prostate Cancer
Most men that go through treatment end up on the other side with a great quality of life, and their relationship is the same sometimes even better because they have a new perspective on the important things in life, he says. Heres what experts suggest you do if your significant other is diagnosed with prostate cancer:
Who Should Think About Getting Tested
To find out if you have a genetic mutation linked to prostate cancer, you can take a simple blood or saliva test. If your urologist suggests genetic testing, they may send you to a genetic counselor. They may also order the test and then send you to a genetic counselor if the results are positive or uncertain.
There are two groups of men who may want to think about being tested for prostate cancer genes, Dr. Morgan said.
The first group are men with localized prostate cancer who have a family history of breast, colon, ovarian, pancreatic or prostate cancer.
Doctors may decide whether to suggest genetic testing based in part on his Gleason score-a grading system that describes how aggressive the cancer is.
The National Comprehensive Cancer Network, a not-for-profit group representing many leading cancer centers, suggests a man should think about genetic testing if he has a Gleason score of seven or higher and at least one of the following:
- At least one close blood relative with breast or ovarian cancer at age 50 or younger, or
- A least two family members with breast, ovarian or prostate cancers at any age.
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Prognosis For Prostate Cancer
It is not possible for a doctor to predict the exact course of a disease, as it will depend on each person’s individual circumstances. However, your doctor may give you a prognosis, the likely outcome of the disease, based on the type of prostate cancer you have, the test results, the rate of tumour growth, as well as your age, fitness and medical history.
Prostate cancer often grows slowly and even more aggressive types tend to grow more slowly than other types of cancer. If diagnosed early, prostate cancer has one of the highest five year survival rates.
What Is The Psa Blood Test
Men over 50 should talk to their GP every year about the PSA blood test.
The PSA blood test measures Prostate Specific Antigen . A PSA blood test does not test for prostate cancer but can help the GP decide if there is a problem with your prostate or not.
PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells. It is normal for all men to have a small amount of PSA in their blood. A raised PSA level does not necessarily mean that you have prostate cancer but may indicate that you have a problem with your prostate such as an enlarged prostate or inflammation of the prostate.
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