Salir
As a retired doctor, Harold Newman, MD, (pictured above) knew he should see a doctor when he began urinating more often.
He assumed he had an enlarged prostate gland. As men age, the prostate often gets bigger. This can cause a frequent or urgent need to urinate. A prostate-specific antigen test, or PSA test, is often used to determine if you have an enlargement, infection, or cancer of the prostate.
“Even though I didn’t have any other symptoms, my doctor ordered a PSA test to rule out prostate cancer,” said Dr. Newman, a Kaiser Permanente member who was 70 years old at the time. “This turned out to be a critical step, because my PSA levels were really high.”
Further testing revealed he had prostate cancer. The cancer had spread to the lymph nodes in his pelvis.
Signs of prostate cancer
The most common symptom of prostate cancer is difficult or painful urination.
When the cancer spreads, patients may also experience bone pain, weight loss, or swelling in their legs and feet.
But people with prostate cancer often have mild symptoms, or even no symptoms at all.
That means prostate cancer can be difficult to diagnose. Dr. Newman felt lucky that his care team found the cancer when they did.
Consulting with a team of specialists
Because the cancer spread outside his prostate, Dr. Newman’s doctors didn’t recommend surgery.
Instead, he first received a drug to stop his body from making testosterone. Most prostate cancer cells feed on testosterone. So reducing testosterone levels can cause the cancer cells to die or grow more slowly.
Andrea Harzstark, MD, a genitourinary medical oncologist at Kaiser Permanente in Northern California, also recommended targeted radiation to destroy cancer cells.
This combination of treatments worked. Dr. Newman’s cancer was no longer detectable. And his PSA levels returned to normal.
Genetic testing can help doctors provide targeted treatment
His care team also recommended genetic testing. About 10% of prostate cancers are related to inherited gene changes, called mutations.
He learned he has a BRCA2 mutation. (Pronounced “BRAH-kuh,” BRCA is short for BReast CAncer.) BRCA mutations can be passed down through families.
“Mutations in the BRCA1 and BRCA2 genes are much more well-known for increasing the risk of breast and ovarian cancer,” Dr. Harzstark explained. “But we’ve learned that they play an important role in prostate cancer, as well.”
Genetic testing can help identify treatments that target certain kinds of cancer. Some patients can benefit right away, while others may not benefit until years later.
“If a genetic test shows that a patient has a certain mutation,” Dr. Harzstark said, “and we only learn years later that it’s significant, our genetics team has a mechanism that enables them to go back through patient records and identify everyone who could benefit from this new knowledge.”
In 2020, 4 years after Dr. Newman’s diagnosis, the U.S. Food and Drug Administration approved a new group of drugs. Called PARP inhibitors, these medicines target the BRCA mutation and can help treat patients with advanced prostate cancer.
Even though his initial treatment was successful, Dr. Newman feels even better knowing that there’s another treatment available if his prostate cancer comes back.
Genetic testing can help protect your family’s health
Genetic testing also provided valuable information for Dr. Newman’s family, including his 2 children in their 40s. After learning that their father had a BRCA2 mutation, both were advised by their Kaiser Permanente care teams to get screened.
His daughter’s test was negative. But his son learned that he also has the BRCA2 mutation. Because of his increased risk, he’ll get regular screenings for cancers related to BRCA2. If he does develop cancer, the aim is to find it early, when it’s far easier to treat.
“This is why genetic testing is so important,” Dr. Newman said. “It expanded my treatment options, and it’s protecting my family’s health, too.”
If you have a family history of prostate cancer, ask your doctor if genetic testing or earlier screening is right for you.
Learn more about cancer care at Kaiser Permanente.