Melbourne study reveals why some men with prostate cancer get more aggressive tumours

A LANDMARK Melbourne-led study has revealed why men with prostate cancer who carry a cancer-predisposing gene have more aggressive tumours.

Kris Hardefeldt was a patient at Peter MacCallum. Picture: Kylie Else

A LANDMARK Melbourne-led study reveals why men with prostate cancer who carry a cancer-predisposing gene have more aggressive tumours.

The new findings may change the way doctors treat this group of patients, justifying a more intensified approach early on.

It also highlights how crucial it is for men to know their family history of prostate, breast and ovarian cancer.

People who inherit genetic mutations known as BRCA1 and BCRA2 have an increased risk of these cancers.

The study, led by the Mon­ash University’s Biomedicine Discovery Institute, shows the tumours of men with the ­cancer-predisposing gene have the same molecular profile as more advanced cancers.

Victorian and Canadian researchers and clinicians made the breakthrough by comparing patient tumour samples.

“We show that at the molecular level, the tumours in newly diagnosed men with the BRCA2 mutation look like very aggressive tumours that you see in men with sporadic disease,” the institute’s Professor Gail Risbridger said.

“It tells us why these BRCA mutation carrier tumours are so aggressive and why the ­patients do badly.”

Research collaborator and director of Genitourinary Oncology at the Peter MacCallum Cancer Centre Associate Professor Declan Murphy said 11-12 per cent of patients with metastatic prostate cancer had the genetic mutation.

Retired vet Kris Hardefledt carriers the cancer-predisposing gene and has a family history of breast and prostate cancers.

Despite blood tests showing a low risk of cancer, his biopsy came back cancerous.

“The decision was obvious to me that I was going to have my prostate out there was no point mucking around, I was a walking time bomb.”

Four of his five daughters are carriers of the BRCA fault, but discovering this early in life allows increased screening and preventative measures to reduce the cancer risk.

Prof Murphy said patients like Mr Hardefledt would most likely have undergone active surveillance if they did not know he was a carrier of the gene.

“But the BRCA2 men are not safe to survey and when we went to take his prostate out, his tumour was much more aggressive than the biopsy suggested.”

The research, which also included: kConFab, Austin Health, the Olivia Newton-John Cancer Centre and Canada’s Princess Margaret Cancer Centre was published in Nature Communications.