Prevention for Men

As outlined on the BRCA in Men page, some BRCA carriers are at significantly increased risk of several cancers over their lifetimes, including prostate, male breast cancer, pancreatic cancer, and melanoma. Here you will find some very basic guidelines and current protocols for managing risk. These are in alignment with the recommendations from BC Cancer. Every man should take the time to get to know his own personal risk and manage it accordingly.

Men who are found to carry a BRCA gene, particularly BRCA2 carriers, should discuss with their doctors the various ways that they can manage their personal risk of several cancers. It is important to have these conversations, as not only can men prevent cancer from being caught at a later stage, but how a potential cancer is handled may be different if BRCA status is known. For instance, drugs known as PARP inhibitors are now being found to dramatically increase the lifespan of men with BRCA-driven Stage 4 prostate cancers.

General Health Awareness

Men should be aware of the following changes in their bodies, according to this reminder developed by the American Cancer Society:

C:  Change in bowel or bladder habits

A:  A sore that does not heal

U:  Unusual bleeding

T:  Thickening or lump in the breast or elsewhere

I:  Indigestion or difficulty in swallowing

O:  Obvious change in a wart or mole

N:  Nagging cough or hoarseness

Screening Options in BC

Male Breast Cancer

  • Men should be aware of any changes in the chest wall and axillae.

  • Men should consider an annual physical exam including a clinical exam of the chest/breast by an experienced health professional every 12 months.

Prostate Cancer

  • Men should discuss prostate cancer screening beginning at age 40 with their family doctor. Prostate cancer screening can include digital rectal examinations (DRE) performed by the family physician to check the size of the prostate and prostate-specific antigen testing (PSA), which is a blood test.

  • PSA testing is sometimes controversial because there are many reasons why PSA levels might be elevated other than cancer. At lower levels (but elevated), PSA might indicate benign disease, but the higher the PSA, the more likely it is to be cancer and the more likely it is to have spread. Male BRCA2 carriers should consider PSA screening because they are at much higher risk of early-onset, aggressive prostate cancer.

Pancreatic Cancer

  • Options for pancreatic cancer screening can be discussed if the family history includes close relatives with pancreatic cancer.

Melanoma

  • Some men may be recommended to see a dermatologist for annual skin checkups or have this performed by their primary care provider.

Lifestyle Changes

Here are the 10 commandments of cancer prevention from the Harvard Men’s Health Watch:

  1. Avoid tobacco in all its forms, including exposure to second-hand smoke.

  2. Eat properly. Reduce your consumption of saturated fat and red meat, which appears to increase the risk of colon and prostate cancers. Limit your intake of charbroiled foods (especially meat), and avoid deep-fried foods. Increase your consumption of fruits, vegetables, and whole grains. Although other reports are mixed, two large 2003 studies found that high-fiber diets may reduce the risk of colon cancer. And don’t forget to eat fish two to three times a week; you’ll get protection from heart disease, and you may reduce your risk of prostate cancer.

  3. Exercise regularly. Physical activity has been linked to a reduced risk of colon cancer, and it may even help prevent prostate cancer. Exercise also appears to reduce a woman’s risk of breast and possibly reproductive cancers. Exercise will help protect you even if you don’t lose weight.

  4. Stay lean. Obesity increases the risk of many forms of cancer. Calories count; if you need to slim down, take in fewer calories and burn more with exercise.

  5. If you choose to drink, limit yourself to one to two drinks a day. Excess alcohol increases the risk of cancers of the mouth, larynx (voice box), esophagus (food pipe), liver, and colon; it also increases a woman’s risk of breast cancer. Smoking further increases the risk of many alcohol-induced malignancies.

  6. Avoid unnecessary radiation exposure. Get medical imaging studies only when you need them. Check your home for residential radon, which increases the risk of lung cancer. Protect yourself from ultraviolet radiation in sunlight, which increases the risk of melanomas and other skin cancers. But don’t worry about electromagnetic radiation from high-voltage power lines or radiofrequency radiation from microwaves and cell phones. They do not cause cancer.

  7. Avoid exposure to industrial and environmental toxins such as asbestos fibers, benzene, aromatic amines, and polychlorinated biphenyls (PCBs).

  8. Avoid infections that contribute to cancer, including hepatitis viruses, HIV, and the human papillomavirus. Many are transmitted sexually or through contaminated needles.

  9. Consider taking low-dose aspirin. Men who take aspirin or other nonsteroidal anti-inflammatory drugs appear to have a lower risk of colon cancer and possibly prostate cancer. It’s an unproven benefit, and aspirin can produce gastric bleeding and other side effects, even in low doses. On the plus side, though, low-dose aspirin does protect men from heart attacks and the most common type of stroke; men at the highest risk reap the greatest benefits.

  10. Get enough vitamin D. Many experts now recommend 800 to 1,000 IU a day, a goal that’s nearly impossible to attain without taking a supplement. Although protection is far from proven, evidence suggests that vitamin D may help reduce the risk of prostate cancer, colon cancer, and other malignancies. But don’t count on other supplements. Careful studies show that selenium, vitamins C and E, beta carotene, folic acid, and multivitamins are not protective and that some may do more harm than good.

Check out our new brochure for men!

Designed with support from the AstraZeneca-Merck Alliance, this brochure was created for men in British Columbia to help them understand the risks associated with carrying a BRCA gene and discuss the benefits of getting genetic testing. The brochure is available for reprint at cost, on request.