Medical Oncologist
CION Cancer Clinics
Positive for HOXB13: what happens next | CION Cancer Clinics
A positive HOXB13 result means you carry an inherited fault that raises the chance of prostate cancer. It is not a cancer diagnosis, and nothing needs to happen today. The next steps are a result session with your counsellor, a plan for earlier prostate checks if you are a man, and a conversation about which relatives could be tested. At CION Cancer Clinics, our oncologists explain what a gene result means for you and your family, and plan the checks that follow.
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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
- What does a positive HOXB13 result mean for me?
- What changes for you, and what changes for the family?
- What happens over the coming months?
- Words you will hear, in plain language
- What a positive result changes, and what it does not
- What this page cannot tell you
- Four worries after a positive HOXB13 result
- Common questions after a positive HOXB13 result
The short answer
What does a positive HOXB13 result mean for me?
It means the laboratory found a harmful change in your HOXB13 gene, present since birth. For a man, it raises the chance of prostate cancer across his life. For a woman, it matters mostly for her sons and brothers. It is not a diagnosis, and nothing needs to be decided this week.
The first few days
Most people read the report before anyone has explained it. That is normal. Write your questions down as they come. Try not to search the variant name online, where results mix up different faults and different populations. Keep the report safe and bring it to the result session.
If you feel anxious or low, say so at the result session. Many people feel relief at having an answer and worry about their children at the same time. Both are common, and both are worth talking through.
If you already have prostate cancer
Your treatment plan usually stays the same. HOXB13 does not currently point to a specific drug. Your oncologist will record the result, and it becomes most useful for your brothers, your sons and other relatives.
A positive result is information about risk. It does not change who you are today.Depends on who you are
What changes for you, and what changes for the family?
The same result leads to different next steps for different people in the family.
A man with no cancer
Your doctor will usually suggest starting prostate checks earlier than for other men, and repeating them more regularly.
What that usually involves
- A PSA blood test
- A plan for how often to repeat it
- A clear route to a urologist if the level rises
A man already treated
Your follow-up after treatment continues as planned. If your PSA is already being checked, little changes day to day. The result mainly helps your relatives. Mention it at every new appointment so it stays in your notes.
A woman who carries it
Your own screening follows the routine advice for your age. The result matters most for the men in your family, and for your sons when they are adults.
Your sons can decide on their own test once they are grown up.Your close relatives
Each parent, brother, sister and child has an even chance of carrying the same fault. Brothers and sons matter most, because they face the prostate risk directly. Sisters and daughters matter because they can pass it on. Your counsellor will give you a letter explaining which test they need.
Not sure whether this applies to you?
Ask an oncologistStep by step
What happens over the coming months?
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The result session
Your counsellor goes through the report, confirms the exact variant and how it is classified, and answers your questions. Bring a family member if that helps you remember.
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A referral for prostate checks
If you are a man, you will be referred to a urologist or oncologist to plan checks. When to start and how often to repeat them depend on your age and family history.
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The family letter
You receive a letter naming the exact fault. Relatives take it to their own counsellor, so the laboratory looks for that one change rather than running a full panel.
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Telling the family
You decide who to tell and when. Many people start with brothers and adult sons. Your counsellor can help with the words, including in Telugu.
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A review over time
Advice changes as evidence grows. Ask how you will be told if anything changes, and keep your contact details up to date with the clinic.
In the result session
Words you will hear, in plain language
- PSA
- Prostate specific antigen, a protein made by the prostate and measured with a blood test. A raised level has many causes, not only cancer.
- Urologist
- A surgeon who specialises in the prostate, kidneys and bladder, and often the doctor who plans prostate checks.
- Cascade testing
- Testing relatives one step at a time for the fault already found in the family.
- First-degree relative
- A parent, brother, sister or child. They share half of your genes.
- Family letter
- A letter from your counsellor naming the fault, for relatives to take to their own appointment.
- Reclassification
- When a laboratory updates how a variant is labelled because new evidence has come in.
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Side by side
What a positive result changes, and what it does not
It can change
It does not change
When prostate checks start
Your current cancer treatment
Whether relatives can have a targeted test
Whether you will definitely get cancer
How closely your doctor watches
Routine screening for other cancers
What future tests look for
Your ability to work, marry or have children
Being straight with you
What this page cannot tell you
It cannot tell you your personal risk. That depends on the exact variant, your age and who else in your family has had prostate cancer. What your specific variant means is a question for the counsellor who ordered the test.
It cannot give you a firm number
Risk estimates for HOXB13 come mostly from studies of men of European ancestry. Studies in Indian men so far are small. A counsellor can describe your risk as raised, but a precise figure for an Indian family is not yet well supported.
Who this does not apply to
If your report shows a variant of uncertain significance, this page does not apply. That result should not change your checks. It also does not apply if the change was found only in a tumour sample. That is a different kind of test, covered under targeted therapy.
It cannot replace the result session
Reading about HOXB13 can help you prepare questions. It cannot stand in for the conversation where someone who knows your family tree explains your report. If travel to Hyderabad is hard, ask whether the session can happen by phone or video, with the report shared beforehand.
Commonly believed
Four worries after a positive HOXB13 result
"I should have my prostate removed now."
Removing a healthy prostate is not recommended for HOXB13 carriers. Earlier and more regular checks are the standard response.
"I must tell everyone in the family today."
There is no deadline. Many people take weeks to decide who to tell first. What matters is that close relatives eventually get the chance to choose for themselves.
"My daughters now face a high cancer risk."
Women do not have a prostate. A daughter's result matters mainly for her own sons, and her routine screening does not change because of HOXB13.
"A positive result will stop my son from marrying."
A HOXB13 result is private health information, and many carriers marry and have children. Whether and when to share it is a family decision, and a counsellor can help you think it through.
Questions we are asked
Common questions after a positive HOXB13 result
Do I need to see a doctor urgently?
No. A positive result is not an emergency. Book the result session with your counsellor and, if you are a man, a routine appointment to plan prostate checks. See a doctor sooner only if you have symptoms, such as trouble passing urine or blood in the urine.
When will my prostate checks start?
It depends on your age and family history. Guidelines for carriers suggest starting the conversation about PSA testing earlier than for other men, and repeating it more regularly. Your urologist will set the starting age and the gap between tests with you.
Will my insurance be affected?
India has no dedicated law on genetic discrimination in insurance. It is a fair question to raise with your counsellor. Read any proposal form carefully and answer honestly what it asks. Some families review their cover before sharing a result widely.
Should my brother be tested even if he feels fine?
Yes, if he wants to know. Feeling well tells you nothing about whether he carries the fault. His test looks only for the change found in you, so it is simpler than yours. He should see a counsellor first.
Does this change the treatment for my prostate cancer?
Usually not. HOXB13 does not currently point to a specific drug, and treatment is planned on the cancer's stage and features. Tell your oncologist about the result so it is recorded, in case future evidence changes this.
Can my children inherit it?
Each child has an even chance of inheriting the fault, whether a son or a daughter. Testing for a risk that only matters in adult life usually waits until the child is an adult and can decide for themselves.
Can the result be wrong?
Laboratory errors are rare, but classifications can change as evidence builds. A pathogenic result is seldom downgraded. If you are unsure, ask your counsellor whether confirmation or a second opinion is worthwhile.
Who can help me in Hyderabad?
A genetic counsellor explains the result, and a urologist or oncologist plans the checks. Call the CION helpline if you are not sure where to start. Someone will point you to the right clinic, and you can ask about counselling in Telugu.
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)
Medical Oncologist
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Sources
- National Cancer Institute — Genetics of Prostate Cancer (PDQ) – Health Professional Version
- MedlinePlus Genetics — HOXB13 gene
- National Cancer Institute — Genetic Testing for Inherited Cancer Susceptibility Syndromes
- NHS — Predictive genetic tests for cancer risk genes
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
Surveillance for HOXB13 carriersHow the prostate checks are actually plannedTesting the family for HOXB13Which relatives to test, and in what orderHOXB13 mutation: which cancers and what riskWhat the raised risk means, and where evidence is thinYour family letter and what to do with itHow to pass the result on to relatives
Talk to us
Holding a HOXB13 report and unsure what to do first?
Tell us what the report says and who in the family is affected. We will help you find a counsellor to explain it and a doctor to plan the checks. One helpline serves every CION centre.