Son’s psa

[Cynthgob]

Husband has advanced prostate cancer metastasized to almost all bones. What psa do you watch for in a son of someone with this bad of diagnosis? 0??? Son 42

[Cynthgob]

Thank u!! He had some blood test done but now they want to do another biopsy for the gene mapping as more accurate?

[Tall_Allen in reply to Cynthgob]

Those are different things - not more or less accurate. The blood test was probably for germline (inherited) aberrations. The biopsy is for somatic (tumor) aberrations. Unfortunately, there are few therapies available for prostate cancer based on genetics, and those are rare.

[Mish80]

Sorry, why daughter ?

[ctarleton in reply to Mish80]

Some inherited gene mutations, such as the BRCA genes, are associated with cancers in both men and women, e.g. breast cancer in women. Knowing this can improve rational screening strategies and perhaps help guide future treatment options.

[tom67inMA]

With the family history, screening should start sooner. The criteria would be the same in my non-expert opinion: a rising trend is more suspicious than an absolute number. I'd also recommend a manual exam. I had PSA screening only and it didn't detect my cancer early. I was stage 4 before the PSA went up. 216 at diagnosis vs about 2 when screened 13 months earlier.

[Tall_Allen]

MSK advocates what I call "thrice in a lifetime" PSA testing. When they give a test to a man in his 40s - if it is below 1.0, they don't see him again until his 50s. If it is still <1.0, he can have his next PSA test in his 60s.

mskcc.org/cancer-care/types...

[Hidden in reply to Tall_Allen]

And that my friend is why more men are metastatic upon initial diagnosis!

[Tall_Allen in reply to Hidden]

My friend, that is why MSK is the best in the business.

[Hidden in reply to Tall_Allen]

Yes, they are very good at increasing their patient lode at the patient’s expense. PSA tests are inexpensive serving as a first line detection system for men; not unlike women mammograms serving women.

Prostate cancer and breast cancer are terrible diseases where early detection is paramount to one’s survival.

Of course old people are not important to the federal/state government and insurance companies when it comes to saving dollars.

GD

[Tall_Allen in reply to Hidden]

You've got it backwards, my friend. The goal of their protocol is to keep men from becoming patients. They base their protocol on actual research geared to minimize harm. I raised a reservation with them that screening men in their 40s would only add to the crisis of maimed men, but they assured me that they are showing excellent outcomes. Probably not every institution could pull this off, but MSK can.

[adlerman in reply to Tall_Allen]

I was never harmed by a PSA or DRE exam.

[Hidden in reply to Tall_Allen]

Their PSA screening guideline, with 3.0 as the threshold, would not have caught my prostate cancer. My PSA was 2.7 at diagnosis. No where do they even mention DRE as a screening tool. Are they swallowing the Preventive Services Task Force line of bull? You know, let's not trouble a man needlessly with dire news.

[Tall_Allen in reply to Hidden]

You misread that. Any man with a PSA over 1.0 gets a more rigorous testing schedule. There will always be false negatives on any test. There are even a few men with prostate cancer that never show any PSA elevation. They have developed 4K Score as a way of detecting PCa by going beyond just PSA (PHI is similar). DRE is an even lousier test than PSA for detecting PCa.

[adlerman in reply to Tall_Allen]

and yet a DRE probably saved my life. The low numbers detected are lives saved in many cases.

[Tonik25]

Also our GP said daughters can inherit the mutation from their fathers and pass the genes to their sons.

[2dee]

Genetic testing if reveals BRCA1 or BRCA2 mutation inherited and passed on. Does not guarantee cancer but likelyhood MUCH higher. Also opens the possibility of some specific treatment not available without mutations.

Also allow you to warn bloodline relatives to be more aggressive with testing and treatment.

I inherited from grandfather through my mother. I'm stage 4, 76yr old, but it skipped my daughter.

one of my aunts and 7 of her children all died early of cancer.

[Hidden]

I commend you on getting him tested at 42. I now know that I was to check at 40 because my dad had pc. Early detection is the best. Stay on it! Take care...

[JavaMan]

Is this the decipher test?

[Eabradley]

my husband had prostate cancer at 65 but caught early and he is fine.. unfortunately my son was dx at age 40 with stage 4 metastatic prostate cancer with a PSA of 1250. The GP doctor he went to refused to do a PSA when he had back pain 6 months prior to his DX at Mayo Clinic . my advise dont wait ...test early and often . I know there are new tests that test for gene mutations and there are vaccines in clinicial trials for men who are more at risk. I have read about men who are Stage 4 with very low PSA .. Find a Doc or Hospital that specializes in prostate cancer and will test your son often .

[cancervictim in reply to Eabradley]

I agree with you. As I understand it, the germline testing is not conclusive as there are more rare genes associated with PCa that have not yet been identified. This is such a horrible disease, I'd take no chances. I've met several men who believed they were being vigilant with testing because of a family history yet their PCa took off rapidly in between annual tests.

[Kevinski65 in reply to cancervictim]

My twin brother and myself were both diagnosed on the same week. My prostate cancer was further along, however. Sort of screams genetics but I donno...

[EdBar]

There is a company called Invitae that can do genetic testing through a simple saliva kit. It tests for 80 different mutations. It can alert your family members to be tested early for various forms of cancers since many mutations can put you at a higher risk for more than just one type of cancer. I don’t believe it is very expensive - two or three hundred dollars. And as stated above there are few treatments currently available for PCa in regards to genetic mutations.

There is still some question involving things like life insurance and medical insurance and how it could affect ones ability to get coverage in the future if through genetic testing one is found to have genetic mutations. Theoretically, an insurance company could ask if a person has had genetic testing done and you must answer truthfully. It’s one of those things where the law is not keeping pace with technology. Give it some thought and proceed with caution.

Ed

[larry_dammit]

Get him to a good urologist and let them discuss how to proceed . I have stage 4 with Mets, my father 87 has been battling high PSA for years and now has Mets. I have my son go in every 6 months

[Cynthgob in reply to larry_dammit]

How old is your son ?

[larry_dammit in reply to Cynthgob]

Just turned 50.

[kiskadog]

My surgeon said to get a good baseline test, and if your PSA raises more than one point in later tests, get further evaluation. He said this is more definitive than the traditional PSA 4.0 warning threshold.

He said that all PSA tests should have proper preparation, that being avoid anything that may irritate the prostrate for 72 hours prior to the test. Such irritations include sexual activity, bicycle riding, infections in the area, falls, or blows that may have jarred the prostrate, or even vigorous exercise, or running.

I have not seen or heard such advice anywhere else.

Has anyone else heard this? I would be interested in hearing comments from others much more knowledgeable than myself regarding the validity of this advice.

[Hidden in reply to kiskadog]

Yes I've read that advice online and heard it from my urologist.

[Hidden]

Now that he is in his 40's he needs to find a doctor who will subject him to a DRE (digital rectal exam) at his annual physical. Not fun for doctor or patient. PSA doesn't normally raise an alarm until it is higher than 4.0. My PSA was a moderate 2.7 when a DRE turned up an abnormality and got me sent to a urologist for a biopsy. Gleason 8. So, PSA testing alone is not sufficient for prostate cancer screening.

[dadzone43]

4.0 ng/ml or less

[ROLNCIN1]

My husband had the genetic testing done for the BRACA gene which proved negative.

We were also told very few tests prove positive. Not certain if the tests were specific for PCA gene only!

Husbands Father had PCA BTW.

BOOGEE

[afab]

I have metastatic prostate cancer so I insisted that my sons, 44 and 51, get tested. I'd rather that they be safe than sorry no matter what the probabilities or current guidelines. The PSA is a simple blood test and the rectal exam is usually standard with an annual physical. So why shouldn't they?

[j-o-h-n]

to Cynthgob.

BELOW IS YOUR POST FROM 2 MONTHS AGO:

After being tested there are no known gene mutations in my husband’s DNA. All mutations were checked that are known to attribute to prostate cancer. My question : is it a good thing or a bad thing? I know it’s good for my family but is it for my husband in that if you have a gene mutation doesn’t it make it easier to attack the specific cancer you have? Isn’t the new lymparza study targeting dna mutations? Just wondering? Thank you!!

Today's answer to today's question.

Get him screened by a GOOD urologist asap. BTW where are you located?

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 03/20/2019 6:03 PM DST

[Cynthgob in reply to j-o-h-n]

Yes he had the blood test and it had no mutations. But the gene mapping will test differently( biopsy). Near Chicago. Thank you for your answer.

[j-o-h-n in reply to Cynthgob]

NO thank you, for your response. well I wish him:

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 03/21/2019 5:08 PM DST

[RCOG2000]

Combined test. Free and total psa would be helpful. Want low psa and high free psa. Also most important that he track changes in psa and compute doubling time if it is rising.

And make sure he has prepared appropriatley proor to each test ss noted above.

Odds change from 1 man in six in general population having disease to one man in three if father or brother has disease

Genetic testing cant hurt but early diagnosis depends on your own skill and committnent to regular testing and working with urologist who is goid with prostate cancer.

DRE from primary care is often false negative. A more experienced finger is better for the finger wave than less experienced

Best of luck.

George

[marykg46 in reply to RCOG2000]

George, I'd just add that my husband had a DRE from his very experienced, highly regarded prostrate cancer specialist and he thought everything was fine when in fact his tumour as well as being quite extensive had spread to seminal vessels. So am now a great believer in the advice you gave about PSA being so important.

[JavaMan]

Thanks Nalakrats!

[marykg46]

Hi Cynthgob. I'm like you and as my son's grandfather and now his father has pc as well I try to make sure I'm able to give my son good info. Also my daughter has 2 sons (just teenagers now) and both grandfathers ( my husband and my daughter's father in law have pc). Our son who is 45 has regular 3 monthly psa's. I'm about to ask a specialist we're seeing in a week or so about DNA testing for my son as I've read about that and he is keen to follow it through. Apart from that I'm not sure what else you can do.....guess some would say watch your diet and exercise too.