BRCA1/2 mutations and risk for aggressive prostate cancer


According to another Reuters report, men who develop prostate cancer and who carry one of three possible hereditary mutations to the so-called breast cancer genes BRCA1 and BRCA2 appear to be at particularly high risk for an aggressive form of the disease.

The original study report was published yesterday in Clinical Cancer Research. (As yet there appears to be no link available to the actual abstract or full text of this article, but see the original media release from Yeshiva University.)

Dr. Robert Burk, the team leader for the study, is quoted as stating that, “One of the biggest problems with early-stage prostate cancer is being able to distinguish between tumors with the potential to become aggressive and those that may persist for many years without enlarging or spreading.” He went on to say that Ashkenazi Jewish men diagnosed with early-stage prostate cancer might want to consider getting tested for the mutations in BRCA2 and BRCA1.

“Our large study shows conclusively that prostate cancer patients with either the BRCA2 gene mutation or the BRCA1-185delAG mutation are more susceptible to aggressive cancers than people without that mutation,” Burk added in a statement.

Burk and his colleagues tested 979 men with prostate cancer and 1,251 men without it for BRCA1 and BRCA2, both of which are rare genetic mutations known to significantly raise the risk of breast and ovarian cancers in women. Note that all the men involved in this study were of Ashkenazi Jewish descent. They showed that men in this study with any one of three mutations in the two genes were no greater risk for prostate cancer than men with no mutation. However, men with one of the three mutations and who did have a diagnosis of prostate cancer were much more likely to have an aggressive form of the disease.

To put the above data in perspective, according to an article on MedicineWorld.org, the incidence of BRCA1 mutation in the general population is between 1 in 500 and 1 in 800. The incidence of BRCA2 mutation is even lower. Individuals with Ashkenazi Jewish background have an increased incidence of BRCA1 and BRCA2 mutations such that approximately 1 in 40 individuals with Ashkenazi Jewish background may be affected with BRCA1 or BRCA2 mutations. Thus, of the approximately 186,000 American men diagnosed with prostate cancer each year, somewhere between 230 and 370 are actually at risk for also carrying a relevant BRCA mutation. This risk goes up as much as 20-fold if you are of Ashkenazi Jewish descent, and men of such descent who are diagnosed with prostate cancer may well be wise to get tested for the presence of a BRCA1 or BRCA2 mutation.

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