Men with metastatic prostate cancer carrying a pathogenic germline variant in breast cancer genes: disclosure of genetic test results to relatives

Fam Cancer. 2024 Jun;23(2):165-175. doi: 10.1007/s10689-024-00377-0. Epub 2024 May 9.

Abstract

Some patients with metastatic prostate cancer carry a pathogenic germline variant (PV) in a gene, that is mainly associated with an increased risk of breast cancer in women. If they test positive for such a PV, prostate cancer patients are encouraged to disclose the genetic test result to relatives who are at risk in case the carrier status changes the relatives' medical care. Our study aimed to investigate how men who learned they carry a PV in BRCA1, BRCA2, PALB2, CHEK2 or ATM disclosed their carrier status to at-risk relatives and to assess the possible psychological burden for the carrier and their perception of the burden for relatives. In total, 23 men with metastatic prostate cancer carrying a PV completed the IRI questionnaire about family communication; 14 also participated in a semi-structured interview. Patients felt highly confident in discussing the genetic test result with relatives. The diagnosis of prostate cancer was experienced as a burden, whereas being informed about genetic testing results did in most cases not add to this burden. Two patients encountered negative experiences with family communication, as they considered the genetic test result to be more urgent than their relatives. This mixed-methods study shows that metastatic prostate cancer patients with a PV in genes mainly associated with increased risk of breast cancer feel well-equipped to communicate about this predisposition in their families. Carriers felt motivated to disclose their genetic test result to relatives. Most of them indicated that the disclosure was not experienced as a psychological burden.

Keywords: Breast cancer; Family communication; Genetic testing; Metastatic prostate cancer; Psychosocial.

MeSH terms

  • Adult
  • Aged
  • Ataxia Telangiectasia Mutated Proteins / genetics
  • BRCA1 Protein / genetics
  • BRCA2 Protein / genetics
  • Breast Neoplasms / genetics
  • Breast Neoplasms / pathology
  • Breast Neoplasms / psychology
  • Checkpoint Kinase 2 / genetics
  • Disclosure
  • Family / psychology
  • Fanconi Anemia Complementation Group N Protein / genetics
  • Female
  • Genetic Predisposition to Disease* / psychology
  • Genetic Testing*
  • Germ-Line Mutation*
  • Humans
  • Male
  • Middle Aged
  • Prostatic Neoplasms* / genetics
  • Prostatic Neoplasms* / pathology
  • Prostatic Neoplasms* / psychology

Substances

  • BRCA2 Protein
  • PALB2 protein, human
  • BRCA2 protein, human
  • Fanconi Anemia Complementation Group N Protein
  • BRCA1 Protein
  • BRCA1 protein, human
  • CHEK2 protein, human
  • Checkpoint Kinase 2
  • ATM protein, human
  • Ataxia Telangiectasia Mutated Proteins