Prostate cancer and the BRCA gene
Every September, Prostate Cancer Awareness Month gives us an opportunity to raise awareness about one of the most common cancers affecting men.
About one in eight men will be diagnosed with this disease during their lifetime.
One message I always try to emphasize in my practice as a UCI Health urologist is that prostate cancer is not only a men's health concern. It is also a family health issue.
We commonly ask our patients about their family history of prostate cancer when discussing their risk. However, a person’s family history goes beyond cancer of the prostate, the walnut-sized gland in men that helps produce semen.
Understanding the family connection
Many people know that the BRCA1 and BRCA2 gene mutations increase the risk for developing breast and ovarian cancers. What is less commonly discussed is that these same genetic mutations also can increase a man's risk of developing prostate cancer, particularly in its more aggressive forms.
This is why I encourage patients to know their broader family cancer history. Knowing the history of prostate, breast, ovarian and pancreatic cancers among parents, grandparents and other close relatives can provide essential information about one’s inherited cancer risk
If several members of your family have had any of these cancers, if they were diagnosed at a young age or if a relative has a known BRCA mutation, it is vital to discuss this with your healthcare provider. In some cases, genetic counseling or genetic testing may be appropriate.
Early detection matters
One of the most important things to understand about prostate cancer is that early disease usually does not cause symptoms. Many men feel completely healthy when prostate cancer is first detected. This is why waiting for urinary symptoms, pain or other problems is not a good strategy for early detection.
The prostate specific antigen (PSA) blood test is one of the tools we use to identify men who may need further evaluation. PSA tests measure the amount of the protein enzyme produced by the prostate gland.
PSA screening should be individualized. Age, family history, ancestry, genetic risk, previous PSA test results and a man’s overall health all play a role in deciding when and how he should be screened.
An elevated PSA does not necessarily mean that you have prostate cancer.
Today, we have several additional tools that help us better assess elevated PSA level, including different blood and urine biomarkers as well as a prostate MRI.These tests help us determine who may benefit from a prostate biopsy and who may be able to avoid an unnecessary biopsy.
At UCI Health, our goal is to identify clinically significant cancers early, when we have the best opportunity to treat them successfully, while avoiding unnecessary testing and treatment whenever possible.
A family conversation
I believe families play an important role in prostate cancer awareness.
Women are often very involved in the healthcare of their families. A wife, daughter, sister or mother may be the one who reminds a man to schedule his annual health checkup, including getting a PSA test, or ask about the family history of cancer.
Men also have an important role. If you have had a PSA screening test, a prostate MRI, a biopsy or treatment for the disease, talking openly about your experience may encourage a brother, friend or family member to take his own health more seriously.
The conversation can start with a simple question: “Do we have a history of prostate, breast, ovarian, or pancreatic cancer in our family?” The answer may be more important than you realize.
What you can do
Recognizing Prostate Cancer Awareness Month can be about more than awareness of the disease. It should encourage conversations between patients, families and healthcare providers that lead to informed decisions and appropriate screening.
Take a few minutes to explore your family’s cancer history and share it with your healthcare provider. If you are a man, ask whether PSA screening is appropriate for you and when you should start.
If there is a strong history of prostate, breast, ovarian or pancreatic cancer in your family, ask whether genetic counseling or testing should be considered.
And if you have a father, husband, brother, son or friend who keeps postponing his routine check-up, encourage him to make the appointment now. Sometimes, a simple conversation can make a meaningful difference.
Learn more about the UCI Health Comprehensive Prostate Cancer Program.