Genetics and Prostate Cancer: What Should Men Remember During Screening?
Most cancers are a disease of getting older and prostate cancer is no exception. With about 3 percent of men diagnosed with prostate cancer being under fifty and the median age of diagnosis is 66, it’s got an age profile higher than all other major cancers -- 80 percent of men are over 65 years old. By comparison, breast cancer has a slightly younger profile with 80 percent of women diagnosed being over 50.
One in nine men
Prostate cancer is diagnosed in about one man in nine, though far more are thought to have the disease. One study suggests that up to 50 percent of black men and 36 percent of white men have cancer cells in their prostate at the time of their death. Prostate cancer is about twice as common in men with an Afro-Carribean heritage though many black men do not know this and this is reflected in their mortality statistics.1
The mere mention of cancer puts an immediate fear of an early and unpleasant death in most people. About 1 in 41 men diagnosed with prostate cancer will die from it. Those surviving will have to manage cancer and treatment side effects. Since 40 in 41 men will survive prostate cancer, that means 97 percent of men will die from something other than prostate cancer.2
What about genetics?
Generally speaking, only about 5 to 10 percent of cancers diagnosed are inherited according to the National Cancer Institute. However, advice from prostate cancer charities is that having a first degree relative with prostate cancer doubles your risk. That’s an increase to about one in four for a Caucasian man.3,4
None of this makes it easy for a man to decide whether or not to be screened for prostate cancer. There are plenty of physicians who are very against screening and it’s worth bearing in mind that the PSA test is far from perfect. Two-thirds of men with a raised PSA don’t have prostate cancer and there are men with a normal PSA who do have prostate cancer. The PSA test coupled with a digital examination is the only tool available to identify prostate disease.5
Finding the BRCA2 gene in my family
I’ll finish on my own experience and that of my father. Aged about sixty-five he had problems urinating. His urologist diagnosed benign prostate enlargement and he had surgery for this. Biopsy samples were taken during the surgery and confirmed that he did not have prostate cancer.
Ten years later I asked for a PSA test. I was subsequently diagnosed with T2C prostate cancer aged fifty. Where did it come from? Not directly from my father, but interestingly there’s a possibility that I am a carrier of the BRCA2 gene as breast cancer seems to run in my father’s family, though it’s a bit late to follow that one up now.
Have you experienced side effects from androgen deprivation therapy (ADT)?