What Everyone Should Know About Hereditary Prostate Cancer
With prostate cancer being the second leading cancer in men it is important to understand one’s risk as well as the recommended screenings. It is estimated that in 2021, close to 250,000 men will be diagnosed with prostate cancer (American Cancer Society [ACS], 2021). Close to 10% of those diagnosed with prostate cancer will die from the disease.
The average risk of developing prostate cancer is 1 out of 8, or 12%, similar to that of an average woman’s risk of developing breast cancer.
Is Prostate Cancer Hereditary?
The majority of prostate cancers occur in those without a family history, but a family history does raise the risk of prostate cancer. If you have a father or brother with prostate cancer your risk more than doubles to develop it as well. When there are several affected relatives, especially if the cancer was diagnosed at a young age or was metastatic (spread to other areas of the body) when it was diagnosed, the risk significantly increases.
We now know that those with a family history of prostate, breast, ovarian, and or pancreatic cancer can have a hereditary risk of developing prostate and other cancers. Mutations of certain genes can raise the risk of these cancers and can be passed on from a father or mother to their children.
Up to 10% of all prostate cancers can be due to an inherited, hereditary risk of cancer, due to alterations in various genes that would normally repair damage to DNA in the body. Also, due to the mutation, the genes are considered broken and therefore do not do the job they are supposed to do in the body, there by increasing the risk that cancer may develop.
How Do I know if I Inherited a Cancer Gene?
The most well know genetic mutations occur in the BRCA1 and BRCA2 genes. These genes are most known to increase a woman’s risk of developing ovarian and or breast cancer, but specifically the BRCA2 gene, can also significantly increase the risk of developing prostate cancer. We now know there are more genes, called CHEK2, ATM, MSH2, MSH6, MLH1, PMS2, and HOXB13 that can increase one’s risk of prostate cancer.
Red flags that you may have inherited a gene that raises prostate cancer risk include:
Having a 1st (mom, dad, sibling, or child) or 2nd degree (grandparent, aunt/uncle, niece/nephew) relative with:
- breast cancer under 50
- ovarian cancer
- pancreatic cancer
- metastatic prostate cancer
- male breast cancer
In addition, having a family history of multiple relatives with breast cancer or a combination of the cancers listed above can be a red flag that there may be a hereditary risk of cancer in the family.
A simple blood or saliva test can help determine if you have an inherited risk for cancer, i.e. genetic mutation. If genetic testing does reveal that you have an inherited risk of prostate cancer, providers can find early prostate cancer by initiating earlier screening with a digital rectal exam and PSA blood tests. For men with an increased genetic risk for prostate cancer, biopsies may be recommended at a lower PSA level than usually is for those with no inherited risk.
Family members of those who are found to have an inherited risk of prostate cancer can then undergo testing as they have a risk of inheriting the same genetic mutation, regardless of being male or female.
Metastatic Prostate Cancer – Arm Yourself
Genetic testing should also be offered to anyone with metastatic prostate cancer (cancer that has spread beyond the prostate gland). In approximately 12% of all men with metastatic prostate cancer there are inherited genetic mutations present. Certain therapies or drugs used to treat prostate cancer may be beneficial in treating those with inherited mutations. These drugs are called PARP inhibitors and can make a difference in those with inherited mutations.
You and your family’s health can be significantly impacted by understanding your hereditary risk of cancer. Learning that you may be genetically vulnerable to prostate cancer can provide you with valuable information that can lead to changes in your treatment plan, as well as ultimately potentially saving your or your loved one’s life.
Mary Jane Glade, DNP, APRN, NP-C is a Nurse Practitioner at CHI Health St. Elizabeth.