Men whose fathers, grandfathers or brothers had prostate cancer are not only more likely to get it themselves, they are likely to have a more aggressive variety, according to data released Monday.
The finding means that men whose close relatives had prostate cancer should be screened earlier for signs of the disease, specialists say. It also suggests these men may need more rigorous treatment and follow-up.
“Our study lends strong support to recommendations that men with family histories of prostate cancer should be screened starting at age 40,” said Dr. Eric A. Klein, a study author who is chief of urologic oncology at the Cleveland Clinic.
The report has large implications, since doctors will diagnose prostate cancer in 334,500 American men this year. About 42,000 men will die of the disease this year.
Diagnosed when it is early and localized, prostate cancer is curable. Widespread use of a blood test called prostate-specific antigen, or PSA, has reduced the proportion of prostate cancer considered incurable at the time of diagnosis from about 50 percent to 5 percent, Klein said.
The study, presented at sessions of the American Urological Association in New Orleans, found that two-thirds of prostate cancer patients with no family history of the disease were free of recurrence five years after their prostate glands were removed.
By contrast, only 46 percent of men who had close relatives with prostate cancer were free of any signs of recurrence five years after surgery.
The researchers determined recurrence by monitoring PSA levels in 529 subjects. Klein said any PSA level above zero in a man who has had his prostate removed is a signal the cancer has spread to bones or other organs, even if no tumor is yet visible.