It was already known that men carrying the BRCA2 mutation were at greater risk of prostate cancer. But research published in the Journal
of Clinical Oncology shows that the cancers spread faster and are more often
fatal in these patients.
As it can be difficult for doctors to determine whether
newly diagnosed prostate cancer will be life-threatening, many patients are currently
put under 'active surveillance' rather than put forward for immediate treatment.
'It is clear from our study that prostate cancers linked to inheritance
of the BRCA2 cancer gene are
more deadly than other types', she said. 'It must make sense to start offering
affected men immediate surgery or radiotherapy, even for early-stage cases that
would otherwise be classified as low-risk'.
Around one percent of prostate cancer patients will have the
BRCA2 mutation. Professor Eeles admits that without clinical trials it is
impossible to be sure that this group of men would benefit from earlier
treatment. All the same, she says, 'the hope is that our study will ultimately
save lives by directing treatment at those who most need it'.
In the study researchers examined the medical records of 61 prostate
cancer patients carrying the BRCA2 mutation as well as 18 patients with the
related BRCA1 mutation and 1,940 non-carriers.
They found that when they received the diagnosis, men with
either mutation were significantly more likely to have advanced stage cancer,
or cancer that had already spread, than other patients. Crucially, patients
with BRCA2 mutations were significantly
less likely to survive the cancer, living an average of six and a half years after
diagnosis compared with nearly 13 years for non-carriers. BRCA1 carriers also
had reduced survival time, but this was not statistically significant.
Professor Alan Ashworth, chief executive of the ICR, said
that the study illustrated how 'knowledge of cancer genetics is now
increasingly shaping the way we treat the disease, by allowing us to offer more
intensive treatment, or even different drugs altogether, for people who have inherited
The study was a UK Clinical Research Network portfolio
study, funded by the Ronald and Rita McAulay Foundation and Cancer Research