By Carol Guzman
The BRCA gene gets its name from breast cancer, a disease commonly linked to mutations of the gene. But a BRCA mutation indicates much more than just an increased risk of hereditary breast cancer in women. These mutations are also associated with ovarian cancer in women, breast cancer and prostate cancer in men, pancreatic cancer, and melanoma. Individuals of Ashkenazi Jewish ancestry may face an elevated lifetime chance of BRCA-associated cancers because they are 10 times more likely to inherit a BRCA gene mutation compared the general population.
Let’s discuss some of the lesser-known and lesser-addressed BRCA-associated cancer in honor of Prostate Cancer Awareness Month and Ovarian Cancer Awareness Month.
Ovarian Cancer and BRCA
The National Cancer Institute estimates that 17% of women with an inherited BRCA2 mutation and 44% of women with an inherited BRCA1 mutation will develop ovarian cancer by the time they are 80 years old.
Ovarian cancer is often called a “silent killer” because detecting it in its early stages is extremely difficult. Many ovarian cancer symptoms are vague and mimic things that women typically deal with regularly: bloating, constipation, abdominal and pelvic pain, fullness after eating, and menstrual changes. Women who notice these changes in their bodies should talk to their doctor if the symptoms persist for more than a few days.
There are no preventative screening tests or early-warning signs for ovarian cancer. Ovarian cancer is detectable once it occurs, but the methods used aren’t perfect. The most common are the transvaginal ultrasound (TVUS) and the CA-125 blood test. TVUS uses sound waves to look for growths inside the uterus, but it can’t identify whether a tumor on the ovaries is cancerous or benign. The blood test method checks for elevated levels of the CA-125 protein, but false positives are possible because elevated levels of CA-125 can be caused by other conditions.
Prostate Cancer and BRCA
One study estimates more than 9% of men with a BRCA1 mutation and 20% of men with a BRCA2 mutation will develop prostate cancer in their lifetimes. Some men with prostate cancer may not develop symptoms. Others experience difficulty urinating, weak or interrupted flow of urine or frequent urination, pain or burning during urination or ejaculation and constant pelvic and back pain.
Similar to ovarian cancer, there is no failproof preventative screening test for prostate cancer at the moment. A prostate cancer diagnosis can only be made with a prostate biopsy, which requires 12 small samples of the prostate to be removed and further examined. Two screening tests are commonly used, including a blood test for prostate-specific antigen levels and a doctor’s examination by hand; however, the latter is not recommended by the U.S. Preventive Service Task Force.
BRCA-Related Cancers and Genetic Testing
Meeting with a genetic counselor and, if appropriate, getting genetic testing for BRCA mutations can help identify your risk early. If cancer occurs, genetic testing can also be vital in determining which cancer treatment is appropriate for you. Ovarian cancer patients with BRCA mutations may be candidates for a new targeted therapy called a PARP inhibitor, in which an enzyme stops cancer cells from repairing themselves. Doctors use the same PARP inhibitor to treat prostate cancer patients and breast cancer patients with a BRCA mutation. Currently, there are clinical trials involving the PARP inhibitor for individuals with BRCA-associated cancers that may result in more treatments.
Ovarian cancer has caused more women’s deaths than any other cancer in the female reproductive system, and prostate cancer is the most common male cancer in the United States. Both cancers are difficult to catch in their early stages, but learning more about your genetic health and speaking to a genetic counselor can empower you to know whether you have a higher risk of developing these cancers and, if necessary, take steps to reduce any risk. This month consider talking to your healthcare provider about how ovarian or prostate cancer may affect you.
Picture Credit: Darryl Leja, National Human Genome Research Institute, National Institutes of Health