Questions Men With a Family History of Prostate Cancer Should Ask

A family history of prostate cancer can change the way a man should think about his own prostate health.

Having a father, brother, or other close relative who developed prostate cancer does not mean that you will develop the disease.

However, family history can increase your risk, particularly when multiple relatives have been affected or when prostate cancer was diagnosed at a younger age.

For men with a family history, one of the most valuable steps is simply to start a conversation with a healthcare professional.

The goal isn't to assume that cancer will happen.

It is to understand your personal risk and determine whether prostate cancer screening or genetic evaluation should begin earlier or be approached differently.

Here are important questions men with a family history of prostate cancer should consider asking.

1. Does My Family History Increase My Risk?

Start with the most important question:

"Does my family history put me at higher risk for prostate cancer?"

Your doctor can evaluate the number of relatives who have had prostate cancer, how closely related they are to you, and the age at which they were diagnosed.

A single relative with prostate cancer may have a different impact on risk than several close relatives who developed the disease.

2. Which Relatives Are Most Important to Mention?

When discussing family history, tell your doctor about prostate cancer in close relatives, particularly:

• Father

• Brother

• Son

Also mention prostate cancer in other relatives when known.

Your doctor may also ask about other cancers in your family.

This is important because certain inherited genetic changes can increase the risk of prostate cancer as well as other cancers.

3. How Old Was My Relative When Diagnosed?

The age at which your relative developed prostate cancer can provide important information.

Ask:

"Does the age at which my relative was diagnosed change my risk?"

Prostate cancer diagnosed at a relatively young age can sometimes be a clue to inherited susceptibility.

If you know your relative's age at diagnosis, bring that information to your appointment.

4. How Many Family Members Have Had Prostate Cancer?

One affected relative is different from several affected relatives.

Ask:

"Does having multiple relatives with prostate cancer increase my risk further?"

Your doctor may want to know whether prostate cancer has occurred on your mother's side, father's side, or both.

Multiple relatives with prostate cancer may suggest a stronger familial pattern.

5. Are There Other Cancers in My Family That Matter?

Family history isn't limited to prostate cancer.

Certain inherited genetic changes can increase the risk of multiple cancer types.

Tell your doctor if your family has a history of cancers such as:

• Breast cancer

• Ovarian cancer

• Pancreatic cancer

• Colorectal cancer

• Endometrial cancer

• Male breast cancer

The specific cancers, relationships, and ages at diagnosis can help healthcare professionals determine whether a hereditary cancer syndrome may be possible.

6. Should I Start PSA Screening Earlier?

One of the most important questions is:

"Because of my family history, should I start PSA screening earlier than other men?"

Men at higher risk may be advised to discuss prostate cancer screening at a younger age than men at average risk.

The appropriate timing depends on your specific risk factors.

Your doctor can help determine whether PSA testing makes sense now or whether monitoring should begin at a later age.

7. Should I Get a PSA Test Now?

If you have never had your PSA measured, ask:

"Would a PSA test be appropriate for me at this point?"

PSA stands for prostate specific antigen.

The PSA blood test measures the amount of PSA circulating in your bloodstream.

PSA can be useful for assessing prostate cancer risk, but it is not a perfect cancer test.

BPH, prostatitis, inflammation, and other factors can also affect PSA levels.

8. What PSA Level Should Concern Me?

If you are getting PSA testing, ask:

"What would you consider a concerning PSA result for someone with my risk factors?"

There is no single PSA number that automatically means cancer is present.

Your doctor may consider:

• Your age

• Family history

• Previous PSA results

• Prostate size

• Symptoms

• Medications

• Other risk factors

Understanding how your doctor interprets PSA can make future results easier to understand.

9. How Often Should My PSA Be Checked?

If you have an increased risk, ask:

"How often should I have my PSA checked?"

The answer may depend on your age, PSA level, family history, and previous results.

Some men may need more individualized monitoring than men at average risk.

Your healthcare professional can recommend an appropriate testing interval.

10. Should I Establish a PSA Baseline?

A baseline PSA can provide a point of comparison for future testing.

Ask:

"Would it be helpful to establish a baseline PSA now?"

Future PSA results can then be compared with your earlier measurements.

The trend over time may provide useful information in addition to the individual number.

11. Should I See a Urologist?

Ask:

"Should my family history be evaluated by a urologist?"

A urologist specializes in conditions involving the urinary system and male reproductive system.

A referral may be appropriate if you have an elevated PSA, concerning symptoms, a particularly strong family history, or other risk factors.

Not every man with a family history needs to see a urologist immediately, but it is reasonable to ask whether specialist evaluation would be useful.

12. Should I Consider Genetic Counseling?

Genetic counseling may be appropriate for some men with a strong family history.

Ask:

"Would genetic counseling help me understand my prostate cancer risk?"

A genetic counselor can review your family history and determine whether genetic testing may be appropriate.

They can also explain what testing can and cannot tell you.

13. Should I Have Genetic Testing?

If your family history suggests a possible inherited cancer risk, ask:

"Should I be tested for inherited genetic changes associated with prostate cancer?"

Genes associated with prostate cancer risk can include BRCA1, BRCA2, ATM, CHEK2, PALB2, HOXB13, and certain DNA mismatch repair genes.

Genetic testing is not necessary for everyone.

A healthcare professional or genetic counselor can help determine whether your family history meets criteria for testing.

14. What Would a Positive Genetic Test Mean for Me?

If genetic testing is recommended, ask:

"If I have an inherited genetic change, how would that affect my screening?"

A positive result does not mean that you will definitely develop prostate cancer.

However, it may indicate that your risk is higher and could influence screening or monitoring recommendations.

The significance depends on the specific gene and genetic variant.

15. Should My Family Members Be Tested?

If genetic testing identifies an inherited risk factor, ask:

"Could this information be important for my children, siblings, or other relatives?"

Some inherited genetic changes can be passed from one generation to the next.

A genetic counselor can explain whether relatives may benefit from testing and what the results could mean for them.

16. Does My Family History Affect My Other Health Risks?

Some inherited genetic changes associated with prostate cancer can also increase the risk of other cancers.

Ask:

"Does my family history suggest that I may be at risk for other cancers?"

This can help ensure that your healthcare plan considers your overall health rather than focusing exclusively on prostate cancer.

17. Are There Symptoms I Should Watch For?

Even if you are undergoing screening, ask:

"What prostate or urinary symptoms should I report?"

Symptoms worth discussing include:

• Difficulty urinating

• Weak urine stream

• Frequent urination

• Urinary urgency

• Nighttime urination

• Blood in the urine

• Pelvic pain

• Difficulty emptying the bladder

• Painful urination

These symptoms have many possible causes and do not automatically mean prostate cancer.

However, persistent or worsening symptoms should be evaluated.

18. Does My Family History Change How I Should Think About Lifestyle?

Genetics are only one part of overall health.

Ask:

"Are there lifestyle changes that can support my overall prostate health?"

While healthy habits cannot eliminate inherited cancer risk, maintaining a healthy weight, exercising regularly, eating a balanced diet, avoiding tobacco, and managing other health conditions can support overall health.

Lifestyle should complement, not replace, appropriate screening.

Build a Family Cancer History

If prostate cancer runs in your family, try to gather as much information as possible.

Useful information includes:

• Who was diagnosed

• Their relationship to you

• Age at diagnosis

• Whether the cancer spread

• Whether they had genetic testing

• Other cancers in the family

• Known genetic mutations

You do not need to know every detail before talking with your doctor.

Even incomplete information can be useful.

Frequently Asked Questions

Does having a father with prostate cancer increase my risk?

Yes. Having a close relative with prostate cancer can increase your risk, particularly if the relative was diagnosed at a younger age or if multiple relatives have been affected.

Should men with a family history get PSA testing earlier?

Some men with increased risk may benefit from beginning the screening conversation earlier than average-risk men. Discuss the appropriate timing with your healthcare professional.

Does family history mean I will get prostate cancer?

No. Family history increases risk but does not guarantee that prostate cancer will develop.

Should I get genetic testing if my father had prostate cancer?

Not necessarily. Genetic testing depends on the broader family and personal history, including the number of affected relatives, ages at diagnosis, cancer types, and other risk factors.

What genes are associated with hereditary prostate cancer?

Several genes have been associated with increased prostate cancer risk, including BRCA1, BRCA2, ATM, CHEK2, PALB2, HOXB13, and certain mismatch repair genes.

Does family history affect PSA results?

Family history does not directly cause a higher PSA level. Instead, it can affect how a doctor evaluates your overall prostate cancer risk and approaches screening.

The Bottom Line

A family history of prostate cancer is not a reason to assume that you will develop the disease.

It is, however, a reason to be proactive.

If your father, brother, son, or other close relative has had prostate cancer, tell your healthcare professional.

Ask whether your family history changes when you should begin PSA screening, how often you should be tested, and whether genetic counseling or testing may be appropriate.

Also ask about other cancers in your family. Certain inherited genetic changes can increase the risk of prostate cancer and other cancers at the same time.

Most importantly, don't wait until you have symptoms to learn about your risk.

Knowing your family history can help you and your doctor make more informed decisions about prostate cancer screening and long-term prostate health.

Related Articles 

How genetics can influence prostate cancer risk 

References

American Urological Association. (2023). Early detection of prostate cancer: AUA/SUO guideline. American Urological Association.

National Cancer Institute. (2024). Genetics of prostate cancer. U.S. Department of Health and Human Services.

National Cancer Institute. (2024). BRCA gene changes: Cancer risk and genetic testing. U.S. Department of Health and Human Services.

National Comprehensive Cancer Network. (2024). NCCN clinical practice guidelines in oncology: Prostate cancer early detection. National Comprehensive Cancer Network.

Pritchard, C. C., Mateo, J., Walsh, M. F., De Sarkar, N., Abida, W., Beltran, H., Garofalo, A., Gulati, R., et al. (2016). Inherited DNA-repair gene mutations in men with metastatic prostate cancer. New England Journal of Medicine, 375(5), 443–453.

Ewing, C. M., Ray, A. M., Lange, E. M., Zuhlke, K. A., Robbins, C. M., Tembe, W. D., Wiley, K. E., Isaacs, S. D., et al. (2012). Germline mutations in HOXB13 and prostate-cancer risk. New England Journal of Medicine, 366(2), 141–149.