What your family history could be telling you about prostate cancer risk
January 27, 2026Categories: Blog Posts
Prostate cancer is extremely common in the U.S., affecting 1 in 8 men in their lifetime. In 2024 alone, according to the American Cancer Society, approximately 300,000 were diagnosed and 35,000 died from the disease. While a family history of prostate cancer increases a man’s risk of diagnosis, recent studies show that a family history of other cancers—including breast, pancreatic and colon—can also elevate that risk.
According to Justin Harmon, DO, a urologist at Trinity Health Mid-Atlantic Medical Group’s Comprehensive Urology Langhorne, the BRCA genes—which produce proteins that help repair damaged DNA and prevent cancer—play a massive role in a man’s chances of getting prostate cancer.
Though a mutation in BRCA1 or BRCA2 is often linked to breast and ovarian cancer, men can inherit that harmful change and be at higher risk for prostate cancer.
“When these genes mutate, that repair mechanism fails,” explains Dr. Harmon. “While often linked to breast and ovarian cancer, a mutation in BRCA2, in particular, is one of the strongest genetic risk factors for developing aggressive, high-grade prostate cancer in men.”
An initial conversation with a primary care provider and/or urologist is vital, as men who carry a mutated BRCA gene tend to have a more aggressive form of prostate cancer. Additionally, they may develop prostate cancer at a younger age compared to men who don’t have the mutation. While the National Comprehensive Cancer Network generally recommends prostate cancer screenings for ages 50-75, those with family history are urged to begin sooner.
“When I sit down with a new patient, I’m looking for a ‘hereditary pattern’ across the entire family tree. If a patient mentions their mother had early-onset breast cancer or a sister had ovarian cancer, my clinical suspicion for a germline mutation rises. This triggers a discussion about formal genetic counseling and more intensive screening,” says Dr. Harmon. “If there is a known hereditary pattern, we often recommend baseline PSA (Prostate-Specific Antigen) testing and a physical examination starting at age 40 or 45. We want to catch the disease while it is still organ-confined.”
It’s important for men to know their family history and risk because, when it comes to prostate cancer, there are usually no symptoms in the early stages. And when symptoms—such as frequent urination—do appear, they could easily be disregarded as a minor condition. However, early detection drastically improves outcomes.
“In the early, curable stages, there are almost never symptoms,” says Dr. Harmon. “By the time a patient experiences bone pain or significant urinary obstruction, the window for a straightforward cure may have narrowed. It’s exactly like high blood pressure—you don’t feel the damage until you check the numbers.”
For men who may feel hesitant or anxious about getting screened or having that initial conversation about family history, Dr. Harmon shares some words of advice: “I tell my patients to think of the people who depend on them. Screening isn’t just about you; it’s about ensuring you are there for your family for the next 20 to 30 years. With the technology and genetic insights we have today, we can manage this disease more effectively than ever before.”
Dr. Harmon and his team follow many patients on active surveillance—a close monitoring system for low-risk prostate cancer without actual treatment to avoid side effects. Patients are treated if/when the cancer progresses and becomes a risk for them.
For those who are diagnosed and require treatment, this doesn’t mean a radical shift in quality of life. As an SRC-accredited Surgeon of Excellence in Robotic Surgery, Dr. Harmon utilizes the latest generation of robotic platforms to perform nerve-sparing, minimally invasive procedures whenever possible, drastically reducing the patient’s risk of side effects.
“Our goal is dual fold: oncologic control (curing the cancer) and functional preservation,” says Dr. Harmon. “By using robotic precision, we can minimize the risk of side effects like erectile dysfunction and urinary incontinence, which were far more common in the era of open surgery.”