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Genetics and prostate cancer

Cancer is a disease in which some cells in the body multiply uncontrollably and spread to other parts of the body. Specifically, prostate cancer is the uncontrolled growth of prostate cells. This gland of the male reproductive system is located below the bladder and in front of the rectum. It is responsible for producing prostatic fluid, a substance that forms part of semen and promotes sperm motility.

 

In most cases, this type of cancer grows slowly, although there are some aggressive prostate cancers that spread at great speed. In reference to the first case, there are studies performed on some autopsies of men who died of other causes, which show that they had prostate cancer without knowing it, since at no time did it affect their lives [3].

 

Regarding the most aggressive version of the disease, it corresponds to the third leading cause of cancer death in men. The aggressiveness of the tumors is partly determined by genetic factors. One example is mutations in the TET2 gene, which is involved in DNA methylation. This DNA methylation process is directly related to gene expression, so mutations in this gene are associated with various types of cancer.   [6]. 

 

Symptoms of prostate cancer

 

This type of cancer is mostly suffered by older men. Ninety percent of cases are diagnosed in men over 65 years of age, while the average age of diagnosis today is 75 years [1]. However, there are also cases of early onset prostate cancer in those under 56 years of age. The risk of developing this cancer earlier is determined by genetic variants.

 

Prostate cancer does not usually cause symptoms, especially in the early stages. If symptoms do occur, they may include the following[2]:

 

  • Problems urinating: difficulty starting, weak or intermittent stream.
  • Sudden urge to urinate.
  • Increased frequency of urination.
  • Pain or burning with urination.
  • Blood in semen or urine.
  • Permanent pain in the lower back, hips or pelvis.
  • Pain when ejaculating.

 

The problem is that these symptoms are not exclusively due to prostate cancer but may be due to other problems related to this organ, such as its enlargement. In the event of suspicion, it is always best to consult a specialist, although having a genetic test done beforehand can be very useful.

 

Prostate cancer and genetics

 

On a general level, only 5-10 percent of cancers are hereditary, while the remaining 90-95 percent are caused by genetic mutations as a natural consequence of aging and exposure to external substances [7,8].

 

13% of American men will get prostate cancer during their lifetime [9]. Risk factors include advanced age, a high-fat diet and family history. It is estimated that 10% of prostate cancer cases have a hereditary component. Large-scale genetic studies have detected several susceptibility genes.

 

Among the genetic factors of prostate cancer, genes related to DNA repair pathways stand out. Among them is where most of the genetic risk variants associated with the development of prostate cancer are found, for example, the RAD51B gene. This is a tumor suppressor gene, responsible for repairing DNA damage. [5].

 

On the other hand, mutations have been described in proto-oncogenic genes, which are those whose presence or activation is associated with an increased risk of cancer. An example is genetic variants in the MYC gene, which have been associated with an increased risk of prostate cancer. 

 

24Genetics and prostate cancer

 

The 24Genetics health test is perfect for finding out your predisposition to prostate cancer. In addition, we differentiate between the likelihood of prostate cancer, aggressive prostate cancer and early onset prostate cancer. The aggressiveness of cancer, i.e. tumors that progress and cause death, is partially determined by genetic factors. Large-scale association studies have identified several genes associated with the degree of aggressiveness of the disease. 

 

Genetic testing is strongly recommended for patients with prostate cancer or when a hereditary prostate cancer syndrome is suspected, as well as the use of genetic information to direct the patient’s treatment [4]. If you have any doubts about this, do not hesitate to consult us before taking your health test with 24Genetics.

 

Bibliography

 

[1] Prostate cancer. Sociedad Española de Oncología Médica – Dra. Aránzazu González del Alba y Dra. Carmen Garcías de España [published Feb. 2021; accessed Nov. 2022] Available at: https://seom.org/info-sobre-el-cancer/prostata 

 

[2] NIH: National Cancer Institute. Prostate cancer [accessed Nov. 2022[ Available at: https://medlineplus.gov/spanish/prostatecancer.html 

 

[3] What is prostate cancer? – American Cancer Society [updated Aug. 2019; accessed Nov. 2022] Available from: https://www.cancer.org/es/cancer/cancer-de-prostata.html 

 

[4] Position of the Spanish Society of Medical Oncology and the Family and Hereditary Cancer Section of SEOM on diagnosis and genetic counseling in prostate cancer – Sociedad Española de Oncología Médica [published May. 2019; accessed Nov. 2022] Available at: https://seom.org/images/Posicionamiento_SEOM_Asesoramiento_Genetico_CaP.PDF?_ga=2.258808586.1012008249.1667382228-480171043.1665661975 

 

[5] Genetics in prostate cancer. Genotyping – Rubén Megía González [published May. 2022; accessed Nov. 2022] Available at: https://genotipia.com/genetica-en-cancer-de-prostata/ 

 

[6] Link between the most aggressive prostate cancer and hereditary breast cancer confirmed. Sociedad Española de Senología y Patología Mamaria [published Jan. 2019; accessed Nov. 2022] Available from: https://www.sespm.es/confirmado-el-nexo-entre-el-cancer-de-prostata-mas-agresivo-y-el-cancer-de-mama-hereditario/ 

 

[7] What is cancer? Instituto Valenciano de Oncología [accessed Nov, 2022] Available from: https://www.ivo.es/el-cancer/que-es-el-cancer/ 

 

[8] Common myths and misconceptions about cancer. NIH: National Cancer Institute [updated Aug, 2018; accessed Nov, 2022] Available from: https://www.cancer.gov/espanol/cancer/causas-prevencion/riesgo/mitos 

 

[9] Who Is at Risk for Prostate Cancer? [updated Aug, 2022; accessed Nov, 2022] Available from:  https://www.cdc.gov/cancer/prostate/basic_info/risk_factors.htm#:~:text=Out%20of%20every%20100%20American,chance%20of%20getting%20prostate%20cancer.

 

Written by Manuel de la Mata

Geneticist

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