ProstateGene

ProstateGene is a genetic test for people diagnosed with or at risk of prostate cancer which examines the DNA code of ten genes known to cause an increased risk of prostate cancer. It is performed on a blood sample.

Find out your risk of developing prostate cancer with fast, accurate genetic testing.

  • National network of registered genetic counsellors
  • Consultations by telephone or face-to-face
  • Genetic counselling given before and after all genetic tests
  • Genetic testing may influence your surgical treatment, choice of chemotherapy and future cancer prevention
  • Expert counsellors explain the testing process and provide you with all the information to help you make the choice that's right for you

 

1,400

* includes a one-hour phone consultation with a genetic counsellor.

Why should I have genetic testing?

Genetic testing offers you a safe and accurate way of finding out if you are at risk of cancer. We offer a personalised service with pre and post test counselling ensuring you are fully supported every step of the way through the process of genetic testing.

Why should I have genetic testing?
 

Frequently Asked Questions

What is hereditary prostate cancer?

Prostate cancer is the most common cancer among men in the UK. Unfortunately, 1 in 8 men will be diagnosed with prostate cancer, with 75% being diagnosed over the age of 65. The majority of prostate cancer occurs by chance however approximately 5-9% of all prostate cancer and 12% of metastatic prostate cancer is estimated to be hereditary.
Prostate cancer is very common in older men, is frequently slow growing and even untreated would often not shorten a man’s life. However, in some men prostate cancer is more aggressive and develops faster, in these situations early diagnosis and treatment will save lives. In some families, with hereditary prostate cancer, it may be possible to find the genetic change (pathogenic variant) which is responsible for the cancers thereby allowing appropriate cancer screening. In general, men with one first degree relative (father or brother) have twice the risk of prostate cancer, while men with two first degree relatives have five times the risk compared to the general population.

How do I know if I am at risk?

You may be at risk of hereditary prostate cancer if you or a close relative (brother, father or son) have prostate cancer AND any of the following signs:

  • Early onset prostate cancer (diagnosed before age 55)
  • Metastatic prostate cancer
  • Ashkenazi Jewish ancestry
  • Two relatives with breast or ovarian cancer
  • One relative with male breast cancer or ovarian cancer or bilateral breast cancer
  • One relative with early onset bowel or womb cancer (before 50)
  • Two relatives with bowel or womb cancer
How can genetic testing help?

Genetic testing can help determine the cause of the prostate cancer and may suggest particular cancer treatment, in particular chemotherapy. Genetic testing can also determine the risk of cancer within a family and guide appropriate cancer screening. Depending on the specific genetic risk different screening tests can be arranged and risk-reducing strategies can be considered.

Which Genes does ProstateGene test?

The following genes have been shown to be associated with prostate cancer and are tested as part of ProstateGene:

 Gene Condition   Main cancer risks About the condition 
 ATM  ATM Associated Cancer

 Breast: 17 - 60%

Prostate: moderate risk

Approximately 1 in 200 people (0.5%) will carry a pathogenic variant in the ATM gene. Individuals with a pathogenic variant in the ATM gene have a moderately increased risk of breast cancer, as well as an increased risk of radiation-sensitivity. Increased breast screening is recommended. This gene has also been shown to cause a significantly increased risk of prostate cancer which is more likely to be of a higher grade and therefore to benefit from treatment. Rarely a baby may inherit an ATM pathogenic variant from their mother AND their father, in which case they will have the congenital condition called Ataxia- Telangiectasia (AT). AT causes uncontrollable movements (ataxia), immune defects, and an increased risk of leukaemia and lymphoma.
 BRCA1  HBOC  Breast: <85% Prostate: ~20% Ovarian: <60%

Pathogenic variants in BRCA1 & BRCA2 cause hereditary breast and ovarian cancer. In the general population 0.25% of Non-Jewish people and 2% of Ashkenazi Jewish people will have a pathogenic BRCA variant.

The estimated cancer risks associated with pathogenic BRCA variants vary. However pathogenic BRCA1 variants are estimated to cause up to an 85% lifetime risk of breast cancer and up to a 60% risk of ovarian cancer. Men with pathogenic BRCA1 variants may have a slightly increased risk of male breast cancer as well as approximately a 20% risk of prostate cancer. Women with pathogenic BRCA variants should have breast MRI from age 30 years and annual mammogram from age 40 years.

Ovarian cancer screening has not been shown to detect cancer sufficiently early to save lives and therefore some women may consider risk-reducing surgery.  Men may benefit from prostate cancer screening with PSA testing.

BRCA2    HBOC  Breast: <90% 

Prostate: ~40%
Ovarian: <30%

Pathogenic variants in BRCA1 & BRCA 2 cause hereditary breast and ovarian cancer. In the general population 0.25% of non-Jewish people and 2% of the Ashkenazi Jewish people will have a pathogenic BRCA variant. The estimated cancer risk associated with BRCA pathogenic variants vary. However women with BRCA2 pathogenic variants have up to a 90% risk of breast cancer and up to a 30% risk of ovarian cancer Men with BRCA2 pathogenic variants have a 5-10% lifetime risk of developing breast cancer, and approximately a 40% risk of prostate cancer. Individuals with BRCA2 pathogenic variants also have an increased risk of pancreatic cancer and possibly other cancers. Women with BRCA gene pathogenic variants should have annual breast screening from the age of 30 onwards, including mammograms and breast MRI.

Ovarian screening has not been shown to be beneficial and therefore some women may consider risk-reducing surgery. Men may benefit from prostate cancer screening with annual PSA testing from age 40.

Occasionally, a baby will inherit two BRCA2 pathogenic variants and will therefore have the congenital condition known as Fanconi Anaemia.

 CHEK2 Hereditary cancer Breast: 25% 

Prostate: moderate

Pathogenic variants in the CHEK2 gene are found in 4% of families with hereditary breast cancer and cause a moderately increased risk of breast cancer as well as an increased risk of prostate cancer and possibly bowel cancer. Rarely individuals have been shown to carry two pathogenic variants in the CHEK2 gene which seems to cause a higher risk of breast cancer. Increased breast or prostate screening, and in some situations, bowel screening will be recommended.
 EPCAM  Lynch Syndrome  Bowel: 33-53% 

Prostate: 12-52%
Ovarian: 6-28%

Lynch syndrome (LS) is the most common hereditary bowel cancer syndrome and is the cause of approximately 1–3% of all bowel cancer. LS associated with EPCAM causes an increased risk of bowel (33-53%), womb (42-72%), ovarian (6-28%), stomach (2-14%), prostate (12- 52%) and other cancers. It has been estimated that in Europe approximately one million people have LS; although many do not know they have the condition. 

For individuals with LS, regular bowel screening with colonoscopy is vital and other risk-reducing strategies will be considered. These strategies include detecting and treating an infection called Helicobacter Pylori as well as taking aspirin, and considering risk-reducing surgery. A new immunotherapy drug known as PD1 is also particularly effective in treating Lynch syndrome related cancers.

 HOXB13 Hereditary Prostate Cancer Prostate: 33 - 60%  This gene has been found in 5% of prostate cancer families and causes an estimated 33-60% risk of prostate cancer. 
MLH1  Lynch Syndrome Bowel: 38-54% 

Prostate: 8% - 25%
Ovarian: 5-15%

Lynch syndrome (LS) is the most common hereditary bowel cancer syndrome and is the cause of approximately 2–3% of all bowel cancer. LS associated with MLH1 causes an increased risk of bowel (38-54%), womb (31 - 49%), ovarian (5-15%), stomach (4-11%), prostate (8- 25%) and other cancers. It has been estimated that in Europe approximately one million people have LS; although many do not know they have the condition. For individuals with LS, regular bowel screening with colonoscopy is vital and other risk-reducing strategies will be considered. These strategies include detecting and treating an infection called Helicobacter Pylori as well as taking aspirin, and considering risk-reducing surgery. A new immunotherapy drug known as PD1 is also particularly effective in treating Lynch syndrome related cancers.
MSH2  Lynch Syndrome Bowel: 33-53% 

Prostate: 12% - 52%
Ovarian:6-28%

Lynch syndrome (LS) is the most common hereditary bowel cancer syndrome and is the cause of approximately 2–3% of all bowel cancer. LS associated with MSH2 causes an increased risk of bowel (33-53%), womb (42 to 72%), ovarian (6-28%), stomach (2-14%), prostate (12- 52%) and other cancers. It has been estimated that in Europe approximately one million people have LS; although many do not know they have the condition. For individuals with LS, regular bowel screening with colonoscopy is vital and other risk-reducing strategies will be considered. These strategies include detecting and treating an infection called Helicobacter Pylori as well as taking aspirin, and considering risk-reducing surgery. A new immunotherapy drug known as PD1 is also particularly effective in treating Lynch syndrome effective in Lynch syndrome related cancers.
 MSH6  Lynch Syndrome

Bowel: 3-27%
Prostate: <44%
Ovarian: <31%

 
Lynch syndrome (LS) is the most common hereditary bowel cancer syndrome and is the cause of approximately 2–3% of all bowel cancer. LS associated with MSH6 causes an increased risk of bowel (3-27%), womb (27-65%), ovarian (up to 31%), stomach ( up to 13%), prostate (up to 44%) cancer and other cancers. It has been estimated that in Europe approximately one million people have LS; although many do not know they have the condition. For individuals with LS, regular bowel screening with colonoscopy is vital and other risk-reducing strategies will be considered. These strategies include detecting and treating an infection called Helicobacter Pylori as well as taking aspirin, and considering risk-reducing surgery. A new immunotherapy drug known as PD1 is also particularly effective in treating Lynch syndrome related cancers.
 PMS2  Lynch Syndrome

Bowel: 7-22%
Prostate: unclear

Lynch syndrome (LS) is the most common hereditary bowel cancer syndrome and is the cause of approximately 2–3% of all bowel cancer. LS associated with PMS2 causes an increased risk of bowel (7-22%) and womb cancer (7-24%). It has been estimated that in Europe approximately one million people have LS; although many do not know they have the condition. For individuals with LS, regular bowel screening with colonoscopy is vital and other risk-reducing strategies will be considered. These strategies include detecting and treating an infection called Helicobacter Pylori as well as taking aspirin. A new immunotherapy drug known as PD1 is also particularly effective in treating Lynch syndrome related cancers.

 

What will the test show?

There are three possible results:

  1. A pathogenic variant is found in one of the genes which is known to increase the risk of prostate cancer. Different chemotherapy may be indicated. Increased screening and/or risk- reducing techniques will be recommended.
  2. A genetic variant of uncertain significance (VUS) is found, but whether this is the cause of cancer is unknown. Screening will be recommended based on the family history.
  3. No variant is found. It is possible that there may be an undetectable variant or a variant in a different gene. Cancer screening may still be beneficial.
What does it mean if I have a pathogenic variant?

If you have a pathogenic variant this explains the diagnosis of prostate cancer in yourself or your family and may mean you have an increased risk of other cancers. Your exact risks will depend on which gene variant has been found. Extra screening and/or risk-reducing strategies will be discussed. It will also be possible to offer predictive testing to other people in your family to see if they also have a pathogenic variant

Screening

Screening aims to diagnose prostate cancers at an earlier more treatable stage however screening for prostate cancer is still imprecise and, in some situations, may lead to unnecessary biopsies or false reassurance. However annual PSA testing is recommended from age 40-69 for men with a high risk of prostate cancer.  A cut off 3ng/ml should be used to suggest a biopsy.

Screening for other cancers may also be needed and will be discussed if necessary.

Prostate awareness

It is important for all men to be prostate aware and inform their doctor if they notice any signs that they are concerned about.

Signs of prostate cancer include;

  • Needing to urinate often, especially at night
  • Difficulty in starting to urinate
  • Straining to urinate or taking a long time to finish
  • Pain when urinating or ejaculating
  • Pain in the lower back, hips or pelvis
  • Blood in the urine.

Most men with these signs will not have cancer but is always important to get them checked out.

Other risk factors

It is known that ethnicity influences the risk of prostate cancer: black men have the highest risk of prostate cancer, then white men and Asian men have the lowest risk.

Height is also associated with prostate cancer: the taller a man the higher his risk.

A personal history of some types of cancer (kidney, bladder, melanoma, lung, thyroid) also increases the risk of prostate cancer as does exposure to radiation.

Warfarin, Acetaminophen and diabetes have been shown to lower the risk of prostate cancer.

Insurance and financial information

Some individuals may be concerned about difficulties obtaining insurance coverage following predictive genetic testing for healthy individuals. This does not need to be a concern if testing is predictive as the Code on Genetic Testing and Insurance ensures that individuals do not have to disclose cancer predictive test results. For individuals diagnosed with cancer, it is unfortunately likely that they will find it difficult to take out life insurance. More information can be found here

Vicki Kiesel, Consultant Genetic Counsellor

For those with a family history of cancer, genetic testing is an invaluable tool, helping them to understand their risk of developing cancer. Genetic testing can help to reassure those at low risk while enabling individuals at high risk to make proactive decisions to lower their chance of cancer and increase the likelihood of early detection.

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