husband is high risk- how to catch it early?

[gainsboroughgirl]

Hi.
My husband is 56. His father died at 72 from prostate cancer and his brother was diagnosed recently and is 65. So, he is statistically at higher risk but the advice as to whether to take a PSA or not, is mixed. I know there are tests now or hopefully will be soon, which alongside the PSA, should indicate if it's aggressive cancer or not. Other recent research showed monitoring was as effective over 10 years as intervention. So, what should my husband do? PSA or not? Are there any other genetic profile tests yet available?
Also, given my father likewise died of prostate cancer, my son's risk is also high- even higher now than my husband's. as for my son, it is on both sides of his family. Please advise as to what can or should be done in terms of screening/treatments etc. My son and husband both eat lots of tinned tomatoes ( I make sure!) but I'd like something a bit more certain than that! Thanks

[Dr Jon Rees]

Hi

I agree that PSA testing is controversial and you will get all sorts of conflicting advice. But for once I will be quite dogmatic in my advice on PSA:

He is at higher risk given this family history and I would personally strongly advise him to have a PSA test. Yes, the ProtecT study made the conclusions you mention, but the role of monitoring is for different from whether to be tested. I feel that higher risk men - i.e. those with a strong family history, and men from Afro-Caribbean backgrounds stand to benefit far more from PSA testing. If your husbands PSA is normal, i.e. less than 3.0 - he should have a further PSA every 2 years or so at the moment - probably until he is 70ish.

As far as your son is concerned - I am confident that by the time he reaches the age where he needs to start considering this, we will have far better tests - genetic profiling alongside PSA, and the use of so-called biomarkers, are just around the corner and will transform our approach to testing.

Information from Prostate Cancer UK: http://prostatecanceruk.org/prostate-in ... ou-at-risk

I hope that helps.

[Mr Benjamin Challacombe]

I fully agree with John
a PSA test is indicated here.
you have worry and a family history
the only way to ensure you don't die of prostate cancer is to be tested.
But make sure if the PSA is high an MRI is done prior to a biopsy

[gainsboroughgirl]

Thank you both, I shall be able to print this off and show him! Your time is much appreciated.