Some families can tell you everybody who had high blood pressure, who had “sugar,” and which uncle had a heart attack before 50. But ask exactly who had prostate cancer, how old they were when they were diagnosed, or whether anybody had an aggressive form of the disease, and the details can get fuzzy.
Sometimes the younger men in the family don’t hear about it at all.
For Black families, that’s information worth passing down.
Prostate cancer is the most commonly diagnosed cancer among men in the United States other than skin cancer, and Black men face a higher risk. According to the American Cancer Society, men of African ancestry are more likely to develop prostate cancer than men of other racial and ethnic groups and are often diagnosed at younger ages.
Family history can raise that risk even further.
So when should a Black father talk to his son about prostate cancer?
Long before his son is old enough for a prostate cancer screening conversation.
Don’t Wait Until He’s 45 to Bring It Up
The American Cancer Society recommends that Black men talk with a healthcare provider about the potential benefits, risks, and uncertainties of prostate cancer screening beginning at age 45. That conversation should begin at age 40 for men at even higher risk, including those with more than one close relative—a father or brother—who developed prostate cancer before age 65.
But that doesn’t mean the first prostate cancer conversation between a father and son should happen at 45. You also don’t need to sit a 15-year-old down for a lecture about PSA levels.
Instead, make family health history a normal part of the conversation long before he needs to make decisions about screening.
Has anyone in the family had prostate cancer?
How old were they when they were diagnosed?
Did anyone die from it?
Have multiple men in the family had it?
And don’t limit the conversation to the men.
According to the National Cancer Institute, assessing inherited prostate cancer risk can involve looking at cancers on both the mother’s and father’s sides of the family, including prostate, breast, ovarian, pancreatic, and colorectal cancers. Certain inherited gene changes, including those involving BRCA1 and BRCA2 and genes associated with Lynch syndrome, can increase prostate cancer risk.
That means your son needs more than “Your grandpa had prostate cancer.”
- when his grandfather was diagnosed
- whether other relatives have had cancer and what kinds
- whether anyone in the family has had genetic testing
Those details could matter years from now when he and his doctor are deciding what his personal risk looks like.
What If Prostate Cancer Doesn’t Run in Your Family?
Talk about it anyway.
Black men already have a higher risk of prostate cancer.The American Cancer Society reports that prostate cancer occurs more often in men of African ancestry than in men of other racial and ethnic groups, and Black men tend to develop it at younger ages.
Family history can increase that risk further, but not having a father, grandfather, or uncle with prostate cancer doesn’t mean your son is in the clear. Most prostate cancers occur in men without a family history of the disease.
That’s another reason these conversations shouldn’t only happen after somebody in the family gets diagnosed.
Give Him Names, Ages and Diagnoses—Not Just “Cancer Runs in the Family”
Families aren’t always great at keeping medical records.
You may know Uncle Clarence “had cancer,” but not what kind. Grandpa died before anyone really talked about what he was sick with. Somebody remembers an aunt having “female cancer,” but nobody knows whether it was breast, ovarian, uterine, or something else.
Start filling in those blanks while the people who know the answers are still here.
A useful family cancer history can be a simple notebook that includes:
- Who in the family had cancer
- What type of cancer they had
- How old they were when they were diagnosed
- Whether the cancer became metastatic
- Whether anyone died from the disease
- Whether several relatives on the same side of the family have had cancer
- Whether anyone has had genetic testing or knows of an inherited cancer-related gene change
You don’t have to create a perfect medical family tree overnight. Start with what you know, ask questions, and write the answers down somewhere your children can find them later.
At 40 or 45, That Family Conversation Can Change
Eventually, “Here’s what runs in our family” becomes “Here’s what you need to ask your doctor.”
The American Cancer Society recommends that Black men begin discussing prostate cancer screening with a healthcare provider at age 45. Men at even higher risk—including those with more than one first-degree relative who developed prostate cancer at an early age—should have that conversation beginning at 40.
The recommendation isn’t that every Black man automatically gets a PSA test the day he turns 45.The ACS recommends informed decision-making between a man and his healthcare provider after discussing the potential benefits, risks, and uncertainties of screening.
If he chooses screening, the primary test is the prostate-specific antigen, or PSA, blood test. A digital rectal exam may also be part of screening.
Knowing his family history before that appointment gives him an important advantage.
Instead of walking in and saying, “I think my dad had something with his prostate,” he can say, “My father was diagnosed with prostate cancer at 58, and my uncle had it in his early 60s.”
That’s information his doctor can actually use.
This may be the most important conversation of the entire article.
If you’ve been diagnosed with prostate cancer, don’t make your son discover that information years later because nobody in the family talked about it.
You don’t necessarily have to tell him every detail about your treatment or your sex life. But he should know that you had prostate cancer, how old you were when you were diagnosed and, if you know, whether your doctor thought there could be an inherited component.
Having a father or brother with prostate cancer more than doubles a man’s risk of developing the disease, according to the American Cancer Society.Risk is even higher when several relatives have been affected, particularly when they were diagnosed at younger ages.
That makes your diagnosis part of his health history, too.
And if genetic testing identified an inherited gene change associated with your cancer, ask your healthcare team or a genetic counselor what that could mean for your children and whether they should think about genetic counseling or testing themselves.
What Should You Actually Say?
You don’t need a speech.
When talking with a teenager or young adult, the conversation might be:
“Prostate cancer is something Black men have to pay attention to as we get older. It runs in some families, so I want you to know our family history now instead of trying to figure it out when you’re 45.”
If prostate cancer does run in your family:
“Your grandfather had prostate cancer when he was 62, and my brother was diagnosed at 57. I want you to remember that because it’s something you’ll need to tell your doctor when you’re older.”
And if you’ve been diagnosed yourself:
“I had prostate cancer at 54. That doesn’t mean you’re going to get it, but it does mean it’s part of your family history. When you’re older, I want you to make sure your doctor knows.”
No scare tactics. Just information he deserves to have.
Make Prostate Health Part of the Family History
For many families, health history gets passed down in fragments: somebody had “sugar,” somebody had “pressure,” somebody had cancer, and nobody remembers exactly what kind.
We can do better with the next generation.
Talk to your sons. Talk to your brothers. Ask your father questions while you still can. Find out what happened to your grandfather and uncles. And don’t forget the cancer history on your mother’s side of the family.
Then write it down. Your son may not need that information today. But one day, when he’s with his own doctor, knowing exactly what happened to the men and women who came before him could help him ask better questions about what comes next.
