Prostate Cancer and Hereditary Risk: A Doctor Explains the Connection

Some genetic mutations linked to breast cancer also can affect men, but in a different way. A Michigan Medicine urologist explains the connection.

7:00 AM

Author | Jessica Webster Sendra

Thanks to Angelina Jolie and Christina Applegate, many of us are now aware that women with certain hereditary genetic mutations have an increased risk of breast cancer.

MORE FROM MICHIGAN: Sign up for our weekly newsletter

What you might not know, though, is that some of those same genetic mutations — and a handful of others — are linked to aggressive prostate cancer in men.

Doctors are seeing more advanced cases of prostate cancer in recent years, and in younger men. After the 2012 U.S. Preventive Services Task Force recommendation to discontinue prostate-specific antigen (PSA) testing in all men, men are being tested for prostate cancer at a later age and less frequently.

While the change in PSA screening means fewer men are receiving unnecessary treatment, others might have less of an opportunity to catch aggressive cancer at an early stage. That's why it's important for men who may have a greater chance of developing prostate cancer to identify if they have an inherited genetic mutation that could lead to prostate cancer.

Michigan Medicine urological surgeon Todd Morgan, M.D., has launched the Prostate Cancer Risk Clinic — the first of its kind in the country — to help men with genetic predisposition to prostate cancer identify and monitor their risk of the disease.

Morgan spoke recently about what all men need to know.

Is there a connection between hereditary risk of breast cancer and the risk of prostate cancer?

Morgan: Yes. Let's say a woman has a strong family history of breast cancer, so she gets tested and finds out that she has a BRCA2 mutation. We have a very robust high-risk breast cancer clinic for that woman, providing counseling around her cancer risk, detection strategies and options for cancer prevention.

That's something people have known for years — BRCA1 and BRCA2 predispose to breast cancer. Once a woman has identified that she has the mutation, she will need very careful screening under the care of some type of clinic like we have here. That woman's sister would likely also go in for genetic testing at this point to find out if she, too, is at risk.

SEE ALSO: Should You Have PSA Screening for Prostate Cancer?

Here's the problem, though: Her brother historically might not necessarily be tested because BRCA1 and BRCA2 have always been linked to breast cancer. Although men do occasionally get diagnosed with breast cancer, it's pretty rare.

But more and more people are realizing that BRCA mutations predispose to other cancers that impact men, like prostate cancer. And, in fact, it's not just that they'll be predisposed to prostate cancer: BRCA2 mutations predispose to a more aggressive type of prostate cancer, but these cancers also may be more responsive to certain types of therapies.

And so that man might get referred from that high-risk breast clinic to a genetics clinic here, where he can get tested for that mutation. If it is determined that he shares the same genetic mutation as his sister, he should begin very careful screening.

Are there other genetic mutations that put men at a higher risk for prostate cancer?

Morgan: Another example would be Lynch syndrome, which predisposes to colorectal cancer as well as several other cancers. Over the last 10 years, we've realized that men with one of the mutations that predisposes to Lynch syndrome are also predisposed to aggressive prostate cancer. But the word hasn't really gotten out.

Other genetic mutations that appear to put men at higher risk for prostate cancer include Li-Fraumeni syndrome (p53), ATM, PALB2, CHEK2, RAD51D, ATR, NBN, GEN1, RAD51C, MRE11A, BRIP1 and FAM175A.

Why is it important for men with a family history to be tested for genetic mutations?

Morgan: Primary care doctors are no longer consistently recommending routine prostate cancer screening to their patients, which seems to be sending the message that men don't need to worry about prostate cancer.

The reality is that prostate cancer is the second-leading cause of cancer deaths in men in the United States. Men who have inherited mutations are much more likely to have aggressive prostate cancer. We know that treatment of aggressive prostate cancer works and prevents death and suffering from prostate cancer. That's what this is about more than anything else: preventing death and suffering from prostate cancer.

For more information on the Prostate Cancer Risk Clinic, call the Cancer AnswerLine at 800-865-1125.


More Articles About: Cancer Care Prostate Cancer BRCA gene Genetic Testing Cancer: Cancer Types
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of health care news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories Cancer Aware surrounded by a circle of multicolor ribbons
Cancer Aware
Focal therapy for prostate cancer
When treating for localized prostate cancer, surgery and radiation are usually what people hear about. However, there are other treatments that could be options under a heading of focal therapy. Dr. Andrew Wood, a urologic oncologist with U-M Health Rogel Cancer Center’s Weiser Center for Prostate Cancer talks about these options and which patients could benefit from them.
cells purple some lighter cells in white
Health Lab
Researchers find early driver of prostate cancer aggressiveness
University of Michigan Health Rogel Cancer Center scientists identified a gene that plays a key role in prostate cancer cells that have transitioned to a more aggressive, treatment-resistant form. The gene can be indirectly targeted with an existing class of drugs, suggesting a potential treatment strategy for patients with aggressive subtypes of prostate cancer.
joe biden speaking
Health Lab
What does Joe Biden’s prostate cancer diagnosis mean for older patients?
Based on former President Joe Biden's recent diagnosis, a Michigan Medicine urologists discusses routine screening procedures and treatment outcomes.
medical glove purple behind patients back being put on
Health Lab
More men with prostate cancer are avoiding unnecessary surgery
Researchers at University of Michigan showed that the proportion of patients undergoing prostatectomy for the lowest risk type of cancer dropped over fivefold between 2010 to 2024.
circular image colorful on navy background
Health Lab
23andMe is potentially selling more than just genetic data
An expert shares details about the privacy issues and genetic data with 23andMe happening.
man standing and throwing in track and field event
Health Lab
After prostate cancer surgery, 70-year-old track and field athlete takes on international competition
Just 8 months after undergoing robotic surgery to remove his cancerous prostate, Mark Cwiek, a 70-year-old track and field athlete, successfully competed in the World Masters Athletics Championship.