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Prostate cancer: when a genetic test is advised | CION Cancer Clinics
A genetic test is advised for men whose prostate cancer has spread, men with high-risk disease, and men with a strong family history of certain cancers. For them, a result can open specific treatments and warn sons, brothers and daughters. Most men with slow, early prostate cancer and no family pattern do not need it. This page explains who qualifies and what a result changes. At CION Cancer Clinics in Hyderabad, our oncologists review your family history with you and guide you to the right genetic counselling and testing.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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On this page
- Which men with prostate cancer are advised a genetic test?
- Which situations put a man on the testing list?
- How does testing usually happen for a man with prostate cancer?
- The words you will meet, in plain language
- What a positive result can change, and for whom
- What this page cannot tell you
- Four things families tell us, and what is actually true
- Common questions about prostate cancer and genetic testing
The short answer
Which men with prostate cancer are advised a genetic test?
A genetic test is now advised for men whose prostate cancer has spread, men with high-risk cancer still inside the prostate, and men with a strong family pattern of certain cancers. For these men, an inherited fault is common enough that looking for it is worthwhile. For most other men with prostate cancer, it is not.
Why prostate cancer joined the list
For years, inherited cancer genes were treated as a women's issue. Then large studies looked at men whose prostate cancer had spread. More than one man in ten carried an inherited fault in a gene that repairs damaged DNA, and the most common was BRCA2. Many of these men had no family history that would have raised the question.
Why it matters to the man himself
If the cancer has spread, a fault in a repair gene can open treatments that target that weakness. It can also tell the specialist that a slow cancer is less likely to stay slow. These are decisions for your oncologist, but they cannot be made without the result.
Why it matters to his family
The same fault can pass to sons and to daughters. In a daughter, a BRCA fault raises the risk of breast and ovarian cancer. One test in the father can change what his children are offered.
A genetic test looks at the man's own inherited genes, from blood or saliva. It is not the same as testing the tumour.Who is usually offered it
Which situations put a man on the testing list?
Guidelines differ in detail, but four situations come up again and again. Meeting one of them is enough to ask the question.
Cancer that has spread
If the cancer has reached the bones, lymph nodes or other organs, testing is advised whatever the family history. This is the group where the result most often changes treatment.
High-risk cancer in the prostate
A cancer that looks aggressive under the microscope, or has certain unusual patterns in the biopsy, can also qualify. Your pathologist's report and your specialist decide which group you fall into.
A family pattern
Relatives on either side with these cancers raise the question, especially when they were diagnosed young.
- Prostate cancer in a father or brother
- Breast or ovarian cancer in close female relatives
- Pancreatic cancer at any age
- Bowel or womb cancer in several relatives
A fault already found in the family
If a sister, cousin or parent has a known fault, a man can be tested for that exact fault. This is quicker and clearer than a broad panel, and it answers the question for him directly.
Not sure whether this applies to you?
Ask an oncologistFrom question to result
How does testing usually happen for a man with prostate cancer?
Your specialist raises it
The urologist or oncologist looks at the stage, the biopsy report and the family history. If you meet the criteria, they refer you, or arrange the test with counselling built in.
Counselling before the test
A counsellor draws your family tree and explains what the test can and cannot find. They cover what a result would mean for your children, and insurance questions, before any sample is taken.
A blood or saliva sample
One sample is enough. It is sent to a laboratory that reads a panel of genes linked to prostate and related cancers. Nothing needs to be stopped or changed in your treatment.
The result, explained in person
The result usually takes a few weeks. It comes back to the person who ordered it and is explained in a second conversation, not handed over as a printout.
A letter for the family
If a fault is found, you are given a letter your relatives can take to their own doctor. It names the exact fault so they can be tested for it.
On your report
The words you will meet, in plain language
- BRCA2
- A gene that helps repair damaged DNA. An inherited fault in it is the one most often found in men with prostate cancer that has spread.
- DNA repair genes
- A family of genes, including BRCA1, BRCA2, ATM, CHEK2 and PALB2, that fix breaks in DNA. A fault in any of them can raise cancer risk.
- Germline
- Present in every cell from birth, and so able to pass to children. This is what a blood or saliva test looks at.
- Somatic
- A change found only inside the tumour. It cannot be inherited, and it is found by testing the tumour tissue instead.
- Mismatch repair genes
- Genes behind Lynch syndrome, an inherited condition that mainly raises bowel and womb cancer risk, and sometimes prostate cancer risk too.
- PARP inhibitor
- A tablet treatment that works on cancers with a broken DNA repair gene. Whether it suits you is your oncologist's decision.
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Side by side
What a positive result can change, and for whom
For the man with cancer
For his relatives
Some targeted tablets may become an option if the cancer spreads
Brothers and sons can be tested for the exact fault
Active monitoring of a small cancer may be reconsidered
Daughters and sisters can plan breast checks with a specialist
Other cancer risks, such as pancreatic, are discussed
Relatives who test negative can drop back to routine care
Treatment already working usually carries on unchanged
Nobody in the family has to be tested if they do not want to be
Being straight with you
What this page cannot tell you
It cannot tell you whether you personally meet the criteria. That depends on the exact stage, the biopsy report and a family history taken properly on both sides. Your specialist or a genetic counsellor can answer it in one conversation.
It cannot read your report
If you already have a result, what your specific variant means is a question for the counsellor who ordered the test. The same gene name can mean very different things depending on the exact change. Please do not search for it and draw your own conclusions.
It does not cover tumour testing
Testing the tumour itself for changes that guide treatment is a different test with a different purpose. It is explained on our targeted therapy pages.
Who this does not apply to
Most men with a small, slow-growing prostate cancer found early, with no family pattern, do not need a genetic test. A counsellor is as willing to tell you that as to recommend one.
Commonly believed
Four things families tell us, and what is actually true
"Breast cancer genes are a women's problem."
Men carry BRCA faults just as often as women do. In men, they raise the risk of prostate, pancreatic and male breast cancer, and a man can pass the fault to his daughters.
"My tumour was tested, so my genes have been checked."
Not necessarily. A tumour test looks for changes inside the cancer. It can hint at an inherited fault, but a separate blood or saliva test is needed to confirm it.
"Only my sons need to worry about my result."
Daughters inherit the fault just as often as sons. For a BRCA fault, the risk to a daughter is mainly breast and ovarian cancer, which is why the family letter goes to everyone.
"Nobody else in the family had cancer, so it cannot be genetic."
Many men with spread cancer who carry a fault have no family history at all. Small families, early deaths and cancers that were never named can all hide a pattern.
Questions we are asked
Common questions about prostate cancer and genetic testing
Is prostate cancer inherited?
Usually not. Most prostate cancer comes from changes that build up with age. A smaller group is driven by an inherited fault, and those men are more likely to have cancer that spreads, a young diagnosis, or relatives with breast, ovarian or pancreatic cancer.
My father had prostate cancer. Should I be tested?
If he is alive, testing him first gives the clearest answer. If he carries a fault, you can then be tested for it. Either way, his diagnosis is worth mentioning to your own doctor, who may suggest starting prostate checks earlier than usual.
Does a BRCA2 fault change my treatment?
It can, mainly if the cancer has spread. Some targeted tablets work better on cancers with a broken repair gene. It may also affect whether watching a small cancer is still sensible. Your oncologist decides this with you, using the result as one piece of the picture.
What is the difference between the tumour test and the blood test?
The tumour test looks at changes inside the cancer to guide treatment. The blood or saliva test looks at the genes you were born with, which your family may share. Some men need both. Your oncologist will explain which one you are being offered.
Should my daughters worry about my result?
If you carry a BRCA fault, each daughter has an even chance of inheriting it. That would raise her breast and ovarian cancer risk. She can choose to be tested for the exact fault as an adult, and plan checks with a specialist if she carries it.
Should I test before treatment starts?
If the cancer has spread, earlier is better, because the result can shape later choices. If the cancer is confined to the prostate, surgery or radiotherapy does not usually need to wait for it. Ask your specialist which applies to you.
Is the test covered by insurance or a government scheme?
Cover for inherited testing varies, and many families in India pay for it themselves. Ask before the sample is taken whether your insurer or scheme will contribute. The counsellor should tell you the full price, including counselling, before you agree.
Where do I start?
Write down the stage of your cancer and every relative on both sides who had cancer, with roughly what age. Take that to your oncologist or urologist and ask directly whether you meet the criteria. Call the CION helpline if you are not sure who to ask.
Your Specialists
Meet CION's oncologists. Bring your family history or genetic report to them.
Our medical oncologists see people with a strong family history of cancer, arrange genetic counselling and testing where it fits, and plan the checks that follow.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Sources
- National Cancer Institute — Genetics of Prostate Cancer (PDQ) – Health Professional Version
- National Cancer Institute — BRCA Gene Changes: Cancer Risk and Genetic Testing
- MedlinePlus Genetics — Prostate cancer
- Cancer Research UK — Risks and causes of prostate cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
BRCA2 and prostate cancer riskThe gene most often found in men, explained on its ownTesting criteria explained without the jargonThe full checklist, for every cancer typeHow tumour and inherited testing fit togetherWhy some men need both tests, and in what orderMale breast cancer and genetic testingThe other cancer in men that always raises the question
Talk to us
Not sure whether your prostate cancer needs a genetic test?
Tell us the stage of the cancer and who else in the family was diagnosed. We will tell you honestly whether a genetic referral makes sense, and arrange it if it does. One helpline serves every CION centre.