It has been said that “Blood is our destiny.” Or that “Bad hens have bad eggs.” Scores of studies show genetics plays a huge role in whether or not we develop malignancy. But how big a role does genetics play in prostate cancer? A worldwide study reports a major breakthrough, showing that some men seem to be genetically predisposed to this baffling cancer.
Earlier studies indicated five to 10 per cent of prostate cancers were due to genetics. For example, a man with one close relative — a father or brother — with prostate cancer is twice as likely to develop this malignancy as a man with no family history of the disease. If two close relatives are affected, the risk of developing this cancer is increased five times.
Research at the Memorial Sloan-Kettering Center in New York suggests that men with mutations in the gene BRCA2 show an increased risk of prostate cancer.
In an intensive international trial, researchers from Denmark’s Rigshospitalet and others discovered congenital defects that predispose to prostate malignancy.
This research involved 31 research groups from all over the world and included 25,000 males with prostate cancer. What was shocking was the finding that 72 congenital genetic defects predispose to prostate cancer. Andrea Roder, a physician at the Copenhagen Prostate Cancer Center at Rigshospitalet, said: “With this study, we believe to have clarified about 30 per cent of the heredity in prostate cancer.”
It is believed this study will help target early discovery of prostate cancer by identifying patients who need early treatment.
A prostate cancer diagnosis presents a difficult question: should one treat it, knowing the treatment will be unpleasant, or just ignore it and hope it’s a slow-growing tumour?
Why ask that question? In some cases, developing prostate cancer is like getting grey hair. Autopsies show that by age 70, about 50 per cent of men have microscopic cancer in the gland. It’s often a slow-growing malignancy that may take 15 years to cause death. In the meantime, death may occur for many other reasons.
The late D. Willet Whitmore, a world authority on prostate cancer, once said: “Growing older is invariably fatal; cancer of the prostate only sometimes.”
Unfortunately, prostate cancer can also move at speed and kill quickly.
Determining which one is present is not easy. Even the PSA test to diagnose prostate cancer has been questioned. In 2011, a U.S. panel of experts reported that healthy men should say no to the test. Others insist the test saves lives.
But how many lives does it save? The New England Journal of Medicine reported a European study that followed 162,000 men for 10 years. Of those who had the test, 363 died. But of those not given the test, 261 died. A difference of 102 deaths out of 162,000 men isn’t terribly impressive.
And even when treatment saves a life, it can leave it scarred by unpleasant side effects.
Hopefully this new genetic research will enable doctors to predict which cancers might as well be left untreated.
docgiff.com.
