Not before 40. Don't base decisions on anecdotes that make the Guiness Book of Records.
I recall my GP administering the infamous DRE all through my 40's. It's possible I got this screening in my late 30's but the cases you illustrate are extremely rare.
My husband just had genetic and genomic testing- genomic to see if he had any gene mutations in his prostate tissue to lead treatment. Genetic to see if he had any hereditary genes that would make our kids, his siblings, their kids... more at risk. (Think BRCA1 or BRCA2- they tested 29 I think) My husband is 50- diagnosed in August at 49. Hid father has prostate cancer but wasn't diagnosed til 67. He also had a paternal grandmother with cancer (dont know where it started- she was a heavy smoker and died quickly after diagnosis) My husband did not have any genomic mutations and and had no hereditary genetic markers. Even so- the genetic center at our cancer center recommended our boys have psa at age 25 to 30 and our daughter and sons early screening for cancers. He recommended other relatives be made aware for early screening as well. Their thoughts- there may be a gene or mutation we don't know about now. They'll keep his samples and test if more are discovered. Our genetic counseling center is a part of our cancer center.
There would be no harm whatever in your son keeping an active eye on his own health, even at 21. Insurance won’t pay for his PSA blood test, but for about $50 he can individually buy the very same test from any major lab company (Labcorp, Quest). Naturally, his PSA won’t be anywhere near out of range at such an age, however he will, as all males after puberty, have some very small amount of PSA in his blood at any point in time. And it will fluctuate, up down etc without any concern. In any event, He should keep the reports for comparison once each year; hence the key diagnostic indicator, ‘rate of doubling’. There is no reason for concern, unless there should be a discernible and continued increase in PSA from the last test. The lack of this type of active individual monitoring is I believe why half of a mets patients where already in stage 4 at the point of biopsy.
My husband is stage 4, diagnosed with aggressive cancer at 49. He's now 61 with bones mets and not doing great at the moment. He found out just before his 95 year old father passed away that he had PCA throughout his body. Apparently diagnosed very late in his life, but never told anyone, although my husband suspected, he was already diagnosed. His father's sister died of ovarian cancer, her daughter is an ovarian cancer survivor, their grandmother died of breast cancer, as did another aunt. I'm a breast cancer survivor, aggressive type but cancer free. We have a 21 year old son. His pediatrician years ago told me he should get a baseline in his early 20's. I asked my husband's onc (who we're switching) and he said 40. We've been advised to get braca tests. I'm on the fence about these tests. One doctor said be very careful. Future insurance, employment issues for our son. And call me a skeptic, but I believe it. So, when my son comes back from college this summer I'm taking him to a doctor and getting his psa tested. I don't care what the professionals say, 1 person, like that 21 year old and 28 year are one too many. My husband also heard of a 19 year from his nurse. I'd rather err on the side of caution than the alternative. Its a $50 test. I also feel like I don't know how long my husband or I will be here and I want my son prepared for anything and know how important it is to keep extremely vigilant about his tracking pca.
Put your mind at ease and take him. They need to be educated and they need to learn how to take care of themselves. Make choices if they have too, freeze sperm if the might need too..while they are young and strong and hopefully a cure before they ever need it. My trust in doctors has seriously declined this past year. Be your own advocate!
I worry about the insurance and employment issue for the kids as well. One more thing to worry about. But agree- most of me feels it's better to know and get earlier treatment if possible. So many great treatments in the works I'm hoping they have a cure, or at least make it a chronic illness, for our kids.
It’s a big decision. I just think vigilance and early testing could be as effective as genetic testing and although your test results are “out there “ not as revealing as having genetic testing. Definitely a personal choice. My husband and I have opted not to for now but that could change. My concern is our kids will be “‘Marked” for the future. Where aggressive and early intervention would serve the same purpose without being marked.
Completely agree. If my husband had tested positive for the genetic markers I'm not sure I would have had my kids tested for the genetic markers for that reason. I don't trust the med insurance industry. Our daughter has crohns and all 3 of my kids are in studies with that. But cancer markers are a different beast. I'm hoping by the time our oldest is 25 (he's 19) there will be more tools and understanding.
I didn't know there were studies for crohn's....my husband was diagnosed with crohn's this year as well. Might be interested in that study for my son. Thanks for info! Wish you and your family the best.
To do the genetic testing is a huge decision. As well as a son I also have 3 beautiful daughters. There is no family history of breast or ovarian cancer. My MO said it's a good idea that's worth thinking about. Any gene mutations they find may benefit me down the track with targeted therapies, and if positive for the braca genes it will of course cause a lot of anxiety for my family, but at the same time it could save a life/lives.
Thank you and all the best to you and your husband.
I am 45 with my first reoccurrence, strong family history (father, uncle, father's uncles). Everyone else was in their 50/60s and still kicking into their 80s. Lucky me, I was the youngest and the only one to get a reoccurrence. However, I heard of one of my father's uncle that got Dx in their 50s, told they have 5 yrs and lived to 87 on 'hormones', but who knows.
In any case, I have a son 10, and a daughter. Got genetic testing at MSK. Initially for BRACA, AMT and HOXB13. All were negative. Now in the IMPACT study, they are doing a full work-up on everything, results pending.
Good to have the information. The treatments are changing fast and moving toward biomarkers vs named disease. I really believe in the future, you will be treated primarily based on your genetic mutation vs 'you have X Y or Z cancer'. It will be more like you have 'ABC mutation, take this'
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