12 November 2024
By Bernie Riley
Head of Telenursing and Supportive Care Programs
Understanding the risk factors for prostate cancer, and how to get checked, can help to ensure the disease is detected early, when it can be more effectively treated.
You may have seen our recent Rate Your Risk campaign, educating the community about prostate cancer testing and early detection.
While this may surprise you, simply knowing your family history of prostate cancer can be critical to early detection. That’s because if your father or brother have ever been diagnosed with prostate cancer, you have twice the average risk of developing the disease.
And if you have two or more close male relatives who have been diagnosed, your lifetime risk of developing prostate cancer increases five-fold.
Your risk also increases if you have a strong family history of breast or ovarian cancer, especially if a BRCA1 or 2 gene mutation was involved.
While it’s imperative to know your family history of prostate cancer, it’s also important to know your family history of other potentially deadly cancers, such as breast or ovarian cancer, which place men at higher risk of developing prostate cancer (and breast cancer!), particularly if these cancers were related to a mutation in the BRCA 1 and 2 breast cancer genes.
Interestingly, all of us have Breast Cancer 1 (BRCA1) and Breast Cancer 2 (BRCA2) genes. They are cancer protection genes that function to repair cell damage helping to prevent certain cancers from developing. In some cases, the cancer protection genes are faulty and do not repair cells as they usually should.
These faulty genes can be passed from parents to children, and although it doesn’t necessarily mean that children who inherit the genes will go on to develop cancer, it does place them at a higher risk of developing cancer, and at an earlier age, with a greater likelihood the cancer will be more aggressive.
Men with African ancestry also have an increased risk of developing prostate cancer, although the reasons for this aren’t well understood.
If you have a high risk of prostate cancer, you should consider PSA testing from the age of 40, and discuss your risk with your GP or with a PCFA Telenurse. Your GP will be able to provide a pathology request form for the test, which is provided free of charge for high-risk men every 11 months.
In addition, if you have a high risk of prostate cancer, your GP will take extra care in monitoring your prostate health if your PSA rises above 2.0ng/ml. Conversely, for men at an average or low risk of prostate cancer, the threshold for concern is usually 3.0ng/ml.
Depending on any other symptoms, if you have a high risk of prostate cancer and your PSA rises above 2.0ng/ml, your GP will most likely repeat the test within one to three months. If your repeat test is high, you should be referred to a urologist for more tests. These tests should all be provided free of charge – just make sure your GP uses the correct Medicare item numbers for patients in the high-risk category.
If you have a medium risk of prostate cancer, which means no family history, no known genetic risk, no risk related to your ethnicity, and no symptoms, you should consider PSA testing from the age of 50.
Under Australia’s Medicare system, you will be able to get a free PSA test every 23 months, and if your PSA rises above 3.0ng/ml, your GP will provide advice about retesting or referral to a specialist, depending on your individual situation.
If you have a low risk of prostate cancer, which means you are under the age of fifty with none of the risk factors mentioned above, and no symptoms, discuss PSA testing with your GP and consider getting a baseline PSA test so that you and your doctor can monitor any future changes that may assist with early detection.
If you have any questions about your risk, signs or symptoms, PSA testing please don’t hesitate to reach out to our Telenursing team on 1800 22 00 99 or email telenurse@pcfa.org.au.
