Hereditary Prostate Cancer: What Every Man Should Know
On a typical day, an average of nearly 480 men in the U.S. are newly diagnosed with prostate cancer.
Most men facing this cancer dont have a family history of the disease. Still, a family history does raise the risk of prostate cancer. For example, having a father or brother with prostate cancer more than doubles a mans chance of developing it too. That risk escalates for men with several affected relatives, especially if they were young when cancer struck.
What Can Genomic Testing Tell Me
In early-stage or localized prostate cancer, where the cancer is still confined to the prostate, there are three types of risk categories:
- Low-risk prostate cancers that are unlikely to grow or spread for many years
- Medium/intermediate-risk prostate cancers that are unlikely to grow or spread for a few years
- High-risk prostate cancers that may grow or spread within a few years
Genomic testing can help men find out their risk category, and therefore which treatment options are available to them.
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If you dont find answers with your initial order, Detect Hereditary Prostate Cancer includes one re-requisition within 90 days to genes within the original clinical area.Simply log into your account, navigate to the order, and click “Add rerequisition
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Genetic Testing For Prostate Cancer
Thanks to research funded by the Prostate Cancer Foundation, we now know that some prostate cancers are caused by changes in your genes. 5%-10% of all cancers are hereditary, meaning that certain cancer-causing gene changes are passed down from mothers and fathers to sons and daughters. Another 10%-20% of all cancers are familial, meaning that a type of cancer occurs in multiple family members, but is not directly related to specific gene changes.
Genes are made of DNA, which is the master instruction manual that tells every cell in the body which proteins to make essentially, the information that each cell needs to do its job. A genetic mutation is a change in part of the normal DNA that makes up a gene. Some mutations are hereditary, meaning that they are passed down from one family member to another. Mutations can also be caused after birth by various lifestyle and environmental factors, such as smoking or the UV rays from the sun.
Genetic mutations can be passed down from father to son, father to daughter, mother to son, or mother to daughter. We now know that some of the same gene mutations that cause prostate cancer can also cause other forms of cancer and vice versa. Therefore, it can be important to consider genetic testing if you have a history of cancer in your family, even if its not prostate cancer. This is referred to as genetic testing for an inherited mutation or genetic testing for inherited cancer risk.
Am I At Risk Of Prostate Cancer
In the UK, about 1 in 8 men will be diagnosed with prostate cancer in their lifetime. We don’t know exactly what causes prostate cancer but there are some things that may mean you are more likely to get it these are called risk factors.
There are three main risk factors for getting prostate cancer, which are things you can’t change. These are:
If you have any of these risk factors or if you have any symptoms, speak to your GP. They can talk to you about your risk, and about the tests that are used to diagnose prostate cancer. You can also get in touch with our Specialist Nurses, who can help you understand your risk of prostate cancer.
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Data Have Shown That Prostate Cancer May Cluster In Some Families
Prostate cancer seems to run in some families, which suggests that in some cases there may be an inherited or genetic factor. Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease. The risk is much higher for men with several affected relatives, particularly if their relatives were young at the time the cancer was found. This also includes relatives with breast, ovarian, colon, or pancreatic cancer.
In addition, scientists have found several inherited gene changes that seem to raise prostate cancer risk, but they probably account for only a small number of cases overall. Genetic testing for these changes is now available in the Urologic Oncology, Medical Oncology, and Radiation Oncology clinics for men with prostate cancer who meet current testing criteria. Testing is typically performed with a blood draw, and genetic counseling services are available for patients with any positive findings present on genetic testing.
Increasing Access To Inherited Genetic Testing
While genetic testing offers tangible benefits to patients, its often underutilized due to cost and accessibility barriers. Invitae is addressing these barriers with the Detect Hereditary Prostate Cancer Program which offers no-charge, sponsored genetic testing and genetic counseling to eligible patients.
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How Do Genetics Tests Work
One option for genomic tissue testing is the Prolaris test, which looks at a specific genetic signature in the tissue, done usually through archived, fresh frozen, paraffin embedded tissue, usually in a pathology lab, and sent to a commercial lab. Results of this test give details of the cancer related to aggressiveness and prognosis.
Germline genetic testing is commonly done with saliva or blood samples. These tests identify germline mutations that may be present and will be present in every cell, not just prostate cells. Another concept in genetic testing is deep sequencing, or next generation sequencing . In NGS, each region of DNA is evaluated multiple times, which minimizes errors and provides more accurate genetic test results.
This Program Is Available To Males In The Us And Canada With One Of The Following Diagnoses:
Stage IIa, age at diagnosis 55 years or under
Stage IIb or IIc at any age
Stage III at any age
Stage IV at any age
Postmortem samples are not permitted through the program at this time
Gleason 6, age at diagnosis 55 or under
Gleason 7 or greater at any age
Metastatic disease at any age
Gleason undetermined, suspected low risk or above at any age
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Genetic Information Nondiscrimination Act
Healthcare providers involved with genetic testing should be familiar with the Genetic Information Nondiscrimination Act . GINA prevents health insurance companies and employers from discriminating against patients based on genetic test results. Unfortunately, GINA does not protect patients from discrimination in life, disability, or long-term care insurance.
Risk Factors In Aggressive Vs Slow
In the past few years, weve learned that prostate cancer really is several diseases with different causes. More aggressive and fatal cancers likely have different underlying causes than slow-growing tumors.
For example, while smoking has not been thought to be a risk factor for low-risk prostate cancer, it may be a risk factor for aggressive prostate cancer. Likewise, lack of vegetables in the diet is linked to a higher risk of aggressive prostate cancer, but not to low-risk prostate cancer.
Body mass index, a measure of obesity, is not linked to being diagnosed with prostate cancer overall. In fact, obese men may have a relatively lower PSA levels than non-obese men due to dilution of the PSA in a larger blood volume. However, obese men are more likely to have aggressive disease.
Other risk factors for aggressive prostate cancer include:
- Tall height
- Lack of exercise and a sedentary lifestyle
- High calcium intake
- Agent Orange exposure
Research in the past few years has shown that diet modification might decrease the chances of developing prostate cancer, reduce the likelihood of having a prostate cancer recurrence, or help slow the progression of the disease. You can learn more about how dietary and lifestyle changes can affect the risk of prostate cancer development and progression in PCFs Health and Wellness: Living with Prostate Cancer guide.
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Identifying Genetic Changes In Cancer
Lab tests called DNA sequencing tests can read DNA. By comparing the sequence of DNA in cancer cells with that in normal cells, such as blood or saliva, scientists can identify genetic changes in cancer cells that may be driving the growth of an individuals cancer. This information may help doctors sort out which therapies might work best against a particular tumor. For more information, see Biomarker Testing for Cancer Treatment.
Tumor DNA sequencing can also reveal the presence of inherited mutations. Indeed, in some cases, the genetic testing of tumors has shown that a patients cancer could be associated with a hereditary cancer syndrome that the family was not aware of.
As with testing for specific mutations in hereditary cancer syndromes, clinical DNA sequencing has implications that patients need to consider. For example, they may learn incidentally about the presence of inherited mutations that may cause other diseases, in them or in their family members.
Importance Of Germline Genetic Testing For Prostate Cancer Patients
Targeted medical treatments
Genetic testing of prostate cancer enables targeted medical and surgical treatment options
Detection of other cancers
Testing can direct surveillance for, and early detection of, other DNA repair-related cancers
Family members at risk
Relatives of a patient may be at risk themselves for cancer. They may benefit from testing and early detection
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Genetic And Genomic Testing
Germline mutation assessment helps assess ones risk for prostate cancer. Somatic mutation assessment examines the genes in a prostate cancer specimen and helps with decisions regarding treatment. Genomic testing can help predict how aggressively a prostate cancer might behave and how likely it is to advance and metastasize.
Genetic testing for prostate cancer is indicated in the following circumstances: early onset prostate cancer, aggressive prostate cancer, regional spread or metastatic prostate cancer, multiple cancers including prostate cancer , in prostate cancer patients who have family members with prostate, breast, ovarian, colorectal or pancreatic cancer, and intra-ductal prostate cancer histology.
The most common mutations found in prostate cancer are the BRCA2 mutation, which accounts for about 50% of hereditary prostate cancer mutations, and Lynch syndrome mutation. Lynch syndrome is an inherited cancer syndrome causing mutations in DNA repair genes called MMR genes . Because of this predisposition to mutation resulting from impaired DNA repair, those with Lynch syndrome have increased risk not only of colorectal cancers, but a host of other cancers including prostate cancer.
Genetic testing has given rise to the exciting field of precision medicine, individualized and customized treatment strategies with specific medications targeted against the specific mutations, a treatment based upon cancer biology and no longer only cancer histology.
What Is A Family History Of Cancer
A strong link exists between family members having cancers. Individuals whose relatives have been diagnosed with cancer have an increased chance of developing the same cancer or other cancer types with similar profiles.
This is because of both genetics passed down through families and also common risk factors . If a family member is diagnosed with a cancer, this means the other families are now at an increased chance of developing this cancer.
From a medical perspective, a family history of cancer exists if one of your family members has been diagnosed with that cancer. However, it is crucial to know which person had cancer in your family. Not all family members influence your chance of developing cancer equally.
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When To Consider Genetic Counseling For Prostate Cancer
Experts recommend that men with a family history suggesting an increased risk of prostate cancer engage in shared decision-making with their physicians about genetic counseling and testing. Genetic testing can educate you about your inherited risk of prostate cancer, and it also can inform your family members that they may have genetic mutations that increase their cancer risk. Here are 7 factors that warrant a referral to a certified genetic counselor:
Journal of Clinical Oncology, Feb. 1, 2018).
This article originally appeared in Cleveland Clinic Mens Health Advisor.
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Inherited Risk Of Prostate Cancer
Over past decades, scientists have learned that some prostate cancer that runs in families is hereditary. In these cases, mutations in genes that raise the risk of prostate cancer occur in every cell of the body and are passed on from either a mother or father to a child, said Elias Obeid, MD, MPH, medical oncologist and director of the Prostate Risk Assessment Program at Fox Chase Cancer Center.
These inherited alterations in genes may be responsible for up to 10 percent of all prostate cancers, according to the American Cancer Society, and often occur in genes that repair damage to DNA, including BRCA1 and BRCA2 genes.
Mutations in these two genes are best known for causing breast and ovarian cancer in women. But they also raise prostate cancer risk in men who inherit them, especially faulty BRCA2 genes, which are tied to aggressive prostate cancer, Obeid said.
Other genes that can cause prostate cancer through mutations include those related to DNA repair, such as CHEK2 and ATM HOXB13, which is related to the development of the prostate gland and the genes tied to a disease called Lynch syndrome.
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Who Should Get Genetic Counseling For Prostate Cancer
In general, there are three groups of men who should consider genetic counseling and testing for prostate cancer:
Genetic Counseling And Testing
People with a strong family history of cancer may want to learn their genetic makeup. This may help the person or other family members plan their health care for the future. Since inherited mutations affect all cells of a persons body, they can often be found by genetic testing done on blood or saliva samples. Still, genetic testing is not helpful for everyone, so its important to speak with a genetic counselor first to find out if testing might be right for you. For more information, see Understanding Genetic Testing for Cancer.
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How Do You Determine If You Have A Family History Of Prostate Cancer
The best way to determine your prostate cancer risk and whether you have a family history is through our free prostate cancer risk assessment. It takes you through all the essential questions that will appropriately categorise and classify your risk. However, if you are starting from the beginning and need to know who to ask and what to ask. Follow these steps.
Prostate Cancer Risk Factors
A risk factor is anything that raises your risk of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a persons age or family history, cant be changed.
But having a risk factor, or even several, does not mean that you will get the disease. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors.
Researchers have found several factors that might affect a mans risk of getting prostate cancer.
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Family History And Genetics
Your family history is information about any health problems that have affected your family. Families have many common factors, such as their genes, environment and lifestyle. Together, these factors can help suggest if you are more likely to get some health conditions.
Inside every cell in our body is a set of instructions called genes. These are passed down from our parents. Genes control how the body grows, works and what it looks like. If something goes wrong with one or more genes , it can sometimes cause cancer.
Is prostate cancer hereditary?
If people in your family have prostate cancer or breast cancer, it might increase your own risk of getting prostate cancer. This is because you may have inherited the same faulty genes.
My father had prostate cancer. What are my risks?
- You are two and a half times more likely to get prostate cancer if your father or brother has had it, compared to a man who has no relatives with prostate cancer.
- Your chance of getting prostate cancer may be even greater if your father or brother was under 60 when he was diagnosed, or if you have more than one close relative with prostate cancer.
- Your risk of getting prostate cancer may also be higher if your mother or sister has had breast cancer.
Do you have a family history of prostate cancer?
If you’re over 45 and your father or brother has had prostate cancer, you may want to talk to your GP. Our Specialist Nurses can also help you understand your hereditary risk of prostate cancer.