How does family history affect prostate cancer risk?

Question

Hello doctor,

I have been experiencing urinary urgency, and my family doctor ordered a prostate-specific antigen test because my father had prostate cancer at 55. My prostate-specific antigen came back at 3.2 ng/mL, which she says is high for my age. I also have a brother who was recently diagnosed with prostate cancer. The digital rectal exam was normal. Should I be seeing a urologist at this point? What other tests might be recommended, considering my family history and ethnicity?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

My PSA came back at 3.2 ng/mL, which she says is high for my age. While this value is raised, PSA levels greater than 10 ng/mL are typically suggestive of cancer, and levels above 35 ng/mL are almost diagnostic of advanced prostate cancer, assuming there is no active urinary tract infection. PSA can also be elevated in conditions like benign prostatic hyperplasia (BPH) and prostatitis. Given my ethnicity, geographical prevalence, and positive family history, all of these factors indicate an increased risk for the development of prostate cancer. The digital rectal exam (DRE) was normal. At this point, it is crucial to consult a urologist. Active surveillance should be considered, including further evaluations such as a DRE, PSA test, multiparametric Magnetic Resonance Imaging (mpMRI), and possibly a biopsy.

I hope this helps you.

Thank you.