My father was diagnosed with prostate cancer in 1994, when he was just 55 years old. He died 6 years later. The cancer was so aggressive, it took only a few weeks from the time he was diagnosed for the cancer to grow to the size of a softball, and even a radical prostatectomy couldn’t save his life. I’m hoping to avoid the same fate.
I’m fortunate to work at a cancer center and have access to experts in medical oncology to whom I can turn for advice. After suggestions to simply start routine prostate-specific antigen (PSA) testing earlier because of my father’s experience, I e-mailed a specialist in prostate cancer I’d met and asked him if there was anything I should do besides having regular PSA tests and prostate exams to monitor for the disease. At the time, I was 46 and wanted to be proactive in my health care to give myself the best shot at being around to raise my young twin sons.
Learning My Risk Factors for Cancer
The oncologist asked whether I had undergone genetic testing, which I hadn’t even thought about, and suggested I meet with a genetic counselor to see whether I was at risk for hereditary cancer. After undergoing genetic screening, I learned that I do, in fact, have the BRCA2 gene mutation, which puts me at increased risk not only for prostate cancer, but breast, skin, and pancreatic cancers as well.
The genetic counselor told me about a clinical trial the National Cancer Institute (NCI) had launched called Men at High Genetic Risk for Prostate Cancer (ClinicalTrials.gov identifier NCT03805919), and I enrolled in the study. The goals of the study are to determine which men with specific genetic changes are at higher risk for getting prostate cancer and whether certain genetic changes and family history can be used to help prevent or treat the disease.
I have yearly blood tests to monitor my PSA levels. In addition, every 2 years, I travel to the NCI in Bethesda, Maryland, for a physical exam, a review of my medical and family histories, additional routine blood tests (including to measure PSA and testosterone levels), and a prostate magnetic resonance imaging scan. So far, I have no signs of prostate cancer. But as I get closer to the age my dad was when he was diagnosed with the disease, I wonder whether that next test will be positive for cancer.
Knowledge Is Power
In addition to prostate cancer, I’ve been screened for other BRCA2-related cancers; so far, I’ve tested negative. What I’ve learned from my cancer surveillance is that it has made me more health conscious about reducing the risk factors I can control. I maintain a healthy weight and exercise regularly; because there is a history of alcoholism in my family, I only drink occasionally and have never smoked tobacco products.
I know being tested for inherited genetic variants associated with an increased risk of cancer can be anxiety-provoking, but for me, the experience has been empowering. When my sons are old enough to have genetic counseling, I will encourage them to do so. I will discuss our family history with them and explain how fortunate we are to know what our increased risks are for cancer and what we can do to blunt those risk factors.
The future will tell whether my vigilance against cancer and my healthy lifestyle will enable me to avoid prostate cancer or another inheritable cancer or, at the very least, catch it at an early, treatable stage. My hope is that by being proactive now in my health care, I will have the opportunity to watch my children grow into adulthood, get married, and have children of their own.
Mr. Kalister lives in Columbus, Ohio.
Editor’s Note: Columns in The Patient’s Corner are based solely on information The ASCO Post received from patients and should be considered anecdotal.