According to the American Cancer Society, it is estimated that there will be about 175,000 new cases of prostate cancer diagnosed in 2019. About one out of every nine (12%) men in general will be diagnosed with prostate cancer in his lifetime, and that number rises to one in six (17%) for black or African American men specifically. Most often, prostate cancer happens sporadically, with no clear reason why the cancer started. However, sometimes prostate cancer can be seen running in a family in a hereditary manner, being passed down from generation to generation. Around 5-10% of prostate cancer diagnoses can be considered part of a hereditary cancer predisposition syndrome.
Genes and the Risk of Developing Prostate Cancer
We have thousands of genes in our body, each with an important job. Some provide our bodies the instructions to give us our hair or eye color, some help us to process nutrients in our food, and still others help protect us from cancer. When one of those genes which protect us from cancer has a “spelling mistake” in the gene that stops it from working properly, we can see cancer start to develop. For someone with a hereditary cancer predisposition syndrome, one of these genes which protects us from cancer has had a spelling mistake or change since birth.
We know of several genes that, when changed, increase the risk specifically for prostate cancer. These genes include BRCA1, BRCA2, ATM, HOXB13, CHEK2, and NBN, among others. While spelling mistakes in these genes increase the risk of developing prostate cancer, environmental and lifestyle factors play a role in the likelihood to develop prostate cancer as well. Age, race or ethnicity, and a family history of the disease all contribute to someone’s chance to develop prostate cancer, and diet, chemical exposure, and other pertinent medical history may play a role as well. While we cannot control the genes we were born with, we can control some aspects of our environment and lifestyle. Someone with a change in a gene associated with an increased risk for prostate cancer is not destined to have the disease, just an increased chance for it. For example, a man in the general population has around a 12% risk to develop prostate cancer in his lifetime, and another man with a change in BRCA2 has around a 20% risk.
What Is Involved in Genetic Testing for Prostate Cancer?
Genetic testing is a blood or saliva test that looks at many of these genes associated with increased risks of prostate and other types of cancer, such as breast, ovarian, or colon cancer. Genetic testing could impact your health in several ways. It could provide you and your oncologist with more information about your specific prostate cancer, including more personalized treatment options. It could also be used to inform you about what other types of cancers you might be at increased risk for and how to appropriately screen for them. Additionally, it could provide information for your other family members to guide their screenings for prostate and other types of cancers. Learn more about how genetic testing is done.
Many people could benefit from genetic screening for prostate cancer, especially the following:
- Men with prostate cancer at a young age, typically below age 50
- Men with more aggressive forms of prostate cancer (Gleason score ≥7)
- Men who have or have had prostate cancer with relatives who also have or have had prostate or other types of cancer, such as breast, ovarian, or colon cancer
- Men without prostate cancer with relatives who have or have had prostate or other types of cancer, such as breast, ovarian, uterine, or colon cancer
- Men with a relative who has tested positive for a gene change known to be associated with an increased risk for prostate cancer
Genetic Testing & Counseling
If you think genetic testing for prostate cancer risk may be beneficial for you or your family, talk to your healthcare provider about being referred for genetic counseling. During the appointment, a genetic counselor will sit down and work with you to provide a detailed overview of genetics and how it relates to prostate cancer. They will discuss the benefits and limitations of genetic testing and work with you to help you make the best decision for you and your family. If genetic testing is ordered, your genetic counselor will discuss your results and how they impact your health and the health of your family members. Your genetic counselor will share your results with your oncology care team to help guide any possible treatment strategies.
At Virginia Oncology Associates, we offer a range of services for patients who have or may be at increased risk of developing cancer. Genetic counseling and testing are just some of the many tools we use to serve the best interest of our patients. Visit us here to learn more about scheduling an appointment with one of our genetic counselors.