New Guidelines Recommend Genetic Testing for Men with Prostate Cancer

By Eleanor Griffith, MS, CGC · Mar 2018

On March 8, the National Comprehensive Cancer Network (NCCN) published new Clinical Practice Guidelines for Prostate Cancer indicating that genetic counseling and testing should be considered for all men with high-risk, very high-risk, regional, or metastatic prostate cancer.

A personal history of metastatic prostate cancer was added in October 2017 to NCCN Guidelines for Hereditary Breast and Ovarian Cancer as testing criteria, even in the absence of any family history of other HBOC-related cancers. The new guidelines cite a 2016 study in which 11.8% of men with metastatic prostate cancer were found to have inherited homologous recombination gene mutations — the same family of genes that includes BRCA1 and BRCA2.

Consensus recommendations from a multidisciplinary 2017 conference of 71 experts also recommended testing genes including BRCA1, BRCA2, HOXB13, and Lynch syndrome genes — depending on family history. The conference also highlighted the importance of detailed family histories in men with prostate cancer, flagging relatives affected by prostate, breast, colorectal, or other cancers.

For Patients

If you have advanced prostate cancer, ask your doctor about genetic testing and a referral to genetic counseling. If your prostate cancer is not advanced but you have a family history of cancer, also discuss this with your doctor. A genetic counselor can evaluate your personal and family history, discuss which hereditary cancer syndromes should be considered, and talk with you about the implications of any test results for your own care and for family members.