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The Gray Area of Favorable Intermediate Risk 3+4=7
Prostate Cancer | Last Active: 3 days ago | Replies (35)Comment receiving replies
Thanks for the comments. I was referred to Genetic Screening and Counseling (the later if necessary). A week or so after a buccal swab process, I was contacted and also sent an e-mail with a report that stated "Negative" for tumor genetic markers. I was a clinical lab director for most of my career. I was pleasantly and surprisingly shocked at how many genetic tumor markers are tested for. Without counting, it look to approach 100 or more. I will ask in my 3-month follow up at the end of July, if there is anything more specific that they can test for, and/or if any in-common environmental factors could be at play. Having been that clinical lab director, I had/have never heard of any environmental factors being contributory to prostate cancer. I have always known that there "can be" a familial genetic propensity for it )which I thought I had), but that most men - like me - fell into the classic "one in five men will get prostate cancer in their lifetime" category. Despite my father having prostate cancer, but living to age 99 years 10 months without treatment or prostatectomy; or my maternal grandfather having prostate cancer without prostatectomy for over 20 years and dying of Alzheimer's; and a maternal uncle having prostate cancer with prostatectomy, but dying of a massive stroke at age 86, there was no genetic link to my father's side of the family or my mother's side of the family. I just fell in that "one in five men will get prostate cancer" category.
Replies to "Thanks for the comments. I was referred to Genetic Screening and Counseling (the later if necessary)...."
Genetics aside, just garden variety prostate cancer can be different for each generation. Your forbears lived in a different environment, and as you point out, we really don’t know specifically what different environmental, dietary or other factors contributed to YOUR cancer. Your father’s and grandfather’s cancers were probably not as aggressive (sorry to use that harsh of a word) - or as strong? - as yours. If they were, how could they live that long if statistics are to be believed?
FWIW - (and you didn’t ask me, I know) and please excuse my offering an opinion on this, but that’s all it is- an opinion; but in your shoes I would get on ADT now and have adjunctive RT as soon as you are cleared for it.
You know the cancer is still there and you know it is a more potent variety so why not get it as early as you can and kill it before it breaks loose? Best of luck with your treatment.
Phil
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Yes, genetic screening is typically known as “germline” screening - genetic testing that examines DNA in non-cancerous cells, like blood or saliva, to identify inherited gene mutations that might increase a person's risk of developing prostate cancers. It's distinct from somatic or tumor testing, which focuses on mutations within cancer cells - which are the other types of tests that I was referring to so that a more thorough view of the prostate cancer can be obtained (without cutting it out just to see).
Yes, there are a lot of gene mutations the genetic tests look at, but only a handful are currently known to be significantly related to prostate cancer. (See attached graphic.). Also note that the genetic predisposition can be passed down to men through the maternal line.
Many malignancies have been linked to specific environmental exposures. Some environmental and occupational factors have been linked to a risk of prostate cancer. These include Agent Orange exposure, pesticides, and industrial solvents like trichloroethylene.
Prostate cancer is highly survivable, especially when caught early. We’re talking 99% when caught in its earliest stages. The number often quoted for men diagnosed with prostate cancer is “1 in 8” (or “1 in 6,” if a minority), and a small subset of those actually die from prostate cancer. However, once it metastasizes, mortality increases significantly.