Is Prostate Cancer Genetic?

The term “genetics” is heard everywhere these days. And rightfully so! Scientific, technological, and engineering advancements have largely contributed to an advancement in research techniques, which, in turn, has ushered techniques that have helped us better understand our genetic blueprint as part of our family history. And while the human genome has been mapped, we are still so far away from fully understanding just how genetics affects everything around as well as within us. Genetic testing has the potential to show up diseases like hereditary prostate cancer and help establish those who are at a higher risk of prostate cancer. But, let’s not digress too much. As with all diseases, the question has been asked: is it genetic? We do know that cancer—and let’s treat it as an umbrella term—is hereditary. And this begs one of many questions about the different types of cancers. One being: Is prostate cancer one of the many diseases that is genetic? Before we address this question, let’s back up a few steps and talk about the anatomy of the prostate, the actual disease as well as what is known so far.

What is the prostate?

The prostate is a gland that is the size of a walnut and that is located just underneath the bladder, above the penis, and in front of the rectum. As the urine flows out of the system, it runs through the urethra from the bladder, through the center of the prostate, and to the penis. The primary function of the prostate is to both nourish and protect sperm by secreting a fluid that will feed sperm as well as protect it from potentially damaging situations. Furthermore, during ejaculation, the prostate squeezes this protective fluid into the urethra before it is expelled with sperm as semen. The prostate, on the other hand, depends on male hormones, or androgens, to function properly. Two of these hormones are testosterone and dihydrotestosterone (DHT). So while the prostate is not essential for life, it does play an important role in reproduction as it ensures that semen remains nourished, protected, and healthy for potential sperm transit, survival, and fertilization.

What is prostate cancer?

There are several conditions that can affect the prostate gland and prostate cancer is one of the more serious ones as it largely affects the quality of life while potentially being lethal. Aside from skin cancer, prostate cancer is the most common type of carcinoma in men. An estimated one out of every nine American males is diagnosed with it and, by virtue of one out of every 35 men dying from it following advanced prostate cancer, it is considered to be less aggressive when compared to some other types of cancer.

The hallmark of every type of cancer is the uncontrollable growth of abnormal cells that accumulate into masses that are called tumors. To back up a bit more, every healthy cell in the body has the machinery that will detect a defect and immediately shut itself down to prevent multiplication and accumulation of abnormal cells. When the self-destructing machinery does not work properly, abnormal cells begin to divide and multiply aggressively, forming masses or tumors. To juxtapose that onto prostate cancer, when abnormal cells in the prostate begin to accumulate, that leads to prostate cancer that uses androgens in order to grow more. In many cases, prostate cancer cells only spread within the prostate and do not affect surrounding organs like other, more aggressive cancers. By virtue of androgens being the fuel for prostate cancer, a typical prostate cancer therapy is administering drugs that lower androgen levels. This process is collectively called “hormone therapy.”

Genetics of prostate cancer?

Genetics of prostate cancer

Thanks to laboratory techniques such as linkage analysis, genome-wide association studies as well as case-controlled studies, several genes as well as chromosome regions have been discovered to be tied to prostate cancer. These genes are the breast cancer 1 and 2 (BRCA1 and BRCA2)—getting their name from initially being found in individuals with breast cancer—and Homeobox B13 (HOXB13). While this is still in its early stages, BRCA2 has advanced a bit more and the research, as well as medical fields, are beginning to treat it as a kind of prostate cancer marker in screening efforts. Furthermore, more than 100 other genetic variations have been found to be linked to the development of the cancer. However, clinical relevance remains to be confirmed in order for these variations to be of practical medical use.

However, the prostate cancer antigen 3 (PCA3) gene test has been widely accepted as a genetic testing marker for prostate cancer. While it is not used to diagnose prostate cancer per se, it is used to detect the levels of a prostate-specific antigen (PSA) that is an indicator of prostate cancer.

Is prostate cancer genetic?

So from what you have read above, you have probably already deduced that, yes, prostate cancer is indeed genetic simply by virtue of there being genetic markers associated with it. In terms of inheritance, the cancer has been largely divided into two categories, namely familial and hereditary. If one of your immediate family members has been diagnosed with prostate cancer before you, then the disease is considered familial. However, if it has been running in your family for at least three generations, it is termed hereditary.

Furthermore, there are some differences based on ethnicity. African-American men, for example, are at a much higher risk for prostate cancer than white men. While scientists are still working on discerning why this is, this cultural aspect highlights the genetic aspect of it even more.

How curable is prostate cancer?

Prostate cancer, by virtue of mostly remaining localized to the prostate alone, is curable. But as with all other cancers, “curable” is a relative term that refers to an individual remaining disease free for a period of time after treatment. Approximately 90% of prostate cancers are detected in the prostate, which is why the cure rate is very high. Nearly 100% of men who were initially diagnosed with it will remain cancer-free five years post-treatment. This is a large improvement from rates in 1970, where the percentage was a much lower at 67%. This ties things back to the initial paragraph that discusses scientific advancements over time.

Laura Day
 

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