We frequently hear about connections between our genes and the risk of developing prostate and other cancers. However, a new study provides further evidence in support of an old idea that our genes may affect something much more important than the development of cancer; indeed, this new research supports the concept that our genes affect survival from prostate cancer.
Dr. Kari Hemminki and colleagues, in a fascinating piece of epidemiologic sleuthing published in the Journal of Clinical Oncology, utilized the Swedish Family-Cancer Database to determine whether survival patterns from prostate cancer clustered within families. By assessing survival data for more than 600 prostate cancer-affected sons and their fathers (who also had prostate cancer), they were able to show that sons of fathers with shorter survival from prostate cancer tended to survive for a shorter period as well. Likewise, sons of fathers who survived for a longer period of time after the diagnosis tended to survive for a longer period of time as well.
Although these results shouldn't be utilized at this point to guide treatment decisions, as they may be subject to some biases and need further confirmation, they should pave the way for future studies aimed at identification of genes underlying this familial risk. This would be a refreshing approach in an area of medicine beset with substantial uncertainty surrounding best treatments - particularly with respect to decisions regarding prostatectomy versus "watchful waiting." It will be very interesting to see how this turns out, and it is important to remember that genes that may confer risk of metastatic disease and/or poor survival may not be genes that are involved in risk of developing prostate cancer (i.e., they only affect the rate of progression or metastasis of the disease once it is already established).
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