In 2024, there will be about 299,000 new cases of prostate cancer in the United States and about 35,250 men will die from it, according to the American Cancer Society. Some prostate cancers tend to be very slow-growing, without significant threat to a man’s health or life. In fact, the ACS estimates that more than 3.3 million men in the U.S. are still alive after being diagnosed with prostate cancer. However, some cases can be aggressive and move quickly beyond the prostate to become a deadly threat.

Prostate cancer is the most likely of major cancers to be inherited, or resulting from genetic factors. Here is some data to consider:

• About 58% of the cases are driven by genetic factors.
• Men with a close relative who has had prostate cancer can be up to twice as likely to develop the disease. (Men with a brother who has the disease are more at risk than those whose father has had it.)
• Men with two or more relatives who have had prostate cancer can be almost four times as likely to be diagnosed.
• The risk is higher if the affected family members were diagnosed before age 60.

Because genetics are such a factor in prostate cancer, the use of genetic testing can be valuable.

The value of genetic testing for prostate cancer

Some men’s inheritance includes genetic mutations that increase their risk of developing prostate cancer, as well as other cancers. Genetic testing can identify the presence of several genes that have been linked to prostate cancer.

Genetic testing for prostate cancer is simple and requires documenting your family history and taking a small sample of blood or saliva. Once complete, a genetic counselor will walk you through the results. Although online tests are available, the Prostate Cancer Foundation recommends in-person genetic testing with a doctor or genetic counselor.

There are four key points to keep in mind when considering the value of prostate cancer genetic testing:

• Men with metastatic prostate cancer, cases in which cancerous cells have spread outside the prostate, can use the results to make treatment choices.
• Men with non-metastatic prostate cancer benefit by learning what cancer screenings they should get in the future.
• Men who don’t have prostate cancer but test positive for certain mutations can take steps to ensure testing is done frequently enough to detect earlier disease and to implement strategies that may help prevent the development of the disease.
• Men can inform their close relatives of any test results that might be useful.

Who should consider genetic testing?

Men who have a history of cancer in their family, especially if it started before age 50, should think about getting genetic counseling for prostate cancer. This includes men who have never had prostate cancer as well as those who have, because they may have a hereditary predisposition to certain malignancies.

These are symptoms of prostate cancer to look for:

• Difficulty urinating
• Blood in your urine or semen
• Bone pain
• Erectile dysfunction
• Unexplained weight loss

According to the American Cancer Society, men who haven’t had prostate cancer might consider testing and counseling if:

• A known gene change that’s associated with the disease runs in their family.
• There’s a strong family history of prostate cancer (or certain other cancers) that indicate that these gene changes run in the family. For example, if many blood relatives have had cancer, if family members have had unusual cancers (like breast cancer in a man), or if their cancers appeared at a younger age than usual.

For men who have prostate cancer, genetic counseling and testing may be recommended if:

• Either of the conditions above are true.
• They’ve had another type of cancer (especially breast cancer).
• They are of Ashknazi Jewish descent (which means a higher risk for a particular gene mutation).
• The prostate cancer has spread to other parts of their body.
• Their cancer has high-risk features or includes intraductal carcinoma.
• Tests of the cancerous cells found a gene change that might have been inherited. (If so, genetic testing can show whether the change is in only the cancer cells or if it’s inherited and is then in all the body’s cells.

The process of genetic testing

Your doctor will start by taking a detailed medical history of your entire family. It’s important to provide information on anyone who has had cancer, as well as the ages and kinds of malignancies that your relatives have battled. Do your best to acquire as much relevant family medical history as you can before the test, including results from any prior genetic testing that relatives may have had. This will help to get a more accurate assessment of your risk factors. In addition, the doctor can use this data to better determine whether there is a history of genetic mutations in your family.

During your visit, your doctor will go over the specifics of the genetic testing process. This will include drawing blood or saliva samples to examine for potentially dangerous abnormalities in your DNA.

When screening for inherited mutations, a doctor may suggest saliva genetic testing as a non-invasive and simple option. Since blood samples might provide further information on genetic abnormalities and biomarkers, they may suggest blood genetic testing for a more thorough evaluation. If the doctor suspects you have prostate cancer, it will be necessary to perform a prostate biopsy for confirmation of the diagnosis.

Deciphering genetic testing results

Medical professionals interpret test findings using databases and established protocols to examine the detected genetic abnormalities and their known links to elevated cancer risk. Based on the patient’s unique genetic profile, they analyze the data and provide individualized suggestions for screening, prevention, and possible treatments.

The impact of genetic testing on prostate cancer

Genetic testing for prostate cancer can uncover certain mutations that impact the disease’s behavior and response to treatments. With this data, doctors also can recommend preventative actions to lower a man’s risk of getting prostate cancer.

Influencing treatment plans

The results of genetic tests help doctors choose tailored treatments that work better against malignancies with specific mutations, which ultimately leads to better treatment results. For example, one type of mutation affects the cells’ ability to repair damaged DNA. If tests discover these mutated genes, doctors can attack the cancer with targeted drugs called PARP inhibitors.

Furthermore, genetic results can guide decisions on the type and dosage of radiation, chemotherapy, or surgery, as well as combining drugs, to allow for a more tailored approach.

Improving prognosis and prevention

In terms of prognosis, clinicians can make more accurate predictions about a cancer’s course and aggressiveness when they have a better grasp of any genetic alterations involved.

If testing reveals that you have a high-risk genetic profile, you may need to adjust your lifestyle and start screening more often. The information might also help family members take preventative steps.

Early identification through genetic testing can be crucial to treating prostate cancer. This is especially true for hereditary prostate cancer since it tends to be more aggressive compared to non-hereditary cancer forms.

Navigating the path forward

The Department of Urology at Florida Medical Clinic Orlando Health  specializes in diagnosing prostate cancer and other urologic conditions. Offering a comprehensive range of urologic services allows us to provide patients with the most cutting-edge and efficient therapies currently accessible. Our urologists are well-prepared to treat even the most difficult situations, including those that need complex operations including prostate laser surgery for enlarged prostate, surgeries for urinary incontinence and the removal of stones from the urinary tract. Request an appointment on our website or call (813) 979-7733 today.

Meet Dr. Kirkpatrick

Dr. Gina Kirkpatrick, DO, MPH, MBA, is a board-certified urologist who has been diagnosing and treating prostate issues, urinary incontinence and urinary voiding dysfunction in the Tampa region since 2017. She takes a patient-centered approach — making sure people understand their diseases and developing personalized treatment programs to overcome any obstacles.

Dr. Kirkpatrick completed her residency in Urological Surgery at the University of Medicine and Dentistry of New Jersey and Rowan University, followed by a fellowship in Female Pelvic Medicine and Reconstructive Surgery at Hackensack University Medical Center.

Beyond her medical practice, Dr. Kirkpatrick enjoys traveling with friends and family, exploring wineries, and maintaining an active lifestyle through activities like jogging, tennis, and Pilates.