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Brother diagnosed

User
Posted 01 Sep 2014 at 15:30

Hi all,

my brother has recently been diagnosed with Prostate Cancer and it has gone into both sides of his lymphatic system.  He has commenced hormone treatment and is awaiting the start of his chemotherapy.

He is 46 and I am 44.

I have read lots of conflicting information with regards to myself going for a PSA test.

I'm unsure what to do.  I have no symptoms.

It would appear that sometimes you can have a higher PCA test and its not to do with cancer etc.

 

Any advice would be appreciated.

Nick

User
Posted 01 Sep 2014 at 20:07

Hi Nick,

 

On the basis of what you've said my advice, if you haven't done so already, is first to speak to your GP. They will help you make an informed decision.

 

You're right in saying that a higher than normal PSA does not necessarily mean you have prostae cancer, but it may point to something probably not being quite right with your prostate. Of course there are a number of other things that can temporarily raise your PSA as well.

 

At 44 it is very unlikely that your PSA will be above the 'norm'. However, with your brother being diagnosed at quite a young age there could be a family predisposition (any other familyt history?). Therefore, for peace of mind, if I was in your position, I'd want to know (and probably repeat the test every couple of years). 

 

flexi

 

ps. I was diagnosed with prostate cancer at 50. I immediately told my brother 48 to get tested. He did and his PSA was normal.

 

 

 

 

 

User
Posted 01 Sep 2014 at 20:56

Nick

 

Given the circumstances I would definitely suggest you have a PSA test. The main thing, however, it not to accept "It's normal" as a result from your GP. Ask for the ACTUAL figure, write it down and re-test a year later (if within normal range of 0 to 4). If the PSA is "elevated" (and believe me, that can be anything higher than normal) then establish a regime of tests over a suitable period e.g. 3 to 6 months. It's the trend that counts but if you end up with a contentious figure ( say 10+) then swing into action sooner. Mine was 153 and I was a "goner" - don't be like me and don't take "No" for an answer http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-wink.gif

 

PS - I saw a guy diagnosed with a PSA of 3.8 - within "normal". Problem was he had a long family history of PCa and his PSA had been steady at 0.8 for years. This is a complex disease with no definitive answers but forewarned is forearmed.

Nil desperandum

Allister

User
Posted 01 Sep 2014 at 21:56
Nick,

I'm 44, I was diagnosed in June and just had my prostate removed.

Don't hesitate mate, get yourself tested & keep your eye on the symptoms. Mine was starting to pee taking a while and the stream useless.

I was told genetics highly likely & I've told my brother & son to keep checked too.

Good luck to you & hope your brother goes on well with his treatment. See if he will join us on the forum. Lots of advice & others in a similar position.

Best wishes

Carlos.

.

Life's a Marathon. Run in peace.

User
Posted 02 Sep 2014 at 01:43
Undoubtedly there seems to be an increased risk to men who have a family history of prostate or breast cancer although it isn't as straightforward as Carlos suggests. Genetics is thought to account for less than 5% of cases, many of these linked to the BRCA genes. The greatest risk factor for getting prostate cancer is being male, followed closely by having close family members who were diagnosed at a young age - the science suggests that whilst genetics may not explain the majority of these family clusters, environmental factors are shared (where you lived, grew up together, the food you ate, etc). All in all, the fact that your brother seems to have been diagnosed with advanced disease (unusual that he is going straight to chemo ... Is that absolutely certain?) at such a young age suggests that you should be at the GP surgery pronto to get your baseline and start monitoring your PSA.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 02 Sep 2014 at 17:39

Nick,

The Trial that suggests men with metastatic disease on diagnosis do better having chemo early on commencement of HT is the E3805 Trial.

Results to be presented sometime this year possibly in the US. Wish Neil had been straight on to chemo when diagnosed. Best of luck for your brother,

 

Fiona.

User
Posted 03 Sep 2014 at 08:08

Just seen this, Jamie mentioned it at Leicester when i was talking to him. so glad i took his advice http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-laughing.gif

 

I was asked if there was one item that was a real game changer at the American Society of Clinical Oncologists (ASCO) meeting for men with advanced prostate cancer. The answer is yes, at this meeting it was formally shown by a study that starting chemotherapy (docetaxel) along with androgen deprivation therapy (ADT) in some men newly diagnosed with metastatic prostate cancer (mPCa) improved median overall survival by more than 13 months.

The PI, Christopher J. Sweeney, MBBS, of the Dana-Farber Cancer Institute in Boston noted, “This is one of the biggest improvements in survival we have seen in a trial involving patients with an adult metastatic solid tumor.”

In his study that 790 men were randomized to receive ADT alone (393 men) or ADT along with docetaxel chemotherapy (397 men). The men had a median age of 63 years. A planned interim analysis showed that the median overall survival (OS) was 44 months in the ADT-only arm compared with 57.6 months in the ADT plus docetaxel arm, a difference that translated into a significant 39% decreased risk of death.

In a subgroup analysis it was determined that this survival advantage was not experienced equally by all of the men in the combination arm of the trial. They found that the men with high-volume disease, the median OS in the ADT-only and combination arms was 32.2 months and 49.2 months, respectively, a 17-month difference that translated into a significant 40% decreased risk of death. In men with low-volume disease, median OS had not been reached at the time of the analysis, according to investigators.

Don't deny the diagnosis; try to defy the verdict
User
Posted 03 Sep 2014 at 11:09

Bl%%%dy thank button's not working now, so I am Thanking you in person Si. A very informative post.

BFN

Julie X

NEVER LAUGH AT A LIVE DRAGON
User
Posted 03 Sep 2014 at 13:56

Copy from earlier postings.

 

"   EVIDENCE SYNTHESIS:

In most published series, median PSA levels in the general male population range from approximately 0.4 to 0.7 ng/ml in men in their 40s and from approximately 0.7 to 1.0 ng/ml in men in their 50s. Evidence from both nonscreening and screening populations has demonstrated the predictive value of a single baseline PSA measurement for prostate cancer risk assessment. Specifically, men with baseline PSA levels above the age-group-specific median have a greater risk of prostate cancer diagnosis during the next 20-25 yr. Additional studies confirmed that higher baseline PSA levels at a young age are also associated with a greater risk of aggressive disease, metastasis, and disease-specific mortality many years later.

CONCLUSIONS:

Baseline PSA measurements at a young age are significant predictors of later prostate cancer diagnosis and disease-specific outcomes. Thus baseline PSA testing may be used for risk stratification and to guide screening protocols "


from

http://www.ncbi.nlm.nih.gov/pubmed/21862205

also read

http://www.sciencedirect.com/science/article/pii/S0090429505011970

 

 If psa figures fall into the above ranges, then those at higher risk just need to test on a regular basis. If above these median figures then more attention to testing might be required. i.e. more often.

User
Posted 10 Sep 2014 at 22:20

My estranged father died of metastatic cancer, I was diagnosed at 62 although a PSA of 6.9 was missed at 59. My brother's PSA was low he was 65 . My half brother at 42 was told by his GP that he was to young to be tested.

Thanks Chris

User
Posted 10 Sep 2014 at 23:14

Chris,
If there is a history within the family then one can insist on having a PSA test.

Chris

 
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