I have previously written about the BRCA gene mutation, the increased risk to women carriers of developing breast and ovarian cancer and the need for better access to genetic testing so women can make more informed decisions about preventative surgery.Mutations in the BRCA gene are classified type 1 or 2. Both types of mutations increase a woman's risk of breast and ovarian cancer, albeit the increased risk with a BRCA 2 mutation is lower than for BRCA 1. A study led by the University of Cambridge has recently confirmed that men who carry the BRCA 2 mutation are more than twice as likely to develop prostate cancer than men of the same age who do not carry the gene mutation. At present, prostate cancer kills almost 12,000 men a year in the UK and is responsible for around 1 in 8 male cancer deaths.
The study also found that the BRCA 2 mutation was also associated with increased risk of stomach and pancreatic cancer and a dramatically increased risk of male breast cancer.
In light of the scientific knowledge about BRCA 1 and 2 mutations and increased cancer risk, the time must have come to provide patients with wider and easier accessibility to genetic testing for the BRCA gene mutation on the NHS. Currently patients must pass a risk-assessment based on their family history of cancer and only qualify for genetic testing on the NHS if the assessment generates a risk of more than 10%. My experience in a couple of cases is that this risk assessment can produce a result below 10% but then the patient does in fact turn out to have the BRCA mutation when they are tested after developing cancer. It is also imperative that patients are given the information that the BRCA gene testing is available privately and how they can access testing privately if they wish to do so should they not be eligible on the NHS.
Providing improved information and access to BRCA gene testing will enable women and men to make informed choices about their health and to take preventative steps to minimise their risks of developing certain cancers and have cancers detected at an early and more treatable stage.
Unlike routine mammography and cervical screening for women, at present men do not have a national screening programme for prostate cancer. The initial investigation for prostate cancer is a PSA blood test, however this is often only offered to patients once they have developed symptoms associated with prostate cancer. Sometimes these symptoms only develop once prostate cancer has become more advanced.
If men were able to access genetic testing for the BRCA gene mutation, those who are carriers of the BRCA 2 mutation could then opt to have regular PSA tests, on a private basis if necessary, in order to try and detect any early changes in the prostate before any cancer becomes more advanced. This would also enable men to seek further investigations at an early stage should this be necessary. Also, if men are aware that they or other family members are BRCA 2 mutation carriers and they are at increased risk of prostate cancer, then they may also be more aware of any developing symptoms which could indicate early prostate cancer. This would enable them to seek medical advice much earlier than they may otherwise have done so.
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