Remember, remember it’s time for Movember… To mark this year’s charity event, when men grow a moustache to raise awareness of men’s health and specifically prostate cancer, we are looking at the BRCA genetic mutation and its role in the disease.
BRCA Genetic Testing for Cancer – Research
According to research funded by Cancer Research UK, men with a faulty BRCA2 gene are at increased risk of developing prostate cancer. The research took place at 65 centres in 20 different countries around the world. It looked at 1,400 men and compared those who carry the BRCA2 genetic fault with those who do not.
They found that men with the faulty gene were almost twice as likely to be diagnosed with prostate cancer than those without it. They were likely to be diagnosed at a younger age – 61 on average compared with 64 in non-carriers – and they were also likely to be diagnosed with more serious tumours – 77% having clinically-significant tumours compared with 40% of non-carriers.
What is BRCA1 and 2?
BRCA1 and BRCA2 genes have long been associated with an increased risk of breast and ovarian cancers. However, the link between BRCA2 and a heightened chance of developing prostate cancer is less well known.
Estimates suggest that around one in 300 men might be carrying this particular genetic fault but only some of them will go on to develop prostate cancer. Scientists are unclear by how much BRCA2 increases the risk.
Genetic Testing for Cancer – Benefits
Genetic testing provides a way for men to find out if they carry the faulty BRCA2 gene which may put them at increased risk of prostate cancer. The test, which is carried out using only a saliva sample, analyses 98 genes from your DNA, including BRCA1 and BRCA2, but also ALK, CEP57 and EZH2. It can identify your risk of 25 hereditary cancers, including prostate cancer. Once the results have been analysed, the laboratory sends a detailed report which shows the presence or absence of mutations that are associated with an increased risk of cancer.
Proactive health management
If it shows that you do have the BRCA2 gene mutation, there are steps you can take to manage your health proactively. The main one of these is undergoing regular screening.
Researchers who carried out the recent study recommended that men with the BRCA2 gene could benefit from regular PSA (prostate specific antigen) testing to detect the disease in its earliest stages. This is when it is most treatable, with 100% of men diagnosed in the early stage of prostate cancer surviving the disease compared to only 29% diagnosed with late stage prostate cancer.
PSA testing is not suitable for screening the general population, previous studies have found. This is due to the possibility of false positive or negative results and overdiagnosis, which is where a cancer would not have gone on to cause harm during the person’s lifetime.
However, in men with the BRCA2 gene fault, PSA tests were more likely to detect the most serious forms of prostate cancer. PSA is a protein produced by normal cells in the prostate and also by cancer cells. A raised PSA level may indicate a problem with the prostate, but not necessarily cancer as the rate rises naturally as men age. Men with raised PSA may be offered a biopsy to confirm if they have cancer or not, and can begin treatment while the disease is in its early stages if the result is positive. If PSA levels are normal they will be recalled for further screening the following year.
Testing family members
Hereditary cancers are passed down through families so as well as undergoing regular screening for prostate cancer, someone with the BRCA2 gene mutation may suggest that other close family members get tested. Parents, siblings and children can have up to a 50% chance of carrying the same mutation, putting them at increased risk too.
If you are concerned about your risk of hereditary cancer, including prostate cancer, genetic testing may help to put your mind at rest. If you receive a positive test for a genetic mutation, you can take proactive steps to protect yourself and potentially save your life.