Medical Aspects of Family History

There is growing interest in the use of Family History and genetics  in relation to risk of developing illness, eg Cancers, Cardiovascular diseases etc.

In our Greens of Greenwich Family – one such condition is Prostrate Cancer – and we have noticed recently there is some increasing interest in genetic risk factors in this condition.

My husband’s maternal grandfather (European background) died of prostate cancer aged 69 years – he had 3 daughters and no sons – he died after the birth of his first grandson in 1953 and which was before the births of the other three grandsons – the knowledge of his cause of death was lost over the years
– he had 4 grandsons – 3 by one daughter, and 1 by another daughter (her only son) – the other daughter had no sons
– all 4 grandsons (European background) have developed prostrate cancer in their 50’s which required removal of the prostate cancer – the 3 who were aged 59 years had an aggressive cancer – the 55 year old’s was less advanced and less aggressive
– thus 100% of his grandsons are affected – and not the 35-40% that might have been expected according to some sources
– there are no other common causal factors other than that none of the 4 were overweight or obese
– one grandson grew up 100’s of kilometres away from his three male cousins
– only 2 of the grandsons had common occupational factors and educational factors – farmers who were educated at an agricultural college
– only 2 of the grandsons had common geographic factors in adulthood ie NSW rural farmland

– we noted a reticence amongst medical professionals to regard an elevated PSA test result as serious even with the information provided that the maternal grandfatherhad died,   and that 3 of his  4 grandsons had been previously confirmed to have Prostate Cancers – as a consequence, this case of 100% of a generation diagnosed with Prostate Cancer and requiring treatment, surgery being voluntarily chosen in each case, has now surprised some medical professionals in Australia who are aware of the case

– we are concerned about the 8 males in the next generation of our family – 5 of these are sons of the two cousins diagnosed with early onset Prostate Cancer and so they will be identified in the  close relatives category. Another is the nephew of one of the cousins diagnosed with early onset Prostate Cancer, and he is the great grandson of  a man who died with prostate cancer – would the relationship be considered close enough for him to be deemed to be at risk of early onset Prostate Cancer ? And then, the last two are maternal great grandsons  of a man who died of Prostate Cancer, and they are only first cousins once removed of the four diagnosed with early onset Prostate Cancer in their 50’s. Would their family relationships be considered to not be close enough under current guidelines to be deemed to be at risk of developing early onset Prostate Cancer ? Interesting questions ?

Information Sources

  • Australia – Key Resources from NHRMC – more – (note the NHMRC advice sheet applies to men without first degree relatives having been previously diagnosed with Prostate Cancer and acknowledges that the benefit of PSA testing may be greater for men with a higher risk of developing Prostrate Cancer, such as those with a strong family history of the disease – although it seems that some gp’s may have applied these guidelines of Watchful Monitoring Waiting in our family even to those with close relatives already diagnosed with early onset Prostate Cancer. Notably however,  the advice sheet does not really address guidelines on PSA testing and with the associated potential  risks of PSA screening  for the case of “early onset prostate cancer” in  “young men” in their 50’s who have close relatives who have been already diagnosed with early onset Prostate Cancer in their 50’s)  – other Australian information  1, 2,  3, 4, 5 , 6, 7,  8, 9, 10, 11, 12, 13, 14, 15,
  • Canada –1,
  • Da Vinci – 1,
  • UK –1,
  • USA – 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14,  15,
  • Wikipedia – 1,

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