In May 2013, Angelina Jolie revealed she carried the BRCA1 gene mutation and had decided to undergo a preventative double mastectomy, as a result awareness of the BRCA gene mutations and female hereditary cancers has increased. This hasn’t been the case for men, however.
Most don’t realise that men have the same chance of inheriting a gene mutation. The mutation can be passed down equally from a father or mother. If one parent is a carrier, each child — male or female — has a 50% chance of inheriting the mutation.
According to data provided by the Basser Research Center for BRCA at the University of Pennsylvania, men with a BRCA mutation have between 5 and 10% lifetime risk of breast cancer, compared to 0.1% lifetime risk for men in the general population. For women with a BRCA mutation, the risks run up to 80%, as they have more breast tissue. A BRCA mutation also puts men at higher risk for prostate cancer (16%), pancreatic cancer (2-5%) and melanoma (3-5%).
Due to the lack of knowledge about male breast cancer, as well as the stigma against it being ‘a women’s disease’, men are often diagnosed dangerously late. Experts also agree that men face bigger barriers to genetic testing and protective strategies than women – partly because of their own attitudes.
Men, particularly those with a BRCA2 mutation, face an increased risk of prostate cancer. Research has shown these cancers tend to have an aggressive nature with more rapid spread of the disease and poorer survival (Prostate Cancer With Faulty BRCA2 Gene Spreads More Quickly).
Like women, males with BRCA mutations have elevated risks of several cancers, and they can take steps to be vigilant.
Prostate cancer screening, with a clinical exam and PSA test, should be started annually from the age of 40.
Regular breast self-exams, plus a physician breast exam every six to 12 months along with annual mammograms, if they have enough breast tissue to compress in the X-ray machine, beginning at age 35.
Male BRCA carriers should also consider annual dermatology visits to check for skin cancer.
Experts also recommend that men from families with known mutations undergo genetic testing, around age 35, or earlier if they plan to start having children. Men need to consider that if they test positive for the BRCA gene fault that this has implications, not only for their health, but also for their children’s health, particularly if they have daughters.
Men’s attitudes to their health care and visiting health professionals differ significantly to women. Traditionally men don’t seek, or are slow to seek, medical advice.
Women, who have mostly assumed responsibility for family communication and health, play a vital role in making sure male relatives are included in sharing of family health information. Fathers, sons and brothers need to be part of these important conversations.
Men very much matter when it comes to hereditary cancer.