DNA mutations

Men with BRCA2 gene mutations are at risk for prostate cancer

Prostate cancer is known to be a silent killer due to the fact that it gives no worrisome symptoms. It is also true that most prostate cancers are slow-growing and may not be life-threatening. However, a recent study has discovered that there is a group of men with a higher risk of developing an aggressive form of prostate cancer, men with a faulty BRCA2 gene. This study raises awareness of the need to get screened for prostate cancer for 40+ aged men with cancer risk genes. 

What is a faulty BRCA2 gene?

Even though cancer is not generally an inherited disease, there are some types of cancer that can be heavily influenced by genes’ mutations and can run in families. Prostate cancer is one of them.

There are genes that normally protect us against cancer, their purpose being to prevent DNA damage that may happen during cells’ division. 

BRCA2 gene was first discovered in 1994 and researchers have found that it plays a crucial role in DNA repair. When it presents problems, mutations occur. Damaged genes are not capable anymore to repair the DNA breaks, inevitably resulting in tumors or cancerous-changes in the DNA. 

The faults in the BRCA2 gene are primarily linked to a higher incidence of breast cancer (BReast CAncer 2 gene). Women who carry these mutations are at higher risk of developing breast cancer or ovarian cancer. This is the reason why Angelina Jolie had preventive breast surgery and the removal of her ovaries. 

When these altered genes are present in men, these mutations are associated with a higher risk of aggressive prostate cancer or even breast cancer. (While men do not need to get screened for breast cancer, it is advisable to follow regular check-ups.)

Men with a faulty BRCA2 gene are 5 times more likely to develop prostate at a younger age. What is more, they are more likely to present a more aggressive form of prostate cancer that may progress rapidly and may be more difficult to treat. In this context, going through screening for prostate cancer may contribute to the early detection of cancer and a higher survival rate.

How do you know that you have a faulty BRCA2 gene?

First of all, researchers have found that there are some ethnic groups that have indicated a higher incidence of BRCA2 gene mutations. These groups include people of the following origins: Scottish, Icelandic, Northern Irish or Quebecois, etc. People belonging to these groups have presented higher levels of male breast cancer and prostate cancer. 

If you do not find yourself in one of the above-listed groups, there are important reasons why you should consider having a genetic test. Remember that genes run in families, and mutations may have happened somewhere through the generations. 

Are there several members of your family who have had breast cancer (even male breast cancer) or prostate cancer?

Genes run in families

 If yes, do not postpone a doctor’s appointment! He may recommend having a genetic test done, which may be helpful in determining your risk group. 

At the same time, bear in mind that even if you have identified BACA2 changes, they do not carry the same risks. All the preventive measures must be carefully thought over in order to prevent any unnecessary invasive procedures. 

Regarding the higher risk of developing an aggressive form of prostate cancer, men with an identified fault in the BACA2 gene are urged to get tested for prostate cancer.

Tests for prostate cancer – the PSA test

PSA test

There is a big debate around the PSA test subject. This simple blood test that analyses the levels of Prostate-Specific Antigen in the bloodstream is commonly used as the first indicator of prostate cancer. 

Protein-specific Antigen is a protein produced by normal (or malignant) cells of the prostate gland. The PSA levels are often elevated in men with prostate cancer. Starting with 1994, the FDA approved its usage, along with the DRE exam, as a diagnosis method of prostate cancer. The results are reported as nanograms of PSA/milliliter of blood (ng/mL).

What is a normal PSA?

Here is where the debate lies. It can not be clearly stated whether a certain level is normal or abnormal, but there is a sum of factors that may indicate if the PSA level is alarming or not. In the recent past, it was widely accepted that a PSA level of 4 ng/mL or less is normal. Thus, id a man’s PSA level was above 4ng/mL, the patient would have been offered a biopsy for prostate cancer staging. 

Lately, researchers have discovered that there is a great variety of factors that can positively or negatively influence PSA levels. Many countries, including the UK, ceased to offer it as a routine check-up, because of its fluctuations. For instance, a man’s PSA level may be higher due to a urinary infection of prostatitis. In this case, there can be a false-positive result, a required biopsy being just an unnecessary invasive and painful procedure. On the other hand, there are some drugs, including finasteride and dutasteride (used to treat BPH), that can lower the PSA level and may lead to a negative-false result. In this given situation, the person does not receive the needed follow-ups, the disease being undetected.

However, the PSA test still remains the most used test for prostate cancer. It is an affordable and easy method of getting tested. Used in conjunction with other non-invasive methods of prostate cancer diagnosis, such as the MRI scan, a doctor can have a more precise perspective on the matter. If all the PSA influencing factors are being taken into account when doing a PSA test, the doctor can better understand the results and avoid over-diagnosis and unnecessary needle biopsies. 

Always remember that prostate cancer does not ring a bell to announce its presence. It is usually asymptomatic. Test to know what are your genetic risks and, if there is any risk, get screened for prostate cancer as early as possible.

Resources:

Cancer Research UK

BMCCancer

 

 

Dr. David Samadi | Robotic Prostate Surgeon
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About

ProstateCancer911.com is a resource created by Dr. David Samadi in order to raise awareness and get more men to receive prostate cancer treatment. The information is strictly general and you should always discuss with your doctor issues concerning your health.

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