What is hereditary prostate cancer?
Prostate cancer is the most common cancer among men in the UK. Unfortunately, one in eight men will be diagnosed with prostate cancer, with 75% being diagnosed over the age of 65.
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This means that men have a 12.5% lifetime risk of prostate cancer. The majority of prostate cancer occurs by chance however approximately 5-9% of prostate cancer is estimated to be hereditary and 25% is familial.
What are the signs of hereditary prostate cancer?
You may be at increased risk of prostate cancer if you have any of the following signs in your family:
- Early onset prostate cancer (diagnosis before age 55)
- Three first-degree relatives (brother, son, father) diagnosed with prostate cancer
- Relatives with prostate cancer in three successive generations
- Ashkenazi Jewish ancestry and breast, ovarian or prostate cancer
- Several relatives with breast cancer, particularly early onset (before age 50)
- Male breast cancer or ovarian cancer or bilateral breast cancer
- Early onset bowel or womb cancer (before 50)
- Several relatives with colorectal or womb cancer at any age
What can I do if I am shown to be at increased risk?
If you have a mutation this means that you have an increased risk of prostate cancer and possibly other cancers. Your exact risks will depend on which gene mutation has been found. Extra screening and/or risk-reducing strategies will be discussed. It will also be possible to offer predictive testing to other people in your family to see if they also have a mutation.
Screening aims to diagnose prostate cancers at an earlier more treatable stage however screening for prostate cancer is still imprecise and, in some situations, may lead to unnecessary biopsies or false reassurance:
Two-thirds of men with a raised PSA test will not have cancer. Recent research has shown that other biomarkers can improve the accuracy of the PSA test and this method of screening is offered.
Screening for other cancers may also be needed and will be discussed if necessary.
Only 5-9% of prostate cancer is hereditary but if there is a family history of prostate cancer, this can be a big worry. Deciding to have a genetic test is a big decision for any man or woman and one that needs careful consideration.
That’s why at Spire Bushey Hospital we offer genetic counsellors to assist you prior to any testing. Our counsellors will provide you with all the information you need to make a decision and will help explain the process of genetic testing to you. Our counsellors will also be available once you have had your testing to discuss your results and options. Consultations take place at Elstree Cancer Centre.
Why would I want to know that I’m at risk of cancer?
Genetic testing can help determine the risk of cancer within a family and guide appropriate cancer screening. Depending on the specific genetic risk different screening tests can be arranged and risk-reducing strategies considered.
It is known that ethnicity influences the risk of prostate cancer: black men have the highest risk of prostate cancer, then white men and Asian men have the lowest risk.
Height is also associated with prostate cancer: the taller a man the higher his risk.
A personal history of some types of cancer (kidney, bladder, melanoma, lung, thyroid) also increases the risk of prostate cancer as does exposure to radiation.
Warfarin, Acetaminophen and diabetes have been shown to lower the risk of prostate cancer.
Lycopenes (from tomatoes and tomato based products) lower the risk of prostate cancer, whilst diets high in calcium may increase the risk.