The Gene Nobody Talks About: BRCA, Men, and the Prostate Cancer Connection

Say the word BRCA out loud, and most people picture the same thing: a woman, a breast cancer diagnosis, and a pink ribbon.

That picture is not wrong, but it is dangerously incomplete.

BRCA is not a woman’s gene. It is a human gene. Everyone has BRCA1 and BRCA2 genes, and when certain mutations affect these genes, they can increase the risk of several types of cancer in both women and men.

For families affected by cancer, understanding this matters. A BRCA mutation can be passed from a father to his children just as easily as it can be passed from a mother to hers.

That means men need to be part of the BRCA conversation, too.

What Is BRCA?

BRCA1 and BRCA2 are genes that help protect the body from cancer. Their normal job includes helping repair damaged DNA and keeping cell growth under control.

When a harmful mutation occurs in one of these genes, the body's ability to repair certain types of DNA damage can be reduced. This can increase the risk of developing certain cancers.

BRCA mutations are well known for increasing the risk of:

• Breast cancer

• Ovarian cancer

• Prostate cancer

• Pancreatic cancer

• Male breast cancer

• Other cancers in some families

Much of the public conversation about BRCA has focused on women because of the strong connection between BRCA mutations and breast and ovarian cancer.

But men can carry these mutations and pass them to their children without knowing it.

Why BRCA Matters for Men

A man who carries a harmful BRCA1 or BRCA2 mutation may have a higher risk of certain cancers, particularly prostate cancer.

Prostate cancer is already one of the most common cancers affecting men. Black men face an especially serious burden, with higher rates of prostate cancer and a greater chance of being diagnosed with aggressive disease.

In the U.S. Virgin Islands, prostate cancer is the most common cancer among men and has an extremely high incidence rate compared with the mainland United States, according to the Virgin Islands Cancer Registry.

This makes awareness, family history, and conversations with health care providers especially important.

For men with a BRCA mutation, knowing their genetic risk may help doctors make more informed decisions about when screening should begin and how closely they should be monitored.

Your Father's Family History Matters Too

There is a common mistake people make when looking at their family history: they focus mostly on their mother's side.

That means they may know that a grandmother or aunt had breast cancer, but they may know very little about their father's side of the family.

This can leave out important information.

A father can pass a BRCA mutation to his children just as a mother can.

If your father carries a BRCA mutation, there is a chance that he could pass it to you. You could then potentially pass it to your own children.

So when you think about your cancer history, do not look at only one side of the family.

You need the whole map.

What Should Men Look for in Their Family History?

Pay attention if breast, ovarian, prostate, or pancreatic cancer appears repeatedly in your family.

It is also important to note:

• Cancer diagnosed at a younger-than-usual age

• Multiple relatives with the same or related cancers

• A man in the family who has had breast cancer

• A relative who has been diagnosed with aggressive prostate cancer

• A family member who has tested positive for a BRCA1 or BRCA2 mutation

• Certain ancestral backgrounds associated with higher rates of BRCA mutations

Your family history does not tell you for certain whether you have a BRCA mutation. But it can provide important clues that are worth discussing with a health care professional.

Who Should Consider Genetic Testing?

Genetic testing is not right for everyone, and deciding whether to test is a personal choice.

However, it may be worth talking with your doctor or a genetic counselor if:

• Breast, ovarian, prostate, or pancreatic cancer appears multiple times in your family

• A family member was diagnosed with cancer at a young age

• A relative has tested positive for a BRCA1 or BRCA2 mutation

• There is a history of male breast cancer in your family

• You have a family or ancestral background associated with higher rates of BRCA mutations

If a relative has already tested positive for a BRCA mutation, tell your doctor. That information can be especially important when deciding whether genetic testing may be appropriate for you.

A Positive BRCA Test Does Not Mean You Will Get Cancer

One important point is often misunderstood.

Having a BRCA mutation does not mean that you will definitely develop cancer.

It means your risk may be higher than that of someone without the mutation.

Knowing about the mutation gives you and your health care team more information. Depending on your personal and family history, your doctor may recommend changes to cancer screening or other steps to help manage your risk.

Genetic information can also be important for your family.

If you carry a harmful BRCA mutation, your children and other relatives may benefit from knowing about it so they can discuss their own risk with their health care providers.

It Is Time for Men to Join the Conversation

For generations, many men have been taught to ignore health problems, avoid doctors, and simply "tough it out."

But when it comes to cancer, silence can come at a cost.

Prostate cancer can be easier to manage when it is found early, and knowing your family history can help you and your doctor make better decisions about your health.

The same is true with BRCA.

If your father, grandfather, uncle, brother, or another relative has had cancer, ask questions.

Find out:

• What type of cancer did they have?

• How old were they when they were diagnosed?

• Was genetic testing performed?

• Did anyone in the family test positive for BRCA1 or BRCA2?

• Are there other relatives with breast, ovarian, prostate, or pancreatic cancer?

Write down what you learn and share it with your health care provider.

Your Family History Is Part of Your Health History

Cancer does not always tell the whole story by itself. Sometimes the pattern across generations provides important information.

The women in many families have been having conversations about breast and ovarian cancer for years.

It is time for men to join that conversation.

BRCA belongs to all of us. And knowing what runs through your family can help you make informed choices about your health and give your family information that may matter for generations to come.

If cancer runs in your family, talk with your doctor about what BRCA could mean for you.

For additional information and resources, visit the YAG Foundation at yagfoundation.org.

Important Note

This article is for general education and is not a substitute for medical advice, diagnosis, or treatment. If you have concerns about your personal or family cancer history, speak with a qualified health care professional or genetic counselor.