Your sitemaster is extremely conscious that (as a consequence of circumstances beyond his control), he has still not provided any meaningful, promised follow-up on other poster presentations made at the recent conference in San Francisco. (For this he is apologetic — but he wasn’t expecting to have to spend much of the past week getting stranded in Florida and having to dig ice off his driveway when he did get home!)
In the interim, he is therefore providing this link to some brief commentary (by Dr. Christopher Tully, and published on the Practice Update web site) about key papers presented at the meeting. We will try to add to this just as soon as we can manage.
Filed under: Uncategorized | Tagged: 2014, Cancers, genitourinary, symposium |
THE "NEW" PROSTATE CANCER INFOLINK 
I have a question. I was diagnosed with prostate cancer at age 59. No family history of any cancer on either my maternal or paternal sides of the family. None. My son is 19. There is a strong history of cancer (breast, lung, stomach) on my wife’s side of the family. All cases of cancer happened in the women of her family, not the men. Should I be thinking about having him genetically tested for prostate cancer or any cancer in general?
I can see no particularly good reason (based on the information you have provided) to think that your son is at any increased risk for any hereditary form of cancer.
His risk for a diagnosis of prostate cancer is somewhat increased by your own diagnosis, but the real risk associated with prostate cancer would also depend on the details of your own diagnosis. In other words, there is a serious question as to whether you have been diagnosed with clinically significant disease or with low- or very low-risk disease that may never be clinically significant.
Because of your diagnosis, your son might be wise to get a baseline PSA test done in his late 30s or early 40s (just to see if he is at increased risk for prostate cancer in the future) but there is no test that I am aware that would predict future risk for prostate cancer in a 19-year-old (unless the women on your wife’s side of the family are know to be carriers of the BRCA1 or BRCA2 genes).
I would also point out that at 19 years of age your son is legally an adult, and so any decision about whether he does or doesn’t want to have specific medical tests is now his to make, although you may wish to offer him guidance.
I had a radical prostatectomy last year with 39 sessions of follow-up radiation. Since then my PSA has been imperceptible. My wife doesn’t want to have the test for the BRCA1 or 2 genes. She would rather not know, even though her sister has recently been diagnosed with malignant squamous cell carcinoma on her left breast.
You’re right about legally being an adult so I will arm him with as much advice as possible and he’ll have to make his own decisions. But I am a worrier and I intend to be on him like white on rice about this until the day I die.
OK … But do remember that he is only 19 — and therefore “temporarily immortal”. He presumably has already noticed that you are a “worrier”. You might want to take a light touch to cooking this particular plate of whitened rice!