Men have more reason than ever to be aware of their family medical history. A recent study reveals that men who have a mutation (change) in the BRCA1 or BRCA2 genes have a "significantly higher" risk of getting cancer than the rest of the population. Men with BRCA mutations who took part in the study were diagnosed with eight times as many cancers as normally occur in the general population.
Because those mutations are strongly linked to breast and ovarian cancer, they have been studied more widely in women than in men. The new study reinforces the message that BRCA mutations are associated with many types of cancer and that men are also at risk.
In this podcast June Mikkelson, MS, CGC, Genetic Counselor at Roswell Park Comprehensive Cancer Center, discusses how important it is that you know Your family history and how women and men with BRCA mutations face higher cancer risk and whether you might be a candidate for a genetic evaluation.
Selected Podcast
Women and Men With BRCA Mutations Face Higher Cancer Risk
Featured Speaker:
June Mikkelson, MS, CGC
June Mikkelson, MS is a Genetic Counselor, Clinical Genetics Service, Department of Medicine, Roswell Park Comprehensive Cancer Center. Transcription:
Women and Men With BRCA Mutations Face Higher Cancer Risk
Bill Klaproth (Host): It is important to know your family history for men and women when it comes to the BRCA genes and here to talk with us about how women and men with BRCA gene mutations face higher cancer risk, is June Mikkelson, certified genetic counselor, clinical genetic services at Roswell Park Comprehensive Cancer Center. June, thank you for your time. So, first off what is the BRCA gene mutation?
June Mikkelson, MS, CGC (Guest): So, the BRCA genes are actually two separate genes BRCA1 and BRCA2 and when there is alterations or errors in these genes called mutations; they are not functioning correctly in our body and that leads to higher risk for certain cancers for both men and women.
Bill: Are we born with these gene mutations?
June: Yes, we are. Typically, these are genetic changes that happened generations and generations ago in our family and have been passed through the families again over the generations through our parents and grandparents.
Bill: So, that’s why family history is so important to study in this case?
June: Exactly. And it’s also very important to know not just one side of the family, but to know both sides of the family because these genetic mutations are inherited equally between men and women.
Bill: So, why do people then with BRCA mutations have a higher risk of cancer?
June: Well these genes are very important in our body. They are designed to help DNA repair in our body. So, if that is faulty mechanism in our body we can get uncontrolled cell growth which could lead to a cancer forming.
Bill: So, speaking of cancer forming June, what types of cancers are linked to BRCA mutations?
June: For women, they are at a significantly higher risk to develop breast and ovarian cancers. Men also get breast cancers and prostate cancers more commonly and, in some families, we see other types of cancers as well including GI cancers like pancreatic cancer or colon cancer or even melanomas.
Bill: Men have more reason than ever to be aware of their family medical history. A recent study reveals that men who have a mutation or change in the BRCA1 or BRCA2 gene, have a significantly higher risk of getting cancer than the rest of the population. You know we don’t think of men like that, but this shows that men need to be aware of their family history as well.
June: You are exactly correct.
Bill: So, why, so is that something that all men should really now start taking an active position in understanding their family history?
June: I think it’s something we all should be doing. I think this is actually a big lack that we all have. When we sit down with our family on holidays, we often catch up about social things, births and deaths in the family and different hobbies and that type of thing. But we don’t think and step back about the medical family history information. It’s really important that we are aware of the different health problems our family members have. This isn’t exclusive to cancer, but it could be important for other types of health concerns like diabetes, heart disease, and others.
Bill: Very interesting. So, June, let me ask you this. Who needs to be tested for mutations?
June: We have established criteria, so the National Comprehensive Cancer Network is a national organization that includes different experts on cancer risk and so they are the organization that basically puts forth the best-case practices for everyone with cancer. And part of that is hereditary risk. So, there are pretty well-established criteria of whom to test for BRCA mutations including women who are diagnosed at young ages, so a woman alone diagnosed under age 45 would be appropriate. If a woman is diagnosed at a younger age say under 50 but has another relative diagnosed with one of these cancers, if we see certain ethnic background in the families. So, if somebody is of Ashkenazi Jewish ancestry, we know they are higher risk to develop cancers simply because they are at a higher risk to have a BRCA mutation. Men, we certainly see more aggressive types of prostate cancers more commonly, so it is called a Gleason 7 or higher prostate cancer is a more aggressive prostate cancer or those individuals with pancreatic cancer. So, if we are seeing a cluster of three types or three individuals in the family with any of these cancers, that warrants testing and an individual diagnosed with ovarian cancer that alone warrants testing.
Bill: Alright, a lot to know there. So, what does a BRCA gene test look like? How does that work?
June: So, for the patient, it’s just a blood sample or a saliva sample and it gets mailed off to a laboratory. The laboratory does testing on those two genes and basically gives us a result back. So, it’s nothing more involved for the patient than having counseling, giving consent and then giving a sample for the test.
Bill: And what if your test comes back and it reveals a BRCA mutation?
June: Then it’s very important to have counseling to make sure that you are aware of all of the different types of risks, because there are pretty established guidelines to say what interventions we should take for these people who have these higher risks. Whether it’s to start certain screenings at a younger age. Whether it’s to start additional screenings, for example breast MRIs in addition to mammograms for women. Whether it’s to have a preventative surgery like to remove the ovaries and fallopian tubes for women who are at the significantly higher risk to develop ovarian cancer.
Bill: So, knowing you have a mutated gene, does that help you then also potentially change your lifestyle too if you are a smoker or a drinker or somebody that doesn’t exercise regularly or has bad eating habits?
June: Absolutely. When we think about risk factors to develop cancer, genetics is one risk factor. And that’s not modifiable. But we can modify those factors that can give us the best potential as possible. So, certainly alcohol consumption in moderation, not smoking, not developing diabetes by having a healthy lifestyle, all of these are definitely appropriate recommendations really for anybody but especially those that have a higher risk for certain cancers based on their genetics.
Bill: So, June, if your test reveals a BRCA mutation; that doesn’t necessarily mean you are going to get cancer, right? It just means you need to watch out for this and potentially take necessary steps to lessen your risk for developing it.
June: Correct. It’s not a guarantee for anyone to develop cancer just because they have a BRCA mutation. They are at higher risk and that risk is not an absolute number.
Bill: So, June anything else you want to add about the BRCA gene mutations that women and men face?
June: I think it’s also really important to know that we are into the era of personalized medicine, so that if somebody has a certain genetic change responsible for their cancer or contributing to why they developed cancer; we are now getting to certain medications that are designed to treat those cancers. So, there is actually a group of medications called PARP inhibitors that are designed to combat cancers that are related to BRCA mutations. So, this isn’t about necessarily only about prevention and for information for family members; but it’s also about treating cancers as well.
Bill: Such important information and we all need to know our family history. June thank you so much for your time today. For more information visit www.roswellpark.org that’s www.roswellpark.org. You’re listening to Cancer Talk with Roswell Park Comprehensive Cancer Center. I’m Bill Klaproth. Thanks for listening.
Women and Men With BRCA Mutations Face Higher Cancer Risk
Bill Klaproth (Host): It is important to know your family history for men and women when it comes to the BRCA genes and here to talk with us about how women and men with BRCA gene mutations face higher cancer risk, is June Mikkelson, certified genetic counselor, clinical genetic services at Roswell Park Comprehensive Cancer Center. June, thank you for your time. So, first off what is the BRCA gene mutation?
June Mikkelson, MS, CGC (Guest): So, the BRCA genes are actually two separate genes BRCA1 and BRCA2 and when there is alterations or errors in these genes called mutations; they are not functioning correctly in our body and that leads to higher risk for certain cancers for both men and women.
Bill: Are we born with these gene mutations?
June: Yes, we are. Typically, these are genetic changes that happened generations and generations ago in our family and have been passed through the families again over the generations through our parents and grandparents.
Bill: So, that’s why family history is so important to study in this case?
June: Exactly. And it’s also very important to know not just one side of the family, but to know both sides of the family because these genetic mutations are inherited equally between men and women.
Bill: So, why do people then with BRCA mutations have a higher risk of cancer?
June: Well these genes are very important in our body. They are designed to help DNA repair in our body. So, if that is faulty mechanism in our body we can get uncontrolled cell growth which could lead to a cancer forming.
Bill: So, speaking of cancer forming June, what types of cancers are linked to BRCA mutations?
June: For women, they are at a significantly higher risk to develop breast and ovarian cancers. Men also get breast cancers and prostate cancers more commonly and, in some families, we see other types of cancers as well including GI cancers like pancreatic cancer or colon cancer or even melanomas.
Bill: Men have more reason than ever to be aware of their family medical history. A recent study reveals that men who have a mutation or change in the BRCA1 or BRCA2 gene, have a significantly higher risk of getting cancer than the rest of the population. You know we don’t think of men like that, but this shows that men need to be aware of their family history as well.
June: You are exactly correct.
Bill: So, why, so is that something that all men should really now start taking an active position in understanding their family history?
June: I think it’s something we all should be doing. I think this is actually a big lack that we all have. When we sit down with our family on holidays, we often catch up about social things, births and deaths in the family and different hobbies and that type of thing. But we don’t think and step back about the medical family history information. It’s really important that we are aware of the different health problems our family members have. This isn’t exclusive to cancer, but it could be important for other types of health concerns like diabetes, heart disease, and others.
Bill: Very interesting. So, June, let me ask you this. Who needs to be tested for mutations?
June: We have established criteria, so the National Comprehensive Cancer Network is a national organization that includes different experts on cancer risk and so they are the organization that basically puts forth the best-case practices for everyone with cancer. And part of that is hereditary risk. So, there are pretty well-established criteria of whom to test for BRCA mutations including women who are diagnosed at young ages, so a woman alone diagnosed under age 45 would be appropriate. If a woman is diagnosed at a younger age say under 50 but has another relative diagnosed with one of these cancers, if we see certain ethnic background in the families. So, if somebody is of Ashkenazi Jewish ancestry, we know they are higher risk to develop cancers simply because they are at a higher risk to have a BRCA mutation. Men, we certainly see more aggressive types of prostate cancers more commonly, so it is called a Gleason 7 or higher prostate cancer is a more aggressive prostate cancer or those individuals with pancreatic cancer. So, if we are seeing a cluster of three types or three individuals in the family with any of these cancers, that warrants testing and an individual diagnosed with ovarian cancer that alone warrants testing.
Bill: Alright, a lot to know there. So, what does a BRCA gene test look like? How does that work?
June: So, for the patient, it’s just a blood sample or a saliva sample and it gets mailed off to a laboratory. The laboratory does testing on those two genes and basically gives us a result back. So, it’s nothing more involved for the patient than having counseling, giving consent and then giving a sample for the test.
Bill: And what if your test comes back and it reveals a BRCA mutation?
June: Then it’s very important to have counseling to make sure that you are aware of all of the different types of risks, because there are pretty established guidelines to say what interventions we should take for these people who have these higher risks. Whether it’s to start certain screenings at a younger age. Whether it’s to start additional screenings, for example breast MRIs in addition to mammograms for women. Whether it’s to have a preventative surgery like to remove the ovaries and fallopian tubes for women who are at the significantly higher risk to develop ovarian cancer.
Bill: So, knowing you have a mutated gene, does that help you then also potentially change your lifestyle too if you are a smoker or a drinker or somebody that doesn’t exercise regularly or has bad eating habits?
June: Absolutely. When we think about risk factors to develop cancer, genetics is one risk factor. And that’s not modifiable. But we can modify those factors that can give us the best potential as possible. So, certainly alcohol consumption in moderation, not smoking, not developing diabetes by having a healthy lifestyle, all of these are definitely appropriate recommendations really for anybody but especially those that have a higher risk for certain cancers based on their genetics.
Bill: So, June, if your test reveals a BRCA mutation; that doesn’t necessarily mean you are going to get cancer, right? It just means you need to watch out for this and potentially take necessary steps to lessen your risk for developing it.
June: Correct. It’s not a guarantee for anyone to develop cancer just because they have a BRCA mutation. They are at higher risk and that risk is not an absolute number.
Bill: So, June anything else you want to add about the BRCA gene mutations that women and men face?
June: I think it’s also really important to know that we are into the era of personalized medicine, so that if somebody has a certain genetic change responsible for their cancer or contributing to why they developed cancer; we are now getting to certain medications that are designed to treat those cancers. So, there is actually a group of medications called PARP inhibitors that are designed to combat cancers that are related to BRCA mutations. So, this isn’t about necessarily only about prevention and for information for family members; but it’s also about treating cancers as well.
Bill: Such important information and we all need to know our family history. June thank you so much for your time today. For more information visit www.roswellpark.org that’s www.roswellpark.org. You’re listening to Cancer Talk with Roswell Park Comprehensive Cancer Center. I’m Bill Klaproth. Thanks for listening.