Steve & Brian T Cancer in the Family

“I think the sooner you get screened, the better.”

Steve Turner of Middlesex is grateful for advice he received about his prostate cancer—not for himself but for his son, Brian.

It was late 2011 and Steve, now 81, underwent surgery performed by urologist Dhiren Dave, MD, Director of Robotic Surgery at Robert Wood Johnson University Hospital (RWJUH) Somerset and a member of RWJBarnabas Health Medical Group, to remove his cancerous gland. “When I was diagnosed, Dr. Dave indicated to me that I should inform my son because prostate cancer can be hereditary, so Brian should start getting tested,” Steve says.

Brian, a now-51-year-old facilities manager who lives in Bound Brook, took the heads-up seriously. Only in his 40s at the time, he decided to get checked for prostate cancer earlier than many men do.

At first, Brian’s prostate cancer screenings, which included a prostate specific antigen (PSA) blood test and a physical evaluation called a digital rectal exam (DRE), were normal. But in 2020, Brian’s PSA levels started to rise. Follow-up X-rays and a CT scan revealed a large, aggressive mass in his prostate.

Like Father, Like Son

Dhiren Dave, MD
Dhiren Dave, MD

Brian considered different treatment options. One was to have doctors implant radioactive seeds that would kill cancer cells with minimal damage to healthy tissue. This approach carries less risk of side effects such as urinary incontinence and erectile dysfunction than surgery does, but takes longer. It also would have prevented him from holding his young daughter in his lap for about a year due to radiation exposure risks to her.

The cancerous mass had started to press against Brian’s bladder, and he wanted to eliminate the cancer as quickly as possible. Like his father, Brian opted to have robotic surgery to remove his prostate—and have Dr. Dave perform the procedure.

As with his father, Brian’s surgery was successful. Neither man suffered side effects from their robotic procedures, and both remain cancer-free today.

Things might have turned out differently had he not started screening when he did, given how quickly his test results changed, Brian says. “I had no signs of prostate cancer,” he says, “no kinds of problems at all. So I was really shocked at how advanced my cancer was when I was diagnosed.”

Inherited Risks

Men with a family history of prostate cancer are at increased risk not only of developing prostate cancer, but also of combating a more aggressive form, Dr. Dave says. Prostate tumors usually are slow-growing and often can be monitored by a physician. But aggressive types can be deadly and require treatment.

“Having a strong family history such as a father who had prostate cancer increases the risk of developing prostate cancer from about one in six, which is the overall risk for the general population, to about one in four,” Dr. Dave says.

Dr. Dave advises men to have in-depth discussions with their doctors about the pros and cons of screening, including potential risks of treatments that may be unnecessary for some. With physician guidance, men can then consider whether and when to start screening, given factors such as age, health and family history.

“I encourage anybody who is at increased risk because of a strong family history or factors such as being African American to start screening at age 40 to 45 with an annual PSA blood test and a digital rectal exam,” Dr. Dave says.

Brian says screening may have saved his life. For men with a family history of prostate cancer, he says, “I think the sooner you get screened, the better.”

Treatments for Prostate Cancer

After skin cancer, prostate cancer is the most common cancer in men. But survival rates are high, especially when the cancer is caught early. Because prostate cancer can be slow-growing, not every man will need to be treated right away. However, depending on the stage of the cancer, leading treatments include:

  • Radiation therapy, which uses a state-of-the-art linear accelerator that delivers external beam radiation. Brachytherapy, in which radioactive material is sealed in a seed and placed inside the body, may also be used.
  • Radical prostatectomy, which removes the entire prostate gland, sometimes with nearby tissue such as lymph nodes. Robotic surgery allows the procedure to be done with small incisions, high magnification and greater precision, which can help quicken recovery and reduce side effects or complications.
  • Cryotherapy, which, in select cases, uses extreme cold to freeze and kill prostate cancer cells.

Do Your Genes Boost Cancer Risks? How to Find Out

If you’re concerned about your personal cancer risk or cancer within your family, the Hereditary Oncology Prevention and Evaluation (HOPE) program at the Steeplechase Cancer Center at Robert Wood Johnson University Hospital (RWJUH) Somerset, in partnership with Rutgers Cancer Institute of New Jersey, offers genetic counseling.

You can meet with a genetic counselor either in person or by phone or video call. Discussing your family and personal medical histories will help determine if you should undergo genetic testing, which may involve a blood or saliva test. (Saliva tests can even be done at home with a testing kit.) If results indicate you have a genetic marker that elevates cancer risk, doctors can determine the next steps, which may include further tests for you and possibly other family members.

To learn about prostate cancer treatment at Robert Wood Johnson University Hospital Somerset or to schedule an appointment, call 609-584-2836.