Genetic Clues Could Expose Prostate Cancer

Prostate cancer can be likened to a stealth aircraft; if it is not on your radar, and without regular check-ins with a healthcare professional, you may never see it coming. There are no tangible early-onset symptoms until it may be too late.

A growing cancer threat among South African men

Presently, prostate cancer is the top cancer affecting South African men and the second deadliest, said Johnson & Johnson Head of Medical Affairs, Vanessa Snow.

“Prostate, colorectal and lung cancer rank the highest amongst the male population in South Africa,” she said, “and it’s showing a notable and concerning rise amongst younger men.” Early onset of prostate cancer is also often a more aggressive form of the condition.

Higher risk among men of African heritage

Men of African heritage carry an even higher risk, often developing the disease at a younger age and in more aggressive forms. Research has shown that one in six men in this demographic will get prostate cancer compared with one in eight white men.

More men of African heritage are also at Stage 3 or 4 of prostate cancer than any other ethnic group. Snow said that while prostate cancer can be well managed, many more men in this group are at risk because of late diagnosis.

Access to screening remains a challenge

Access to healthcare in developing countries, Snow noted, also plays a key role in whether it is caught in time. Yet across all groups of men, the common denominator is a lack of knowledge and access to screening for prostate cancer.

“The earlier the disease is diagnosed the greater the chances anyone has of successfully entering a treatment path,” she said. She recommended that all men regularly undergo screening with a Prostate-Specific Antigen blood test.

Genetic testing enters the picture

Science and innovation can help, too. Genetic testing, once out of reach of the general public, is emerging as a tool that could change the trajectory of prostate cancer.

A growing body of evidence suggests genetics can play an important role determining a man’s risk for developing prostate cancer and also how aggressive it may be.

Targeted treatment and family screening

Andrew Oberholzer, Chief Executive Officer of the Prostate Cancer Foundation of South Africa, said that specific inherited genetic mutations can substantially increase a man’s risk of developing prostate cancer.

Men with genetic mutations, specifically the BRCA2 gene, are at risk of developing the disease at a younger age and in a more aggressive form. There is the inherited kind of genetic mutation, and then the type that occurs and develops over a person’s lifetime.

Testing for specific somatic genetic mutations, he said, can help identify men who may benefit from new treatment options, such as Poly(ADP-ribose) polymerase inhibitors. These inhibitors are a targeted therapy that is effective in certain forms of prostate cancer.

They block the PARP enzyme, which in turn repairs damaged DNA.

Oberholzer said that while it goes without saying that individual men should be tested for prostate cancer at any life stage, for families, the impact of genetic testing early on can be even broader.

“If a man carries one of these inherited changes or mutations, his children or siblings may also carry the same mutation,” he said. “By identifying risks early, relatives can opt for proactive screening, improving their chances of avoiding late-stage disease as well.”