Genetic testing is playing a growing part in how prostate cancer risk is identified and managed. One of the most important genetic factors involves the BRCA1 and BRCA2 genes. These are best known for their link to breast and ovarian cancer, but they also affect prostate cancer risk, particularly for more aggressive disease. This guide explains BRCA testing and prostate cancer: what the genes do, who might consider testing and how results can shape care.
What BRCA genes do
BRCA1 and BRCA2 are tumour suppressor genes. Their normal role is to help repair damaged DNA. When someone inherits a faulty copy of one of these genes, that repair process works less well, which increases the likelihood of certain cancers developing.
Faulty BRCA genes can be inherited from either parent. A family history of breast, ovarian, pancreatic or prostate cancer may therefore be relevant, whichever side of the family it comes from.
How BRCA changes affect prostate cancer risk
Men who carry a BRCA2 gene change have a significantly higher lifetime risk of prostate cancer than the general population. They are also more likely to develop it at a younger age and to have faster-growing, higher-grade disease. BRCA1 changes are less strongly linked but may still increase risk. Prostate Cancer UK explains these risks in more detail.
Who might consider testing
BRCA testing may be relevant if you:
- have a family history of prostate cancer, especially at a young age or in an aggressive form
- have relatives with a known BRCA gene change
- have close relatives with breast, ovarian or pancreatic cancer
- have been diagnosed with prostate cancer and want to understand whether genetics may affect treatment
- would like a clearer picture of your inherited risk
Testing within the NHS is usually arranged through a clinical genetics service, based on personal and family history. The NHS guide to BRCA gene testing explains how it works.
A careful testing pathway
Good genetic testing involves more than a laboratory result. A structured pathway usually includes:
- an assessment of personal and family history
- accurate testing using validated laboratory methods
- clear results that explain what they mean for prostate cancer risk
- professional interpretation and genetic counselling
- secure, confidential handling of genetic information
How results are used
If you carry a BRCA change
Men with a BRCA gene change may be offered earlier and more regular PSA testing, MRI scans or referral to a specialist. If prostate cancer is diagnosed, BRCA status can influence treatment choices. For example, some men with advanced prostate cancer and a BRCA change may be suitable for targeted medicines called PARP inhibitors.
If you do not
A negative result can offer reassurance and help set an appropriate level of monitoring, avoiding unnecessary tests while staying alert to other risk factors. Our overview of prostate cancer describes the symptoms and tests involved.
The personal side of genetic testing
Learning about inherited risk can bring up difficult feelings, and results may have implications for children, brothers and other relatives. That is why genetic counselling and clear communication are important parts of the process. Consent, confidentiality and the right to decide how results are shared should be respected at every stage.
Looking ahead
Genetic testing reflects a wider move towards earlier detection and more personalised care in prostate cancer. As research continues, BRCA status is likely to become an increasingly routine part of risk assessment and treatment planning.
If you are diagnosed and surgery is being considered, our guide to robotic prostatectomy and our article on whether you are a candidate for surgery may help. You can also read about Professor Dasgupta's background.
If you have questions about your prostate cancer risk, please contact the clinic.