Genetic counseling helps assess prostate cancer risk

While prostate cancer is known to be the most common form of cancer among men other than skin cancer, it’s only recently that more has been discovered about its causes. These discoveries enable the use of different tools to treat the disease and provide a better understanding of who may be at risk.

Over the past decade, the public has gained a greater understanding of the role genetics can play in developing cancers, such as breast cancer. However, many men still don’t realize that similar factors are involved in prostate cancer.

“For a long time, prostate cancer was considered to be so common in older men that the cause was assumed to be age-based,” says Brittany Burnett, lead genetic counselor at Sharp HealthCare. “But over the last decade, research looking at a large number of patients has shown that an inherited gene mutation was related to the development of prostate cancer in up to 10% of cases.”

A common cancer

More than 300,000 men are diagnosed with prostate cancer in the United States each year. About 1 in every 8 men will be diagnosed with prostate cancer in their lifetime. It’s so common that most men who live to an elderly age will likely die with some cancer cells in their prostate.

Many of these cancer cases develop late in life and are slow-growing, with little impact on the physical well-being and activities of the man. Those cases may not need treatment — only careful monitoring by a doctor through a process called active surveillance.

However, for cases in which oncologists do recommend treatment, genetic counseling can be a very useful tool.

What is genetic counseling?

Genetic counseling examines how your personal and family health history may affect you or your relatives. This information can be important for several reasons, such as for individuals starting a family or those concerned about potential conditions that may be affecting their child. Counseling can also help gauge the risk of developing diseases, such as cancer.

The counseling process typically begins with genetic testing, which is usually conducted through a blood test. The goal of testing is to identify changes, or mutations, in a person’s DNA. The genetic counselor can then use that information to help evaluate the potential impact.

“When a patient has a mutation, we can tell them we’ve identified the cause of their prostate cancer,” says Burnett. “But then, we can also look for other cancers that particular mutation is connected to so that the patient knows they are at higher risk.”

As an example, Burnett cites a recent prostate cancer patient for whom genetic testing revealed he also has an elevated risk of pancreatic cancer. Armed with that information, the patient and his doctor now know to screen for it more often, with the hope of catching potential pancreatic cancer at an early stage.

Understanding family history

Receiving genetic counseling benefits not only the patient — but also their immediate family members.

“Because so many men think prostate cancer just comes with age, they don’t realize there can be a genetic component,” says Burnett. “If you have a son, getting genetic counseling can help determine if they have a higher risk of developing prostate cancer, as well.”

She points out that finding whether a child carries the gene mutations tied to prostate cancer can help lead to conversations with their doctor about the appropriate age and intervals to get screenings.

“Sometimes we get people who come to us wanting to have their cancer risk evaluated because their father has prostate cancer,” Burnett says. “It’s always best if we can start the process with the patient themselves — that gives us the best chance of identifying the cause of the cancer, finding any mutations, and then analyzing the risk to family members.”

Helping guide treatment

The value of genetic counseling goes beyond identifying causes and additional risks. As technology has advanced, genetic counseling can now assist doctors in identifying the most effective medications to treat their patients.

“We’re able to provide more information now about the root causes of the cancer,” says Burnett. “So, we’re starting to see more oncologists recommend that their patients get genetic counseling. Besides being able to inform patients and families about potential cancer risks, this information can also help them determine which medications are most likely to be effective for each individual patient. They can design a treatment plan to best target the specific form of prostate cancer their patient has.”

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