Many doctors take family history of cancer into account when recommending treatments for several types of cancer.
But a family history of prostate cancer is not associated with an increased risk of developing an aggressive form of the cancer, a study indicates. The finding suggests that family history should not be the lone criteria doctors use to decide on active surveillance rather than treatment of localized prostate cancer.
Another study finding is that African-American men with a family history of prostate cancer may be at increased risk of a more aggressive disease, although more research is needed to confirm the finding.
The research, “Prostate cancer, family history, and eligibility for active surveillance: A systematic review of the literature,” was published in BJU International.
Doctors use several criteria to decide on a prostate cancer treatment, such as tumor volume, the stage of the tutor that shows up in tissue biopsies, and blood levels of PSA, a prostate cancer biomarker. Standard care guidelines recommend that doctors use active surveillance rather than chemotherapy or surgery in patients with low-risk tumors. Active surveillance involves monitoring a patient closely to determine if, or when, a treatment is needed.
Many doctors have used a family history of prostate cancer as their only criteria for selecting patients for active surveillance. But until now there were no studies of family history’s association with tumor progression and on whether family history was a proper criteria for deciding on active surveillance.
A detailed analysis of previous studies showed no relationship between family history and prostate cancer progression and between family history and active surveillance as a clinical strategy. Researchers found no relationship between family history and several prostate cancer biomarkers associated with tumor aggressiveness, for example. This suggested that family history does not increase the risk of prostate cancer aggressiveness.
One study showed family history to be a significant predictor of prostate cancer progression in African-Americans, however.
“Our results suggest that having a family history of prostate cancer should not automatically exclude men from being considered for active surveillance treatments, although some questions remain about risks for African-American men with a family history of prostate cancer,” Jim Dupree, senior author of the study, said in a press release.
Additional research is needed on the association between family history and race, and whether family history should be used to decide whether active surveillance should be used with African-American patients.
“Men obviously need to have thorough conversations with their doctors about risks, benefits, and options, and more research needs to be done to confirm these findings, especially among African-American men,” Dupree said.