How Men Can Benefit From Proactive Cancer Screening

An important test that can help you take control of your overall wellness

Posted November 5, 2020By Justin Lorentz, Medcan genetic counsellor

A 3-D model of the BRCA2 gene.

Knowledge is power. That’s one of Medcan’s founding principles. It’s also integral to the field of genetics.

If your DNA predisposes you to certain health problems, the facts can motivate you to make lifestyle decisions that improve your chances, should you ever develop the condition for which you are predisposed. Such knowledge can also benefit your family members.

Take mutations in the BRCA1 and BRCA2 genes—two among the 147 genes analyzed in those who choose to get Proactive Genetic Screening. Mutations in these cancer-protecting genes predispose individuals to certain types of cancers. Best known for their association with increased risk for breast and ovarian cancer in women, these genes can also have implications for men. For example, Beyoncé’s dad, Matthew Knowles, found out that he has a BRCA2 mutation only after being diagnosed with breast cancer.

Past studies on families with many cases of cancer found up to one in 400 (mostly Caucasian) individuals in North America have a mutation in BRCA1 or BRCA2. Medcan’s Proactive Genetic Screening data, however, found a mutation in closer to one in 200 individuals. This number can be even higher in certain ethnicities. For example, in Ashkenazi Jews the prevalence may be as high as one in 40 individuals.

Men with BRCA2 mutations specifically are twice as likely to develop prostate cancer, which tends to be more aggressive than in those without mutations. Breast cancer in men is rare, unless you have a hereditary predisposition. According to the American Cancer Society, just one in 833 men will get breast cancer, compared to one in 12 men who have a BRCA2 mutation.

Those with a BRCA2 mutation also are at higher risk for developing melanoma and pancreatic cancer. Here’s where an important consideration comes in. At this time, in contrast to melanoma, breast and prostate cancer, there is no proven effective screening tool for pancreatic cancer. (That’s where there’s room for research studies to help solve these problems.)

So, knowing you have a BRCA1 or BRCA2 mutation can be difficult. What use is it for men to know? Excellent question. The utility falls into three broad categories:

PARP Inhibitors — Exciting new ways to treat cancer exist for people with BRCA1 and BRCA2 mutations. PARP inhibitors are a new type of therapy that targets cancers caused by these mutations. These drugs were recently approved by Health Canada for men with BRCA1 and BRCA2 mutations who have metastatic prostate cancer. Qualification for treatment with PARP inhibitors is currently on a clinical trial basis. If a man is diagnosed with metastatic prostate cancer, knowing in advance whether he has a BRCA1 or BRCA2 mutation means he’ll be ahead of the game.
Lifestyle Factors — Genetics alone is not destiny. Men will respond to cancer treatment better if they’re in good health, and healthy lifestyle decisions may be able to increase the range of treatment options available to them. For example, some men aren’t eligible for prostate surgery if they’re overweight or have too many comorbidities, such as diabetes or a smoking habit. Awareness of one’s BRCA1 or BRCA2 mutation status can be an excellent motivation to exercise, eat well and stop smoking. Men with these gene mutations should also talk to their doctors about increased cancer screening.
Family Members — Genes are shared. Having a BRCA1 or BRCA2 mutation increases the risk that other family members also may possess one. Biological parents, siblings and children each have a 50% chance of having inherited the same gene mutation. That information can affect their lives. Women with BRCA1 or BRCA2 mutations are eligible for more aggressive breast cancer screening beginning at age 30, for example. Once they’ve finished having children, women with these mutations also may consider preventive removal of the ovaries and fallopian tubes. Finally, partners who both have a BRCA2 mutation have a 25% chance for each future pregnancy to have a rare condition called Fanconi anemia, which is associated with developmental delays and other significant medical issues. Any individual found to have a BRCA1 or BRCA2 mutation should speak with a genetic counsellor to learn more about the implications for their relatives.

Men who discover they have a BRCA1 or BRCA2 mutation can be referred to the Familial Prostate Cancer Clinic at Sunnybrook Hospital for annual screening. For men who meet the criteria, the clinic also offers research-based screening protocols for other risks like male breast cancer.

We are all seeking ways to take control of our health. Proactive Genetic Screening can provide you with piece of mind—as well as the context required to make important lifestyle decisions.

Learn more about Proactive Cancer Screening at Medcan.

Questions? Get in touch with genetics@medcan.com.

Justin Lorentz is a genetic counsellor at Medcan. Find him on Twitter @geneticjustin.