Scientists Identify Inherited Prostate Cancer Gene

Thank you for posting about the identification of the gene mutation associated with increased RISK of hereditary PC.

Not mentioned in this article, but important to keep in perspective, is the BIG PICTURE fact that less than 5% of PC is hereditary, which is considered "rare." Furthermore, only about 15% of PC is familial (runs in the family). The majority of PC cases are sporadic and influenced by environment (including lifestyle choices).

My son is 33. Hopefully, down the road, the research will be helpful to him.

It makes me wonder if I should be tested. Something to ask, for sure.

Mel

Purgatory said... with all of my current medical team , including 2 oncologists among them, they feel strongly that PC in particular , is more the case of genetics directly, and has little if anything to do with environment and lifestyle choices as casey suggests. I'm not going to comment about anyone's "current medical team," but it is clearly worth noting that my earlier post in this thread ( and this one) are not based on Dr Casey's research...but they come directly from Dr Kathleen Cooney's research & publications.  Dr Cooney is the lead researcher on the work reported in SHU93's article (you can see her name listed last (indicating that she was in charge) in the pubmed abstract associated with SHU's article.  See the abstract here:  http://www.ncbi.nlm.nih.gov/pubmed/22236224   (SHU93 posted a link to an article about a research paper; but this link goes directly to the abstract for the research paper itself.) For those interested in “brushing up” on their understanding of the risks associated with hereditary and familial forms of prostate cancer ( or wishing that their doctors would “brush up” on this topic ), I recommend a brief article in the April 2011 issue of the AUA News , which summarizes a “state of the art” lecture to be given by the author ( another puiblication by Dr Cooney) at the 2011 annual meeting of the American Urological Association.   By the way, the  AUA News is the Official Newsmagazine of the American Urological Association, written for urologists by urologists.   AUA News features current, highly relevant cutting-edge news of practical value to urologists while also serving as a vehicle for prompt and current communication between the AUA and its members.  Too bad all the doctors treating prostate cancer don't read it, because it is dominated by PC-related articles (but with the explosion in PC diagnosis which followed the commercialization of PSA testing, PC has dominated the urology field).  Here’s the LINK to the AUA News article written by Dr Cooney but I’ll give you the Cliffs Notes version in the bullets below:  (by the way, did I mention that this AUA News article is from the very SAME author who lead the research reported on in SHU93's article link?) ·          In truly hereditary forms of prostate cancer, which may account for up to 5 percent of all cases of prostate cancer, there is a clear and strong set of genetic signals over several generations.   [Researchers typically characterize this risk as “rare,” SUH93’s article specifically calls it “a small fraction,” but this is the type of PC gene that was characterized in that article.] ·          Familial forms of prostate cancer, which seem to account for about 15 percent of all prostate cancers, the evidence of a genetic component is less clear and may not be as strong from generation to generation. ·          “As with other common malignancies, the majority of prostate cancers are sporadic , occurring in men with no family history.”   (I thought that this sentence would be easiest just to quote (copy/paste) directly from Dr Cooney's article in the AUA New Sporadic cancers are an environmental disease.   Cancer researchers use the term “environmental” broadly to mean anything that is NOT genetic.   (For hopefully unnecessary additional clarity, “environmental” is not merely pollution-caused, as in “Environmental Protection Agency.”)   It is nearly impossible to prove what caused a cancer in any individual because most cancers have multiple contributing causes, and every body reacts slightly differently to their environment.   It makes no sense to blame your PC on yourself for eating way too much red meat, for example, because while red meat is an increased cancer risk factor (it “fuels” cancer growth), there likely are other contributing ("fueling") factors…the net impact of which are impossible to isolate. Keep in mind that there is also a strong socionomic component which drives the environmental risk factors – if your family regularly serves each other a lot of the foods that “fuel” cancer and not many of the foods that “fight” cancer (see this LINK), then your offspring will be prone to do the same because it is what they learned at home .   Teach your children well.   " Hope" should not be your sole strategy for helping the next generation prevent PC.   Teach the next generations to exercise frequently and eat better than the SAD (Standard American Diet) if you want to make a difference in their healthy lives.   Consider printing out this quote from the medical journal “CA – A Cancer Journal for Clinicians” in large, bold print and taping it to your refrigerator: For the great majority of Americans who do not smoke cigarettes, dietary choices and physical activity are the most important modifiable determinants of cancer risk. That act of taping it up on your frig won’t prevent cancer, but hopefully further explanation is not necessary on this very clear and impactful message… Teach your children well.     edit:   added pubmed link reference Post Edited (Casey59) : 1/25/2012 5:11:57 PM (GMT-7)

My oldest son will turn 35 in July, has promised to have a base line. My youngest son is still 28, he said he will follow
through on his 35th birthday, I will remind him. There is no evidence of PC anywhere in my side of the family, but of course,
there may have been men where it was never diagnosed or even checked. I am not highly worried about my boys, but taking
that preventative step makes sense.

david

I hadn’t noticed Dr Cooney’s name before, but have learned that she is prominent in genetic testing for prostate cancer.   Thanks, again, SHU93 for posting the original article.   Dr Cooney runs the Prostate Cancer Genetics Project out of the University of Michigan Comprehensive Cancer Center.   LINK Cooney’s work reported in SHU93’s article says that although the familial strain she identified is very rare compared to other types of PC, it was fairly common for those carriers to pass-on the unfavorable mutation to their offspring.   In expressing how rare the “carrier rate” is, 5,083 unrelated men with PC were tested and 72 (or 1.4%) were found to be carriers, but in 1,401 the control group (no PC) only 0.1% of men had the mutation.   So the good news is that it is rare (only 1.4% of men with PC, from this study), but the bad news is that if you are a carrier, then you have a likelihood of passing it on.   This was demonstrated in another part of the study where four men with the mutation had 18 relatives who had PC (and other relatives that did not), and all 18 also carried the mutation. One possible outcome from Dr Cooney's work could be the future development of a test panel to which will help doctors decide individually who does or does not need PSA screening...if indeed PSA screening is still around in the future and hasn't been replaced with a better, more PC-specific screen. But close examination of the article should be largely reassuring to men who have expressed concern about passing a familial strain on to their next generation… it’s so rare that you probably don’t have it .   Keep in mind that from autopsies of men who died in accidents, about 50% of men in their 50’s have a form of what today would be called “prostate cancer” (which includes the low volume, low risk cases which may not be called “prostate cancer" in the future—but that’s a topic for different threads, HERE , or HERE , or HERE ).   So, based on their individual accumulation of environmental (home life, lifestyle choices, etc) cancer risk factors, your male offspring may already have a pretty high likelihood of being diagnosed with PC…so (personally) I wouldn’t be concerned about the relatively low likelihood of the rare strain identified by Dr Cooney.  Age is the most signficant risk factor for PC.   edit:   typo Post Edited (Casey59) : 1/26/2012 9:57:11 AM (GMT-7)

compiler said...
Does this have any implications for a cure for those who have the gene?
 
 
 
 
Mel, that’s a good question, but I didn’t see anything in the several related articles I read on this topic about a “cure.”  It appears to me that the near-term potential is primarily associated with “identification,” in the way I described in my earlier post. 

 

I could, however, conceptualize possible benefits beyond “identification.”  As I've said many times before, I'm no expert and I'm no doctor, but nonetheless by brainstoming just a little...

A “cure” is really the “prevention” of cancer, and “prevention” means “lowering risks.”  Some laypeople think of “prevention” in more absolute terms (I either got cancer or I didn’t), but cancer researchers think of prevention in terms of lowering risks.  So, if we can identify the unique mutation that causes this rare strain of PC (as Dr Cooney reported that her team did), maybe we can find a targeted means of suppressing it to lower risk of PC progression/development.  Targeted cancer therapies are all the rage in the last 5-years or so for other types of cancer…but not so much (yet!) in the PC arena. 

That’s my take on the article.  Did anyone else take-away anything different?

 

I think it’s important to re-emphasize that familial PC is only a small, rare percentage of cases.  If all the familial PC cases Dr Cooney reported on were completely eradicated, it would impact the rate of PC incidence by less than 1.4%.  The vast majority of PC cases are “sporadic cancer,” which means it occurs from the accumulation of risk factors through one’s daily life -- not familial or hereditary.

NOTE: I made some changes to an earlier reply and re-posted.