Prostate Cancer Risk and Prevention Clinic

Nearly everyone has at least one family member with cancer. When several members have cancer, suspicions are raised about a genetic predisposition --- especially when cancer occurs in multiple family members at a young age. In some families, genetic testing may identify altered cancer predisposition genes that are passed from parent to child. Genetic information may help some people learn whether they have an increased likelihood of developing certain cancers or whether inherited factors have contributed to their own or family member’s cancer. Individuals who are determined to be at increased risk may take steps to reduce their risk through regular screening and prevention strategies

The UCSF Cancer Risk Program was established in 1996 as a multi-disciplinary, genetic counseling service for families with hereditary cancer. The Prostate Cancer Risk and Prevention Clinic is an expansion of this program through a collaboration with the UCSF Comprehensive Cancer Center Prostate Cancer Program. Specialty-trained genetic counselors and physicians assess the personal and family history, verify cancer diagnoses, provide education and counseling, and offer genetic testing for cancer predisposition genes, when appropriate. Based on risk factors and genetic testing, the genetic counselors and physicians provide an individualized risk management program for each patient that includes recommendations for preventive measures and future screening for cancer.

Services

The UCSF Prostate Cancer Risk and Prevention Clinic offers the following services:
	In-depth cancer-risk assessment based on personal and family history
	Genetic counseling and education of cancer risk for patients and their families
	Screening examinations and tests, as appropriate. These may include:
		Transrectal ultrasound guided biopsy using local anesthesia and the most current biopsy strategies
		Color-doppler ultrasound imaging
		Magnetic resonance imaging (MRI)
		Magnetic resonance spectroscopy (MRS)
		More Specific and/or sensitive serum tests
	Development of a personalized screening and prevention plan (in collaboration with the patient’s referring physician)
	Strategies to reduce cancer-risk that include modifiable lifestyle changes and cancer-prevention options. The relative importance of diet in reducing risk is thoroughly discussed.
	The opportunity to participate in clinical research trials of new agents for prevention of prostate cancer, genetic testing, or other appropriate research studies

Who is at an increased risk of prostate cancer?

The following guidelines help to identify individuals whose cancer risk may be greater than the general population. Suggestive personal and family histories include:

	2 or more family members with prostate cancer – especially when cancer is diagnosed in close relatives (father and son, brothers, etc.)
	Prostate cancer occurring at age 60 or younger
	African American men
	Families with prostate cancer and breast cancer or ovarian cancer – especially when these cancers occur in Jewish families
	Individuals with more than one primary cancer diagnosis
	Individuals with rare or less-commonly diagnosed cancers (for example, breast cancer in a male)
	Families with known hereditary cancer syndromes
	Men with abnormal or rising serum prostate-specific antigen (PSA) levels
	Men found to have premalignant cancer on previous biopsies (i.e., high grade prostatic intraepithelial neoplasm or atypia)

Our multi-disciplinary team

At your first visit, you will see one or more of the following health care professionals: genetic counselor, urologist, and medical oncologist. Other professionals, such as nutritionists and psychologists are also available to consult with you and your family.

Research component

Family history is one of the established risk factors for prostate cancer, and it is estimated that 42% of the variability in prostate cancer occurrence can be explained by hereditary factors. There are no standard-of-care genetic tests for identifying men at high risk of developing clinically important prostate cancer. To elucidate the genetic basis for this disease and improve standards of clinical care, we are conducting clinical and epidemiologic research as part of the risk and prevention clinic for genitourinary cancer patients at the UCSF Hellen Diller Family Comprehensive Cancer Center. As part of this program, patients are asked to complete a detailed questionnaire about the history of cancer in their relatives at check-in or via their pre-visit mailed packets. After these data are reviewed by a genetic counselor they are used in research studies, which include: qualitative and descriptive studies, and genetic epidemiology. Patients are contacted by the genetic counselor and a urologist if they indicated an interest in follow-up and have a strong family history of cancer. This research may help future generations by improving our ability to screen, diagnose, and treat prostate cancer; and in particular identify those cases which may be the most clinically significant. The clinic is supported by intramural funds.

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Contents of This Page

Faculty

Peter Carroll, MD, MPH
June Chan, ScD
Maxwell Meng, MD
Katsuto Shinohara, MD
Marc Shuman, MD

Key Staff

Genetic Counselor
415/885-7779

Jeanette Broering, RN, MS, MPH,
Director of Data Procurement and Quality Assurance
jbroering@urology.ucsf.edu
415/514-0203

Janet Cowan, Programmer Analyst
jcowan@urology.ucsf.edu
415/353-7424

Appointments & Location

Urologic Oncology, Comprehensive Cancer Center
1600 Divisadero Street, 3rd Floor
San Francisco, CA 94143-1711

Contact Number

For patient consultation please call us at 415/885-7779

Additional Information

UCSF Hellen Diller Family Comprehensive Cancer Center's Cancer Risk Program

UCSF Medical Center's Cancer Risk Program 415/885-7779
877/RISK4CA (877/747-5422) toll free

G-CEPS
The Genitourinary Cancer Epidemiology and Population Science (G-CEPS) program encompasses all studies involving patients or populations conducted by or in collaboration with Urology.