Guidelines for Genetic Testing in Prostate Cancer

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The list of gene mutations known to promote prostate cancer continues to grow, which has led to questions about the role of genetic testing in detecting and managing the disease.

The National Comprehensive Cancer Network (NCCN), an alliance of leading cancer centers across the country, has released guidelines recommending that doctors and patients discuss so-called cancer-susceptibility genes, such as the BRCA2 gene mutation, which increases the risk for prostate cancer two- to sixfold.

The NCCN suggests that your doctor consider recommending genetic testing and counseling if you have:

  • a brother, father, or multiple family members diagnosed with prostate cancer before age 60.
  • more than one relative who has had breast, ovarian, or pancreatic cancer.
  • tested positive for any gene mutation that increases the risk for prostate cancer (or if you have a close relative who has).
  • more than one relative who has had colorectal, endometrial, gastric, small bowel, urothelial, kidney, or bile duct cancer (which indicates the possibility of Lynch syndrome, which increases the risk for prostate cancer).

The NCCN also recommends that doctors consider ordering genetic testing for all men with high-risk and metastatic prostate cancer, since the results may help guide treatment decisions. The recommendations were published in 2018 in NCCN Guidelines Updates, Prostate Cancer Early Detection, Version 2.