Is Prostate Cancer Genetic? Here’s How Family History Affects Your Inherited Risk

Prostate cancer is one of the most common cancers worldwide. Experts estimate that 1 in 8 men in the U.S. will develop prostate cancer during their lifetime. That means you or someone you know may be affected. 

Researchers don’t know exactly what causes prostate cancer. But genetics do play a role. Read on to learn more about prostate cancer and how your family history and inherited genes can affect your risk.

How do genes cause cancer?

Cancer is a health condition where the cells in your body grow in an abnormal way.

Your body’s cells contain genes, which are small sections of DNA. Genes control how your cells function and behave. Sometimes, your genes can change (or “mutate”). These gene changes can make your cells grow and behave abnormally, which can lead to cancer. 

Not everyone who inherits gene mutations will develop prostate cancer. The exact risk depends on the gene and the person. Researchers are still identifying genes that can increase the risk of developing prostate cancer. They’re also still learning how changes in these genes affect people differently and why everyone isn’t affected in the same way.

What’s the link between prostate cancer and genetics?

Prostate cancer isn’t a purely genetic condition. Not everyone who has a family history of prostate cancer will definitely develop prostate cancer. And your genes aren’t the only things that affect your risk of developing prostate cancer. Other things, like smoking or your diet, can also increase your risk of developing prostate cancer. 

But your genetics do still matter. There are different ways that genes play a role in prostate cancer.

Familial prostate cancer

Sometimes prostate cancer runs in a family, but not because of one specific inherited gene. It may be related to a mix of different genes, environment, or other factors. Familial prostate cancer makes up about 20% of all prostate cancer cases.

Hereditary prostate cancer

This means your family has specific cancer-causing genes that can be inherited (passed down from parent to child). Inherited genes play a role in 5% to 10% of all prostate cancers. Examples of genes that can increase your risk of developing prostate cancer include:

• BRCA1 and BRCA2

• CHEK2

• ATM

• PALB2

• RAD51D

• DNA mismatch repair genes (like MSH2, MSH6, and others)

• RNASEL (also called HPC1)

• HOXB13

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How do you get a genetic mutation?

You can get a gene in two different ways:

1. You’re born with it

This is called an inherited gene mutation. An inherited gene mutation is passed down to you by your mother or father. Both women and men can carry genetic mutations that increase the risk of developing prostate cancer. 

Just because you inherit one of these mutations doesn’t mean you’ll definitely develop prostate cancer. But it does mean your risk is higher than someone who doesn’t have one of these gene changes.

2. You developed it at some point during your life 

This is called an “acquired” gene mutation. This means you’re born without the gene change, but it happens at some point during your life. 

Genetic mutations can develop naturally as you get older. Certain things in your environment, like cigarette smoke exposure, can also increase your risk of developing gene mutations.

Does prostate cancer run in families?

Yes, prostate cancer does run in families. But it isn’t always caused by an inherited gene mutation. Researchers are still working to understand the connection. 

But it’s clear that if you have family members with prostate cancer, your own risk goes up. Having a first-degree relative (like a brother or father) with prostate cancer makes you 2 to 3 times more likely to get it too. 

How do inherited genes affect my risk for prostate cancer?

Inherited genes are passed down from parent to child. Some of these genes can make you more likely to get prostate cancer. There are over 20 different inherited gene mutations linked to prostate cancer. 

Researchers estimate that gene changes play a role in 60% of prostate cancers. 

Some of the same mutations that cause hereditary prostate cancer can also cause other types of cancer, like breast, colon, pancreatic, and ovarian cancer. So even if no one in your family has prostate cancer, you could still inherit a gene mutation linked to it.

If I inherit a genetic mutation, will I definitely get cancer?

No. Having a genetic mutation can increase your risk, but it doesn’t mean you’ll definitely get cancer. Some people with genetic mutations will never develop prostate cancer. 

How do BRCA2 mutations affect my risk of getting prostate cancer?

BRCA1 and BRCA2 are types of genes called “tumor suppressor genes.” These genes normally help your body repair mistakes in your DNA and tell your cells when to grow and die. 

If you have a mutation in these genes, it can make it easier for cancer cells to grow in your body. 

Inherited BRCA1 and BRCA2 mutations are best known for causing breast and ovarian cancer in women. But BRCA2 mutations can also cause prostate cancer. 

A person with a BRCA2 mutation is 3 to 4 times more likely to get prostate cancer, particularly more aggressive forms. If you have this mutation, screening and early detection are especially important.

Is hereditary prostate cancer more aggressive?

There’s evidence that changes in certain genes can cause more aggressive prostate cancer. Researchers are still learning which genetic mutations are linked with aggressive prostate cancers. Understanding this connection can help researchers develop new treatments for prostate cancer in the future.

How can I tell if I inherited a genetic mutation?

Genetic testing can help you find out if you’ve inherited genetic mutations that increase your risk of developing prostate cancer. Genetic testing uses your blood or saliva to look for certain gene changes linked to prostate cancer. 

Your healthcare team can order genetic testing for you. 

Should I get genetic testing for prostate cancer?

Genetic testing isn’t typically included in prostate cancer screening. But it’s often included as part of prostate cancer diagnosis and treatment. Your healthcare team may recommend genetic testing if:

• You have an advanced or aggressive form of prostate cancer

• You develop prostate cancer at a young age

• Prostate cancer runs in your family

• You have a relative with a known prostate cancer gene mutation (like BRCA1 or BRCA2)

• You’re of Ashkenazi Jewish ancestry

How does genetic testing affect my prostate cancer treatment? 

Most of the time, you don’t need genetic testing to get started with treatment. 

But in some cases, genetic testing can help you and your healthcare team make the best choices — especially if your cancer hasn’t responded well to first-choice treatment. For example, people with certain gene mutations may be able to enroll in clinical trials or benefit from specialized medications.

What can I do to lower my chances of getting prostate cancer?

You can’t change your family history or your inherited genes. But lifestyle choices can help you keep your prostate healthy — and potentially lower your risk for prostate cancer. 

Some helpful habits include:

• Eating a diet full of whole grains, fruits, and vegetables

• Cutting back on red meat, processed meat, and alcohol

• Staying active

• Maintaining a weight that’s in a healthy range

• Not smoking

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Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Reviewed by:

Brandon R. Mancini, MD, MBA, FACRO

Brandon R. Mancini, MD, MBA, FACRO, serves as medical director at BAMF Health in Grand Rapids, MI, in the emerging field of theranostics. His clinical focus is treating people with metastatic prostate and neuroendocrine cancers.

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