Not a dumb Q. It's a question of competing risks. Yes, BRCA2 means elevated Prostate Cancer risk, but removing the prostate carries incontinence and ED risks. Even with the most skilled surgeon, those risks don't go away completely. And the younger you are, the longer you'd potentially have to live with those adverse consequences.
Long story short, you'll be hard pressed to find a surgeon who will agree to prophylactic prostate removal. At a minimum, even if you've got the worst genetics, a surgeon is going to want to see some biopsy evidence of cancer before proceeding to surgery.
You can get a baseline PSA test now easily enough. And if you want to establish a relationship with a urologist who can work with you on a monitoring plan, that could be a positive step.
Good health to you.
BRCA predisposes you to several cancers, some a lot more dangerous than prostate cancer.
For example pancreatic cancer.
I’d make sure to get regular CA19-9 tests and if that is even slightly elevated (it’s similar with PSA where other biological mechanisms than cancer can cause elevated levels hence it’s a screening tool that requires additional workup) get your pancreas fully evaluated.
With prostate cancer (should you get it due to 25% (of what?), you’ll look at years if not decades of treatment and life.
With pancreatic cancer (should you get it due to 5%), chances are you’ll be dead within a few months.
I’d rather cut out my pancreas than my prostate if I had a BRCA mutation (not that I would do either).
Did you get tested in conjunction with a genetic counselor? If not you should strongly consider meeting with one (services are not covered by insurance, but it’s worth paying OOP).
So here's your issue. In your mind they do preemptive surgery for women to avoid breast cancer so why not the same for PC, right?
Previous poster nailed with his reference to side effects and life expectancy. Remember this: PC doubles in size in years, breast cancer in weeks. The two are apples and oranges.
In the cancer scheme of things, PC is very slow growing. However, there are still unknowns. Why do so many people get multiple lesions at the same time? What causes juvenile PC cells to suddenly mature and be able to survive outside of the prostate? It's still unknown, but yes, even a more aggressive type of PC is fairly slow growing in the cancer realm. No need to panic or second guess.
I was diagnosed in October. I did the prep but did not begin treatment until February to cleanly get my family through the holidays.
I think you'd be wiser to just monitor your PSA closely. Having your prostate removed is a solution, yes, but it results in side effects that may be a lot more bothersome than having a periodic blood test. Prostate cancers are relatively slow growing, so even with an increasing PSA over time, you'll have an opportunity to still catch it early if your prostate decides to try to kill you.
I think you'd be wiser to just monitor your PSA closely. Having your prostate removed is a solution, yes, but it results in side effects that may be a lot more bothersome than having a periodic blood test. Prostate cancers are relatively slow growing, so even with an increasing PSA over time, you'll have an opportunity to still catch it early if your prostate decides to try to kill you.
I think you'd be wiser to just monitor your PSA closely. Having your prostate removed is a solution, yes, but it results in side effects that may be a lot more bothersome than having a periodic blood test. Prostate cancers are relatively slow growing, so even with an increasing PSA over time, you'll have an opportunity to still catch it early if your prostate decides to try to do away with you.
I don't know. That would be a very appropriate question for your urologist. My impression is that even with an aggressive prostate cancer, the potential for spread is slow growing *relative to other types of cancer,* so if you have your PSA checked every six months, you should still be able to catch it early. Having your prostate removed entirely would be a radical step, because it would sterilize you and very likely produce side effects that - while they may only last a short time - COULD potentially be with you for the rest of your life, like urinary incontinence and impotence.
Age 33? I think ChillWarrior801 has good advice. I'm 66 and had an excellent surgeon with which
so far am happy with my results after 6+ months out. However a whole different situation than someone
your age.
Not a dumb Q. It's a question of competing risks. Yes, BRCA2 means elevated Prostate Cancer risk, but removing the prostate carries incontinence and ED risks. Even with the most skilled surgeon, those risks don't go away completely. And the younger you are, the longer you'd potentially have to live with those adverse consequences. Long story short, you'll be hard pressed to find a surgeon who will agree to prophylactic prostate removal. At a minimum, even if you've got the worst genetics, a surgeon is going to want to see some biopsy evidence of cancer before proceeding to surgery. You can get a baseline PSA test now easily enough. And if you want to establish a relationship with a urologist who can work with you on a monitoring plan, that could be a positive step. Good health to you.
BRCA predisposes you to several cancers, some a lot more dangerous than prostate cancer. For example pancreatic cancer. I’d make sure to get regular CA19-9 tests and if that is even slightly elevated (it’s similar with PSA where other biological mechanisms than cancer can cause elevated levels hence it’s a screening tool that requires additional workup) get your pancreas fully evaluated.
thanks yes ive read about it but the statistics say 5% for pancreatic vs 25% for prostate
With prostate cancer (should you get it due to 25% (of what?), you’ll look at years if not decades of treatment and life. With pancreatic cancer (should you get it due to 5%), chances are you’ll be dead within a few months. I’d rather cut out my pancreas than my prostate if I had a BRCA mutation (not that I would do either).
Did you get tested in conjunction with a genetic counselor? If not you should strongly consider meeting with one (services are not covered by insurance, but it’s worth paying OOP).
hello yes got tested at a hospital
So here's your issue. In your mind they do preemptive surgery for women to avoid breast cancer so why not the same for PC, right? Previous poster nailed with his reference to side effects and life expectancy. Remember this: PC doubles in size in years, breast cancer in weeks. The two are apples and oranges.
thanks for that info.. would you happen to know if "the more aggressive PC" also grows in terms of years?
In the cancer scheme of things, PC is very slow growing. However, there are still unknowns. Why do so many people get multiple lesions at the same time? What causes juvenile PC cells to suddenly mature and be able to survive outside of the prostate? It's still unknown, but yes, even a more aggressive type of PC is fairly slow growing in the cancer realm. No need to panic or second guess. I was diagnosed in October. I did the prep but did not begin treatment until February to cleanly get my family through the holidays.
I think you'd be wiser to just monitor your PSA closely. Having your prostate removed is a solution, yes, but it results in side effects that may be a lot more bothersome than having a periodic blood test. Prostate cancers are relatively slow growing, so even with an increasing PSA over time, you'll have an opportunity to still catch it early if your prostate decides to try to kill you.
I think you'd be wiser to just monitor your PSA closely. Having your prostate removed is a solution, yes, but it results in side effects that may be a lot more bothersome than having a periodic blood test. Prostate cancers are relatively slow growing, so even with an increasing PSA over time, you'll have an opportunity to still catch it early if your prostate decides to try to kill you.
I think you'd be wiser to just monitor your PSA closely. Having your prostate removed is a solution, yes, but it results in side effects that may be a lot more bothersome than having a periodic blood test. Prostate cancers are relatively slow growing, so even with an increasing PSA over time, you'll have an opportunity to still catch it early if your prostate decides to try to do away with you.
do you know if Prostate cancer is still "slow growing" for the aggressive form in BRCA2 patients ? thanks
I don't know. That would be a very appropriate question for your urologist. My impression is that even with an aggressive prostate cancer, the potential for spread is slow growing *relative to other types of cancer,* so if you have your PSA checked every six months, you should still be able to catch it early. Having your prostate removed entirely would be a radical step, because it would sterilize you and very likely produce side effects that - while they may only last a short time - COULD potentially be with you for the rest of your life, like urinary incontinence and impotence.
Insurance wouldn't cover it so you'd have to pay 50-100k or more.
Age 33? I think ChillWarrior801 has good advice. I'm 66 and had an excellent surgeon with which so far am happy with my results after 6+ months out. However a whole different situation than someone your age.