‘What do I tell my son?’ Talking to your family about prostate cancer

It’s normal to feel a range of emotions when you find out you have prostate cancer. You’ll probably have lots of questions, too – about your own health and what it might mean for your family. 

For some men, the hardest conversations they have are with their children, especially their sons, about whether they might also be at risk.

Understanding inherited risk

Let’s start with the facts.

• You’re more likely to get prostate cancer if you have a family history of the disease.

• If your father or brother has had prostate cancer, you’re two and a half times more likely to get it yourself. And your risk increases if you have more than one close relative who’s had it – for example, a dad, grandad, brother or uncle – especially if they were diagnosed before the age of 60.

• If you’ve inherited a BRCA gene variation from your parents, you’ll also have a higher risk of developing prostate cancer at some point in your life.

You can see why it’s so important that men who’ve been diagnosed with prostate cancer talk to their families, to help them understand what it could mean for them.

Prostate cancer mainly affects men over the age of 50 and any man can speak to his GP about having a PSA blood test. But if you have a family history of the disease, it’s a good idea to speak to your GP about the PSA test from the age of 45.

What about BRCA gene variations?

You may have seen in the news recently that the UK National Screening Committee has recommended prostate cancer screening for some men who have variations in their BRCA genes. 

Everyone has BRCA genes. They help to keep healthy cells growing normally, while preventing cancer cells from developing. Around 1 in 300-400 people will have variations in their BRCA genes, which stop the genes from working properly. 

You can talk to your GP about genetic testing for BRCA variations if:

• you have a close relative who’s been told they have BRCA gene variations

• several people in your family have had breast, ovarian or prostate cancer in the past

• you’re from an Ashkenazi Jewish background.

The NHS has lots more information about having a genetic test on its website.

Nick’s story

Nick was diagnosed with prostate cancer at the age of 51, with no known family history of the disease. It was caught early and hadn’t spread, so he was monitored with active surveillance. 

When he was diagnosed, Nick’s doctor told him his son – who was 31 at the time – should start having regular PSA blood tests in his early to mid 40s. Because having a close relative with prostate cancer would increase his own risk of getting the disease.

“When I went for my MRI, I told my son I was getting tested for prostate cancer,” says Nick, now 53. “We both thought it would be nothing to worry about. 

“Once I was diagnosed, I told my son that night on the phone. He lives a fair distance away, so we couldn't talk face to face.

“My son isn’t great with doctors and hospitals, so I knew this would be tough for him to hear. But I reassured him that tests and treatments are improving all the time.”

Nick knew the conversation had affected his son more than he let on.

“When I spoke to my son’s wife a couple of weeks later, she said he’d been very subdued and quiet, and not really himself. I think it was tough for him because his nan on his mother's side had also been through cancer. He worries about what lies ahead for me, and also potentially for him.

“But as time passed, my son has seen that life is moving along fairly normally for me, and this has helped ease his worries.”

Nick’s message is simple: if you have prostate cancer, consider talking to your family about inherited risk. Although it was a difficult conversation for Nick to have, talking to his son about prostate cancer has kept him informed and optimistic about the future.

“It was important to tell him early, so that he knows all the information about prostate cancer and understands his risk. It's important to stay positive, that it doesn't mean a death sentence if you find it early. ‘Cancer’ can be a scary word, but prostate cancer is treatable if caught early.”

How to start the conversation

When you’ve been diagnosed with prostate cancer, it can feel daunting to talk to the men in your family about their risk of getting the disease. But it’s one of the most important ways you can protect your family’s future health. 

You don’t have to do it straight away – choose a time that works best for you and for them. And if your children are still young, you may decide to wait and have the conversation when they’re older. 

If and when you do decide to speak to your family about prostate cancer, here are a few ways to help you begin: 

• Choose your moment
  Try to find a calm, quiet time and place when you can talk without distractions. 

• Be open and reassuring
  You might say something like, “because I’ve had prostate cancer, it means you could have a higher risk too - it’s something to be aware of”.

• Focus on the positives
  Explain that early diagnosis often improves outcomes, and tests and treatments are constantly improving. Let your loved ones know that if they know their risk, it can help them take charge of their own health and stay one step ahead. 

• Acknowledge how it feels
  It’s natural for these conversations to bring up feelings of worry or fear. Let your family know this is okay, and that support is available for all of you. 

• Leave space for future chats
  You don’t have to cover everything in one go. Keeping the conversation open will help your family take time to think, do their own research and come back to you with questions when they’re ready. 

We're here for you

If you’re unsure about how to start a conversation, our Specialist Nurses are here to listen and support. Sometimes just talking it through can make those first few words a little easier. 

Talking about the inherited risk of prostate cancer isn’t easy. But, like Nick, you may find that talking openly and honestly helps reduce any anxiety you may feel. And it can give your loved ones the information they need to take control of their own future health.

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