According to the National Cancer Institute, more than half of prostate cancer risk is due to inherited factors. Knowing whether you were born with genetic variants that may contribute to your risk of prostate cancer can guide your treatment options as well as help your family understand their cancer risk.
Who should be tested?
The National Comprehensive Cancer Network (NCCN) Prostate Cancer guidelines provide recommendations for whether a patient should undergo genetic testing. You can take a short survey in the Outcomes4Me app, based on these guidelines, to see if testing is recommended.
Genetic testing may be recommended for prostate cancer patients who have family members who have had prostate cancer, breast cancer, or one of several other cancers, or who have known gene mutations, such as BRCA1 or BRCA2 mutations. If these genes sound familiar, you may have heard about them in relation to breast and ovarian cancer.
Testing may be also recommended based on the characteristics of the prostate cancer itself, such as whether it is metastatic, regional (spread to local lymph nodes), or has a high risk of recurrence. Your ancestry may also play a role in genetic testing recommendations. Black men and those with Ashkenazi Jewish ancestry have a higher risk of prostate cancer.
What does the test look for?
Genetic testing can be done using a blood, urine, or saliva sample. Genes that are involved with repairing damage to your DNA are analyzed in prostate cancer patients. In addition to BRCA1 and BRCA2, these genes include HOXB13, ATM, CHEK2, and DNA mismatch repair genes (MLH1, MSH2, MSH6, PMS2).
What happens next?
Genetic counseling is strongly recommended if you test positive for a genetic mutation. A genetic counselor is a genetic disease expert who can help you understand your test results. Your care team may already include a genetic counselor or may be able to recommend one.
The results of your genetic test may influence your treatment options. For example, if you have metastatic prostate cancer and a BRCA1 or BRCA2 mutation, your care team may treat you with a PARP inhibitor, such as olaparib (Lynparza), rucaparib (Rubraca) or niraparib (Zejula). Your genetic test results might drive decisions about other therapy options such as immune checkpoint inhibitors, platinum-based chemotherapy, or androgen deprivation therapy (ADT).
Genetic testing can also help family members understand their risk of prostate cancer and other cancers. For prostate cancer, the result may influence how often and at what age family members screen for prostate cancer with a PSA test.
If you’ve been diagnosed with prostate cancer, you’re dealing with a lot of new information. While genetic test results are yet another piece of information to understand, they can provide valuable insights into your risk, family risks, and treatment options for you and your care team.
If you would like to learn more or need guidance for your next conversation with your care team, you can connect with an Outcomes4Me oncology nurse practitioner at no charge through the Outcomes4Me app, using the “Ask Outcomes4Me” button.
