NEW YORK, April 15 (Reuters) -- New research indicates that men with a family history of prostate cancer may be at risk for a more aggressive, harder to treat form of the disease than men who develop the cancer but have no such family history.
However, men with familial history of the disease also tend to be diagnosed at an earlier age, and at an earlier stage of the cancer, when treatment is more likely to be effective than it might be in their later years.
"This would be expected, since the presence of prostate cancer in the family could lead to increased awareness and earlier presentation for screening and diagnosis," researchers reported in the April issue of the Journal of Clinical Oncology.
The study is one of the first to specifically study the impact of family history on the outcome of cancer in a large population.
Of the 1,038 men with cancer in the study, 11% had a positive family history of cancer. Following diagnosis of their cancer, patients were treated with either radiation therapy or removal of the prostate.
Men with a family history of prostate cancer were more likely than those with no family history to have a poor treatment outcome, reported Dr. Patrick A. Kupelian, of the Cleveland Clinic Foundation. "Even in the presence of all pathologic factors in surgically treated patients, family history remained associated with worse outcome," Kupelian wrote.
The tumors themselves may be the reason for the differences seen among men with a family history and those without, he added. This may be due to a biological advantage of some sort that makes familial prostate cancer more aggressive in the body. Familial cancer may be caused by a rare dominant gene. It is estimated that inherited prostate cancer may account for 9% of all prostate cancers that occur before age 85.
Prostate cancer is the second leading cause of cancer death in men. An estimated 317,100 new cases were diagnosed in the United States last year.
Men aged 40 and over should have a digital rectal exam as part of their regular annual checkup. In addition, the American Cancer Society recommends that men aged 50 and over have an annual prostate-specific antigen blood test.
SOURCE: Journal of Clinical Oncology (1997;15:1478-1480)
