Does prostate cancer run in families?

Family history is very relevant for prostate cancer detection. Men with a first-degree male relative—a father or a brother—who was diagnosed with prostate cancer before age 65, are at increased risk for prostate cancer themselves. Their risk of prostate cancer is 1.5 to 2 times greater than the average risk. Because of the use of prostate-specific antigen (PSA) screening, prostate cancer is being found at earlier, more treatable stages.

Some types of prostate cancer run in families. If you have a grandfather, father, brother or uncle who was diagnosed with prostate cancer, particularly before the age of 50, you may have an increased risk of getting prostate cancer.

Risk is also increased if family members had early-onset prostate cancer. It is important to know if there are members of your family who have had prostate cancer, at approximately what age it was diagnosed, and if it was an aggressive form.

With a family history of prostate cancer, especially if it was diagnosed before the age of 65, men tend to be diagnosed at a younger age, and at a more advanced stage than without a family history. This is why men with a family history are considered at high risk for prostate cancer and may be advised to begin screening at a younger age, such as 40 or 45.

About 15 percent of men diagnosed with prostate cancer have a first-degree male relative (father or brother) who has had the disease, compared to about 8 percent of the total male population in the United States. This involves nearly a doubling of the risk.

A 1997 study involving nearly 2,000 men who died from prostate cancer out of nearly 500,000 followed for nine years confirmed this risk. The researchers found that, compared with men who have no family history of prostate cancer, having a father or a brother who was diagnosed under the age of 65 doubles a man's risk. The younger the age the relative was diagnosed, the more likely there is to be a genetic link. Nearly one-half of cases diagnosed in men under the age of 55 are related to genetic defects. The risk is somewhat less when the relative was diagnosed at an older age because it is less likely due to a genetic cause. Prostate cancer that develops later in life is more likely to be related to environmental causes. A greater number of relatives affected also increases the risk. If a man's father and brother have had the disease, the risk is tripled.

It has also been suggested that men with a family history of breast cancer in their mother or sisters may have an increased risk of prostate cancer. Both cancers are hormone dependent and thus there may be some genetic relationships. Further research needs to confirm this relationship, but a man with breast cancer in his family may need to pay closer attention to screening for prostate cancer.

Risk is increased with a family history, but even if you don't have a family history of prostate cancer, 1 in 6 men get it—so it's important for all men to be evaluated on a regular basis. Watch urologist Harry Fisch, MD, explain why it's essential to have a simple prostate exam regularly.

The American Cancer Society recommends that men have a chance to make an informed decision with their healthcare provider about whether to be tested for prostate cancer.

The talk about testing should take place at age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.

This talk should take place starting at age 45 for men at high risk of getting prostate cancer. This includes African American men and men who have a father, brother or son found to have prostate cancer at an early age (younger than age 65).

This talk should take place at age 40 for men at even higher risk (those with several family members—father, brother, son) who had prostate cancer at an early age.

Dr. Jesse N. Mills, MD

A family history of prostate cancer can increase your risk of developing the disease. There are genes that run in families that make a man more likely to get prostate cancer. Doctors do not routinely screen men for those genes. However, they know that if man’s relative is diagnosed with prostate cancer in his sixties, especially under age 60, the man’s chances of getting the disease go up.

However, if your father was diagnosed at 75 with prostate cancer, you probably do not have that much of an increased risk-unless your father is first diagnosed with metastatic prostate cancer at age 75. That means the cancer spread and probably started developing it in his 60s or even late 50s. That represents a pretty strong family history.

So it really depends on your dad and his prostate cancer stage. If he is diagnosed with a low-risk prostate cancer that doesn't appear to be harmful or may not kill him, then your risk of developing prostate cancer is not any greater than the general population. The chances of getting the disease goes up every decade by about 10 percent. By the time a man is 70, there is a 70 percent chance of that he will develop or be diagnosed with prostate cancer.

Dr. Marc B. Garnick, MD
Hematologist & Oncologist

Scientists do know that a person's genes play a role in prostate cancer. For example, certain genes (oncogenes) encourage cells to grow and divide. Other genes (tumor suppressor genes) can tell cells to slow their growth and when to die. Like lights, these genes have switches. If the switch that controls an oncogene is stuck in the "on" position, or if the switch for a tumor suppressor gene is stuck in the "off" position, cancer can grow.

Deoxyribonucleic acid (DNA) mutations may be inherited or may occur during a person's lifetime. For example, an inherited gene called hereditary prostate cancer 1 (HPC1) seems to account for a small percentage of prostate cancer cases. Men with changes in their breast cancer type 1 (BRCA1) and breast cancer type 2 (BRCA2) genes—genes that when mutated can cause breast cancer in women—also seem to have a higher risk of prostate cancer. But experts estimate that inherited mutations cause only about 5 to 10 percent of prostate cancers.

DNA mutations that occur during a person's lifetime may simply be random mistakes, errors made in copying the DNA when a cell divides. Researchers aren't sure whether lifestyle factors, such as diet, or environmental factors, such as toxic chemical exposure, might speed up cell division, which could cause more copying errors. Perhaps these factors cause mutations on their own.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.