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If you’ve been diagnosed with prostate cancer, exploring what may have contributed to your cancer might not be at the top of your list. However, learning about your family history and the genetic characteristics of your prostate cancer can help your care team zero in on the best treatment plan for you.
Daniel Childs, M.D., a Mayo Clinic medical oncologist specializing in genitourinary cancers, and Joan Steyermark, a Mayo Clinic genetic counselor, explain the roles of family history and genetics in the development and treatment of prostate cancer.
Familial history vs. inherited risk
Though prostate cancer is considered highly heritable, most people who develop prostate cancer don’t have a strong family history of the disease. "The majority of prostate cancers are believed to occur sporadically. By that, I mean that we haven't found a particular genetic susceptibility that's passed along within families," says Dr. Childs.
Unless you have genetic testing to evaluate for select cancer mutations, you won't know if you have a genetic predisposition —an inherited risk — to developing prostate cancer. Some of the genes that have been associated with an increased risk for prostate cancer include BRCA1, BRCA2 and HOXB13 genes. Lynch syndrome, a condition in which a particular set of genes doesn't work as expected, can also increase prostate cancer risk.
Knowing your family’s cancer history and information obtained from your genetic testing can also be important for other family members who may also want to do their own screening tests based on your results.
Mutations and your treatment plan
Some genetic mutations respond better to targeted drugs and specific treatments. If you've been diagnosed with high-risk or metastatic prostate cancer, your healthcare professional might recommend genetic testing for you.
Dr. Childs says specific characteristics in a patient and their cancer can indicate the need for genetic testing. "Patients diagnosed with prostate cancer at particularly young ages or with aggressive forms of prostate cancer are much more likely to have a hereditary contributor," he says.
Meeting with a genetic counselor
Before getting genetic testing, Dr. Childs and Steyermark recommend meeting with a genetic counselor who can help you understand what to expect from the process.
When you meet with a genetic counselor, the first step will be recording your known family history of cancer, says Steyermark. "We usually spend about 30 minutes building a family tree. And we ask many questions — about grandparents, aunts, uncles, cousins, siblings, parents and children — and focus on cancers in the family and ages of onset of those cancers," she says.
Some of the concerns Steyermark hears from patients include:
- The emotional burden of test results.
- Sharing test results with family.
- Genetic discrimination and privacy concerns regarding their results.
- Costs associated with testing and insurance coverage.
A genetic counselor can help you think through and address these concerns and identify solutions.
Excerpted from Mayo Clinic News Network
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