Dr Yuh on the Role of Genetic Factors in Risk Stratification for Prostate Cancer

Bertram Yuh, MD, MISM, MSHCPM, professor, Division of Urology and Urologic Oncology, Department of Surgery, director, the Urologic Oncology and Robotic Surgery Fellowship, associate chief medical information officer, clinical documentation and analytics lead, City of Hope, discusses the role that genetic factors, such as BRCA mutations, play in the risk stratification of patients with prostate cancer.

The field of genetic assessment in prostate cancer is developing and holds significant potential, Yuh begins. Prostate cancer is highly heritable, making genetic testing an important tool for gathering crucial information, he says. Prostate cancer tends to cluster in families, so assessing family history of cancer is key when evaluating a patient, Yuh explains, adding that DNA damage repair mutations, especially in BRCA1 and BRCA2, increase the risk of developing prostate cancer, particularly in the context of these mutations. Therefore, people with a family history of breast, ovarian, or pancreatic cancers should consider genetic testing and counseling, he expands. BRCA mutation carriers face a higher risk of developing prostate cancer andtend to present with more aggressive disease characteristics, such as higher grades and advanced stages of disease, which are associated with poorer survival outcomes, Yuh reports. Additionally, prostate cancer, as well as colorectal cancer, are linked to Lynch syndrome, he notes.

When patients with prostate cancer are found to have genetic mutations, this information can guide family members toward genetic counseling or testing, offering broader insights for the family, Yuh continues. He adds that the research into the influence of genetic factors on treatment decisions is ongoing. At present, the greatest effects of genetic testing in prostate cancer appear to be in later-stage disease, he emphasizes. However, genetic testing shows considerable promise in improving disease prognosis and informing treatment decisions, Yuh reports. At City of Hope, Yuh and colleagues recommend routine genetic testing for all patients diagnosed with prostate cancer to identify relevant mutations.