What should I know about testing?

There are two different types of genetic testing, commonly referred to as germline or somatic. The way the test is done determines which type of mutation it can detect.
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Hereditary mutations

A hereditary (germline) mutation exists in all of your cells (even outside of your tumor), is present since birth, and can be inherited by your children.
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Who Should Test
You are at higher risk for BRCA mutations if:
  • You are of Ashkenazi Jewish ancestry
  • You have a family history of BRCA mutations or associated cancers
    • breast
    • ovarian
    • pancreatic
    • prostate
    • colorectal
    • endometrial
  • Your prostate cancer has spread
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How to Test
  • Blood draw
  • Saliva sample
  • OR
  • Cheek swab
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When to Test
  • If you are high risk for BRCA, you should be tested as soon as you are diagnosed with prostate cancer
  • Everyone else should get germline testing once your prostate cancer becomes metastatic
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Spontaneous mutations

A spontaneously acquired (somatic) mutation can develop in your tumor over time and cannot be passed down to your children.
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Who Should Test
Anyone with metastatic prostate cancer should receive somatic testing
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How to Test
Testing can be performed using:
  • Tumor tissue from a previous biopsy
  • Tumor tissue from a new biopsy
  • OR
  • Blood draw (with tumor DNA in it)
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When to Test
  • Once your prostate cancer becomes metastatic

Should I get tested more than once?

You may be wondering whether you need another test if you have already been tested once. Depending on which type of test your doctor ordered and when, a negative result does not always rule out the possibility of a BRCA mutation. Talk to your doctor to confirm which test you took (germline or somatic), when the test was taken, and whether a follow-up test should be considered.
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If you got tested at an earlier stage of prostate cancer, you may need to test again in case your tumor mutated since then
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If you have been tested using tumor tissue, you may need to take another test (ie, blood or saliva) to confirm if it can be passed on to future generations
The NCCN Clinical Practice Guidelines In Oncology (NCCN Guidelines®) recommend that all men with metastatic prostate cancer get tested for both germline and somatic mutations.

Men with metastatic prostate cancer should talk to their doctors about BRCA testing

Download the Doctor Discussion Guide for tips on what to ask your doctor.

Knowing your BRCA status can reveal treatment options for your specific cancer

Understand your test results and how to talk to your doctor about them.

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