Many factors affect the risk of prostate cancer, including genetics.
If you’ve inherited certain genetic mutations, your risk for developing prostate cancer may be higher than average. People with certain genetic variants also tend to develop more aggressive prostate cancer than others.
If you’ve received a diagnosis of prostate cancer, your doctor might advise you to undergo a type of genetic testing known as germline testing to learn if you have certain genetic traits.
In some cases, doctors or genetic counselors also offer germline testing to family members of people who’ve tested positive for certain genes.
Here are some questions you can ask your doctor to learn whether germline testing might be right for you.
According to the Urology Care Foundation, approximately 5 to 10 percent of prostate cancers are hereditary. That means they have a genetic component that may be passed from one generation to the next.
Multiple genetic mutations have been linked to prostate cancer, including mutations in the:
- BRCA1 and BRCA2 genes, which are also linked to breast and ovarian cancer
- DNA mismatch repair genes, which are also linked to colon cancer and several other types of cancer
- HOXB13 gene
If you have a family history of cancer, let your doctor know. It may be possible that certain genetic mutations run in your family.
If you have prostate cancer, your doctor might encourage you to undergo germline testing if the cancer has spread to other parts of your body. This is also known as metastatic prostate cancer.
Your doctor might also recommend germline testing if you have localized prostate cancer and a family history of cancer in the:
Your doctor will take into account how many of your blood relatives have received diagnoses of those cancers. They will also consider how closely related you are to them.
If one of your blood relatives has cancer and has tested positive for certain genetic traits, their doctor or genetic counselor may offer germline testing to other members of the family.
This is known as cascade testing. It can help you and other family members learn if you have an increased risk for developing certain types of cancer, including prostate cancer.
If you test positive for certain genetic traits that raise your risk for cancer, your doctor or genetic counselor may:
- advise you to begin cancer screenings at a younger age than usual
- encourage you to get more frequent cancer screenings than usual
- recommend lifestyle changes or other strategies to reduce your risk for developing cancer
Your doctor will likely advise you to get early cancer screenings if you have a close relative with prostate cancer, even if you haven’t gone through germline testing.
Prostate cancer screening may be conducted with a simple blood test, known as the prostate-specific antigen (PSA), as well as a digital rectal examination (DRE).
If you test positive for elevated levels of PSA, or you have abnormal exam results, your doctor may order a prostate biopsy or additional tests to check for cancer.
Some genes linked to prostate cancer are also linked to other cancers, such as breast and ovarian cancer. Talk to your doctor to learn which cancer screenings you should get and when you should get them.
To perform germline testing, your doctor or other healthcare provider will collect a sample of your saliva or blood. They will send this sample to a laboratory for genetic sequencing.
If your genetic test results are positive for certain traits, your doctor may refer you to a genetic counselor. They may also recommend genetic counseling if your test results are uncertain.
A genetic counselor can help you understand the findings.
If you’ve received a diagnosis of prostate cancer, germline testing may help your doctor predict which treatments are most likely to work for your cancer.
Some immunotherapy treatments may be particularly beneficial for treating prostate cancer in people with certain genetic mutations.
A new class of drugs known as PARP inhibitors have also shown promise for treating prostate cancer in people with certain genetic variants.
If you test positive for genetic traits that are linked with prostate cancer, it’s possible that other members of your family have inherited those traits, too.
Those genetic mutations may raise their risk for prostate cancer and, in some cases, other types of cancer as well.
A genetic counselor can help you learn more about your test results, including the chances that other members of your family may carry the same genetic variants.
Your genetic counselor can also help you decide if, when, and how you want to share information about your test results with family members. In some cases, they may offer germline testing to your relatives.
Germline testing is one of two main types of genetic testing that may be used in people with prostate cancer.
The other type is known as somatic mutational testing. It’s also called tumor testing.
If you have prostate cancer, your doctor may order somatic mutational testing to learn whether the cancer cells have developed certain mutations. Those mutations may affect how the cancer responds to treatments.
To conduct somatic mutational testing, your doctor or other healthcare provider will collect samples of a tumor from your body to send to a lab for testing.
The test results may help your doctor determine which treatments are likely to be most effective.
Depending on your medical history, your doctor might recommend somatic mutational testing, germline testing, or both.
Somatic mutational testing is ordered more often than germline testing.
If you have prostate cancer or a family history of the disease, consider asking your doctor about the potential benefits and risks of genetic testing.
If you test positive for certain genetic traits, it may affect your recommended treatment or screening plan for prostate cancer.
Your doctor or a genetic counselor can help you learn more.