What is Prostate Cancer

Each year in Australia, close to 3,300 men die of prostate cancer - equal to the number of women who die from breast cancer annually. Around 20,000 new cases are diagnosed in Australian every year.

Prostate cancer can be cured if detected and treated while still confined to the prostate gland. The tests for prostate cancer are the prostate specific antigen (PSA) blood test and the digital rectal examination (DRE). These tests do not give a conclusive diagnosis of cancer but can indicate the presence of prostate cancer.

While prostate cancer is most common in men over the age of 50, younger men with a history of prostate cancer in their family are at greater risk. What is complicated with prostate cancer is that some cancers grow very slowly and don’t threaten life, whilst others grow more rapidly and do. It is as a result of this dilemma that we recommend you take an active role in your decision on testing, and if you develop cancer, how you choose to be treated. It is your choice.

GENETIC RISK AND PROSTATE CANCER

In May Australian researchers announced a world-first discovery, that a gene that causes breast cancer can also cause prostate cancer. The confirmation of this new risk factor, based on laboratory experiments, will help men determine whether they have a four-times greater risk of developing prostate cancer and allow these men to be monitored more closely for the disease.

One in 11 Australian men will develop prostate cancer by age 70. The strongest risk factor is age and the chance of developing the disease rises rapidly after age 50. Family history of prostate cancer is also a known risk factor – and now, thanks to the kConFab research, a family history of breast or ovarian cancer can now be added as a known risk factor. Some families are cancer-prone because one of their genes carries a genetic fault (a mutation) that is passed from one generation to the next. Women who inherit a mutation in the BRCA2 gene are at high risk of developing breast and ovarian cancer, and this means they often have a family history of these cancers.

Supported by the National Breast Cancer Foundation and the National Health and Medical Research Council, kConFab, the Australian and New Zealand consortium for research into familial breast cancer investigated families with multiple cases of breast and ovarian cancer over a 10-year period. This recent work on prostate cancer was funded by the Peter MacCallum Foundation. Using the large kConFab resource of biological samples and lifestyle data, laboratory, researchers based at the Peter MacCallum Cancer Centre and statisticians from the University of Melbourne were able to show that mutations in the BRCA2 gene are directly responsible for most of the prostate cancers in men who inherit these mutations.

A man with a genetic fault in the BRCA2 gene has almost four times the risk of developing prostate cancer than do men in the general population. The BRCA2-prostate cancers that arise in these men also tend to be more aggressive. This kConFab study demonstrates the importance of men’s family cancer history, especially men who belong to a family with many cases of breast and/or ovarian cancer. Future research may provide evidence to support intensified screening of men at increased genetic risk and may lead to new treatments for this type of prostate cancer.

kConFab National Manager, Heather Thorne, said, "We hope our discovery will lead men to do what women already do about breast and ovarian cancer – assess their personal risk. If a man comes from a family with multiple cases of breast or ovarian cancer, or knows there is a BRCA2 gene mutation running in their family, they may be at increased risk of developing prostate cancer. "These men can go to a Family Cancer Clinic and discuss genetic testing, and be given appropriate advice if they are found to be at increased risk."

The National Breast Cancer Foundation (NBCF) CEO Sue Murray said she was delighted that research into breast cancer provided this vital clue about prostate cancer. NBCF was mindful of the potential to positively impact on other cancers when choosing which breast cancer research to fund. "NBCF’s long-term investment in kConFab has not only led to one of the best familial breast cancer resources in the world, but now is helping unlock the mysteries of other cancers, as well as breast and ovarian cancer," she said.

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