When a man is diagnosed with prostate cancer, he and his family will have many questions. “Is it because my father had cancer?” “Is it in my genes?”
Researchers are working to answer these questions in prostate and in other types of cancer. Why might your genes (the “instructions for life” in every cell of our body we inherit from our parents as DNA) matter in prostate cancer?
Cancer is the uncontrolled growth of cells. When cells undergo genetic mutations that allow them to grow abnormally, the cells can become cancer. These genetic changes happen in individual cells in our bodies all the time but, fortunately, we have special genes that work to repair DNA. Two important such genes are called BRCA1 and BRCA2.
These genes were made infamous by actress Angelina Jolie, who helped raise awareness of hereditary breast and ovarian cancers, and prompted many women who carry these genes to undergo significant cancer-preventing measures.
New findings
Now we know men may also be affected. In 2016, PCF-funded research found that inherited mutations in BRCA1, BRCA2, and other DNA repair genes are present in about 12 percent of men with metastatic prostate cancer and about 6 percent of men with localized high-risk prostate cancer. These patients were also more likely to have a first-degree relative with a cancer other than prostate cancer. This means prostate cancer is not just a man’s problem — it may have implications for a man’s whole family.
These discoveries have led to important changes in how we care for men with prostate cancer. National Comprehensive Cancer Network (NCCN) guidelines now recommend genetic counseling in all men with high-risk, very-high-risk, regional, or metastatic prostate cancer; men of Ashkenazi Jewish ancestry who have prostate cancer; and men with lower-risk disease based on family history. New therapies called PARP inhibitors that target cancer cells with defects in BRCA2 or BRCA1 are being approved by the FDA for treatment of men with prostate cancer who carry these mutations.
Answering the big questions
PCF is funding more research to help men and their families understand the genetic underpinnings of prostate cancer. For example, mobile and web-based tools will help educate physicians, patients and the public on prostate cancer genetics, and help identify men with prostate cancer who meet criteria for genetic testing. Research is also underway to distinguish gene mutations that cause cancer (think of them as “drivers” of cancer) from those that do not (“passengers”) across different racial backgrounds.
This is important in ensuring men can receive precision screening and, if necessary, treatment, based on their individual cancer risks. New precision medicines are being developed for patients with these mutations.
We don’t yet know the exact answers to the many troubling questions men face with their diagnosis. PCF researchers are working to help families in the future better understand their risk for prostate and other cancers.