HIS MEDICAL CHOICE
05.20.13 8:45 AM ET
British Man Has BRCA2 Gene, Removes Prostate
Angelina Jolie had her breasts removed after discovering that her genetic makeup gave her an 87 percent chance of breast cancer. Now, an unnamed 53-year-old Londoner has become the first man in the world to have his prostate preemptively removed after discovering that, like the Hollywood actress, his genetic code made him a prime candidate for prostate cancer.
Although standard tests showed no evidence of cancer, doctors finally agreed to go ahead with the controversial operation—which leaves men infertile as the prostate gland is responsible for the production of semen—and were astounded when, after the operation, examinations showed the organ to be riddled with cancer.
The man discovered he was a carrier of the BRCA2 gene (Angelina tested positive for an associated gene named BRCA1) after he was asked to take part in a genetic trial at the Institute of Cancer Research (ICR) in London, according to a report in the U.K. Sunday Times.
Several people in the man’s family had already suffered from both breast and prostate cancer.
The Sunday Times reports that “there were no signs the man’s prostate was anything other than healthy” and that neither “the prostate-specific antigen (PSA) screening test” nor an MRI scan showed any issues with the prostate but that “doctors were finally persuaded to operate” when a tissue sample taken from the prostate gland showed up “microscopic malignant changes.”
The surgeon, Roger Kirby, told the paper: “The relatively low level of cancerous cells we found in this man’s prostate before the operation would these days not normally prompt immediate surgery to remove the gland, but given what we now know about the nature of BRCA2, it was definitely the right thing to do for this patient.”
Amazingly, when the prostate was examined after surgery it was discovered that there was “a considerable level of undetected cancer” which had not shown up in either the MRI or the PSA screening.
Removal of the prostate leaves a man infertile, and can also lead to increased risk of permanent incontinence and sexual dysfunction.
Kirby told the paper that he feels more men with BRCA genes will now come forward asking for the surgery, despite the problems associated with wholesale removal of the prostate. Men who carry BRCA1 have a 3.4 times higher risk of developing prostate cancer, while those who carry BRCA2 have 8.6 times the risk of non-carriers.
The prostate is a small gland that is wrapped around the urethra, and often the first sign that something is wrong comes when a man feels pain when urinating because the urethra is being squeezed and blocked. Prostate cancer affects as many as one in eight men, but it frequently advances so slowly that it is not the ultimate cause of death.
Angelina has been hailed as a hero and inspiration for women after she revealed that she had taken drastic surgical measures to reduce her chances of getting breast cancer in a New York Times piece last week.
She wrote: “My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.”
Following the operations, Angelina's risk of contracting breast cancer has dropped to under 5 percent.