If you had a genetic mutation that greatly increased your odds of cancer, what would you do? Opt for regular screenings that could help catch the disease early in its development, or immediately undergo surgery to remove the at-risk body part?
It's a question more people are thinking about after news came out last week that superstar actress Angelina Jolie had undergone a preventative double mastectomy in February because she carried a mutated gene that increased her risk of getting breast cancer.
Now, news is emerging that a British man has recently become the first in the world to have his prostate removed for similar reasons.
According to the Daily Telegraph, the man has a mutation of the BRCA2 gene, which is known to increase the risk of prostate cancer. The Independent reported that doctors decided to operate after a tissue sample showed a small amount of cancerous cells. That, coupled with the man's genetic mutation, convinced doctors that removal was the best course of action.
That's not to say it would be the right decision for every man. Prostate cancer is slow-growing and there is mounting debate over when screening and treatment are truly necessary, particularly since prostate removal can have serious health consequences, including sexual dysfunction and incontinence.
But people with BRCA mutations face a much greater risk of cancer than the general population. Although the mutations are rare, people who have them must decide whether to undergo surgery or to simply do frequent cancer screening.
Jolie made worldwide headlines with her recent New York Times piece, which recounted her decision to undergo a double mastectomy. Many medical experts have praised her decision to come forward and raise awareness of the existence of the BRCA gene mutation.
The cost of BRCA mutation screening is covered in many parts of Canada, but patients might not know they should be tested. Those at risk include women with a family history of breast and/or ovarian cancer and those of Ashkenazi Jewish descent.
At the same time, there is growing recognition that BRCA mutations can increase the risk of prostate cancer in men, as well as testicular and pancreatic cancer.