Michael Leshin was diagnosed with prostate cancer in the springtime of 2017 — a rise in PSA led to a biopsy, which led to a diagnosis, which led to a trial at Dana-Farber Cancer Institute in Boston. Since then, Michael and his wife Roz, as well as his three adult children, Miriam, Jonah, and Rachel, have endured the ups and downs of his prostate cancer journey. Among them, a prostatectomy, current surveillance and containment treatments, and a critical discovery about his genetic makeup that would have implications for his entire family.
“Beyond dealing with the disease, we were dealing with what I learned to be a genetic mutation of the BRCA2. I have what’s called the non-founder mutation,” Michael told ZERO. Both men and women possess two genes that are related to breast cancer: BRCA1 and BRCA2. Certain individuals have a mutation of either gene, which means that they are at a much higher risk of developing breast cancer. Recent research has shown a high correlation between the BRCA genetic mutation and the risk for developing prostate cancer as well.
After hearing this information, it was critical that Michael’s children know their status as soon as possible. The mutation is only found in about 1 in 500 women; however, knowing one’s status is essential to assessing one’s risk of developing not only breast cancer, but other cancers as well. All three children tested positive.
“They were so strong and emotionally grounded,” Michael said. “We’ve come away with a sense of real resilience and a love for each other – we’re here for each other.”
October is Breast Cancer Awareness Month. All over the world, amazing charities not unlike ZERO are campaigning, fundraising, and working tirelessly to end the deadly disease. According to the CDC, breast cancer is the second most common cancer among women — 250,000 women will be diagnosed in the United States in a given year, not to mention roughly 2,100 men as well.
This important month of advocacy comes directly after September, which we all know was Prostate Cancer Awareness Month. It’s no coincidence that these months are back to back: the two cancers are closely linked in terms of genetic predisposition.
“While most men realize that their risk of prostate cancer is increased if they have a family history of prostate cancer, what is less well-recognized is that their risk of prostate cancer is also increased if they have female relatives with certain female cancers,” Dr. Christopher Amling of Oregon Health and Science University told ZERO. “Men who have mothers, daughters, or sisters with a history of breast or ovarian cancer also have an increased risk to develop prostate cancer.”
“The BRCA gene in prostate cancer is probably the most exciting thing to happen in the last five or six months,” said Dr. Michael Curran of Greater Boston Urology. While men who have a BRCA mutation are more likely to develop an aggressive form of prostate cancer, the knowledge of such a mutation can completely change the course of a patient’s treatment.
“We have a whole set of treatments called PARP inhibitors that are now FDA approved and commercially available,” Curran continued. “These medications have significant survival advantages for patients who happen to possess the BRCA gene in their prostate cancer.”
BRCA mutations can give prostate cancer patients a clearer sense of what they are dealing with; for example, those who test positive for the mutation have more specialized treatment options than those who test negative. In order to avoid mismanaging treatments, it’s critical that prostate cancer patients know their genetic composition, especially those with a family history of breast cancer or potential inheritance of BRCA mutations.
“It’s so important to be an active patient,” said Michael. “Know your family history, look for care that might not necessarily be articulated by your provider, and find ways to have agency while you’re going through treatment.” Because the Leshins are now aware of this inherited mutation, they have a much better understanding of the unique risks they face when it comes to both cancers.
As cancer research gets more and more advanced, hopefully discoveries like the BRCA mutation will be even more common, where understanding one type of cancer can lead to breakthroughs in another. This October, in addition to supporting breast cancer patients, caregivers, and physicians, we at ZERO hope we can educate about how the BRCA gene uniquely affects the prostate cancer community as well.
Make sure to check out ZERO’s BRCA Gene and Prostate Cancer resource page, as well as our previous blogs on the BRCA gene, including our informational “What Men Should Know About the BRCA Gene,” as well as Michael Sudman’s personal account “I’m a Man with the BRCA Genetic Mutation.”