There’s a known genetic tendency for the development of many diseases such as high cholesterol, type 2 diabetes and high blood pressure, but evidence now also identifies genes that are passed from parent to child and increase the risk of developing certain cancers. The study of inherited genetic mutations, or alterations, shows immense promise. Two specific alterations, BRCA1 and BRCA2, have been linked to the increased risk of prostate cancer.
The Breast Cancer 1 (BRCA1) and Breast Cancer 2 (BRCA2) genes were the first to be identified and associated with breast cancer. Everyone has these genes, but it is their alteration that makes them cancer causing. Women with a BRCA mutation have five times the risk of developing breast cancer as other women. Men can carry and pass on these same genetic changes. Men who are carriers of these mutations also have an increased risk of prostate cancer compared to non-carriers, and the risk rises significantly with the number of family members who have been diagnosed with prostate cancer. The overall lifetime chance of prostate cancer for men who carry the BRCA mutated gene is 10%. Within a population of carriers the risk seems quite high, but in fact, the occurrence of these mutations is low — only between 0.06% and 0.26% of the general population.
So, how does this risk impact outcome? The risk of developing prostate cancer is a complex interaction of events; besides heredity, it also includes environmental and lifestyle factors. There is no conclusive molecular pathway that can be specifically correlated to the initiation and progression of the disease. But certain genetic characteristics increase the risk, with family history playing a significant role. While the presence of BRCA1 and BRCA2 gene alterations raise the risk of prostate cancer significantly, genetic testing and counselling are not endorsed, since the occurrence of mutations is low and the emotional and financial cost is high. Individuals and families should discuss their risks with their medical practitioners. Prostate cancer screening guidelines have been developed to help decide on appropriate screening methods.
Adopting a healthy lifestyle remains the cornerstone of all disease prevention strategies, and is encouraged for any family that feels they may be at risk.
