Are castration sensitive prostate cancer patients being over treated?

@smoore4 You mentioned genetic tests Our radiation oncologist did not do a genetics test. I asked him about it and he said that was because my husband's father developed prostate cancer when he was in his 60's. Therefore, genetics wouldn't apply. I think I have read that genes mutate and change . Does anyone know about this?

You mentioned genetic tests Our radiation oncologist did not do a genetics test. I asked him about it and he said that was because my husband's father developed prostate cancer when he was in his 60's. Therefore, genetics wouldn't apply. I think I have read that genes mutate and change . Does anyone know about this?

@fbuckwalter
Here is a list

@gkgdawg
That is one of the most absurd statements I’ve ever heard of As an excuse for not Doing genetic testing.. Having prostate cancer, that young can be directly caused by a genetic problem. I had it at 62 because I have BRCA2 Which I got from my mother. My brother got it at 77 because he doesn’t have BRCA2, but our father died of prostate cancer, which doubles the chance.

That doctor was incompetent when it comes to Understanding, genetic testing.

@jeffmarc I checked the pdf you linked to for the most recent acronym that I had to look up and that is MDT. MDT stands for Metastasis-Directed Therapy and needs to be added to that otherwise excellent list.

@fbuckwalter , welcome. You're right that there are a ton of acronyms to learn with cancer diagnosis. The guys have built a list here:
- Prostate cancer-related abbreviations: What acronym would you add?https://connect.mayoclinic.org/discussion/prostate-cancer-related-abbreviations-what-acronym-would-you-add/

As for using AI to search for information and decision making for health, it's top priority to fact check. AI tools do not replace human judgment or oversight. Any text, image, or video generated by AI should be used only as a starting point, not as verified information. It may contain inaccuracies, biases, and other problems. Generative AI tools can sometimes generate plausible-sounding answers that are wrong.

Here's some sound advice about using AI
- What is Generative AI? What does this mean on Mayo Clinic Connect? https://connect.mayoclinic.org/blog/about-connect/newsfeed-post/what-is-generative-ai-artificial-intelligence-what-does-this-mean-on-mayo-clinic-connect/

fbuckwalter, Is your oncologist suggesting another androgen therapy with the rising PSA? What are next steps?

@gkgdawg Makes ZERO sense.

@heavyphil So, you agree with me? Genetic testing should be part of his tratment?

@gkgdawg
Technically speaking what the issue would be is that genes are selected and omitted. So the likelihood of bad genes is higher (if never actually checked in your father) that he had a bad gene (or two ...), and the possibility is there that if he had a bad gene it (they) was passed onto you, but the only way to be certain is to test you.

Now the doctor may have treatment guidelines on all this so it's not entirely his decision and the genetics test costs whatever it costs but isn't too cheap, and that's what that is. So no matter how high the odds, the only way to be certain is to run the test. You're not a number you're an individual. And more and more medicine is guided for solid scientific reasons on genetics.

At worst it confirms what he's already assuming.

But at best it's a new guideline that might save you from over-treatment - and even save the insurance company some money!

@gkgdawg I was disagreeing with your oncologist’s statement that a genetics test does not apply to him because his father developed PCa in his 60’s. Genetics is the basis (IMO) for prostate cancer so knowledge is power, treatment-wise.
However, if your husband has a relatively lower Gleason score, Decipher test, negative PSMA, etc., your doctor may simply mean that it is not necessary since treatment will unfold along fairly standard lines; in other words, nothing dire or of
Significance.
Phil