“When people come in and talk to me about their family history and the possibility that they carry a BRCA mutation, they usually ask about the health risks affecting their sisters and mothers, not their brothers and fathers,” says Tehilla Brander, a cancer genetic counselor and co-director of the cancer genetic counseling program at Mount Sinai Hospital in New York City. However, there are definite cancer risks for men who carry BRCA1 or BRCA2 mutations, including an increased risk of prostate cancer. Men who have a BRCA1 mutation have a 29 percent risk of being diagnosed with prostate cancer in their lifetime, according to a study published in January 2020 in European Urology. That risk climbs to 60 percent for those who have a BRCA2 mutation. What’s more, men with a BRCA2 mutation may experience a higher grade or a more aggressive prostate cancer, Brander says. If you’re a man and have relatives with breast or ovarian cancer, or if you know that BRCA mutations run in your family, here’s what you need to do. “Often in families, women are the keepers of stories and will know the family history,” says Allison Werner-Lin, PhD, an associate professor at Penn Medicine’s School of Social Policy and Practice in Philadelphia who specializes in hereditary cancer. “They may communicate this to their daughters rather than their sons, but it’s important to open the door so that everyone knows the family history and is open about risk,” she says.
Relay This Information to Your Doctor
It’s critical that men relay the information they learn and any history of breast or ovarian cancer to their healthcare providers. Knowing about your family’s history with these diseases can help a doctor advise you about your own risk and the next steps, Brander says.
See a Genetic Counselor
If there is a history of either breast or ovarian cancer in your family, your doctor will probably send you to a genetic counselor to further discuss your risk, and the counselor will likely arrange for you to have genetic testing done. You can also find a genetic counselor by checking out the National Society of Genetic Counselors ’ website. Brander recommends its Find a Genetic Counselor tool, which can help you connect with a counselor near you. After you’ve gone through genetic testing, if you are found to have either a BRCA1 or BRCA2 gene mutation, you’ll likely begin prostate cancer screenings with your general practitioner. This will include routine prostate-specific antigen tests and digital rectal exams. While men usually go through this process around age 45 to 50, men who have tested positive for a BRCA mutation may start this process earlier, at 40, Brander says.
Manage Your Risk
You can’t stop a cancer diagnosis altogether, but some research suggests that there are lifestyle measures you can take to help reduce your risk. The Mayo Clinic recommends eating a healthy, low-fat diet consisting of more fruits and vegetables, and less dairy, along with at least 30 minutes of physical activity most days of the week. Studies suggest that more frequent ejaculation may decrease your chances of diagnosis. Although lifetime prostate cancer risks are relatively high and increase with age among BRCA mutation carriers, there is still a strong belief that hereditary cancers are mostly limited to women, Dr. Werner-Lin says. “As many men traverse genetic counseling and come to terms with their risk, they may find that lots of the messaging isn’t about them — it’s about them protecting their daughters,” she says. It’s important to keep these lines of communication open — especially with your father and sons, brothers, and other men in the family — and continue discussing your health history. “Part of what’s important is for men to have permission to focus on their own risk,” Werner-Lin says. “Your risk may be lower than your sister’s and mother’s and daughter’s, but it’s okay for you — in concert with the rest of the family — to claim the space to care for yourself, too.”
