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Curtis A. Pettaway, MD, Professor of Urology at the University of Texas, discusses how germline DNA mutations like BRCA1 & 2 can predispose men to aggressive prostate cancer as well as influence how men respond to different kinds of therapies. He notes the increased frequency of certain mutations in particular ethnic groups, but emphasizes that while testing for these important alterations is becoming common and guideline-based it is less commonly performed among African Americans and other minorities. Given the higher incidence and mortality of prostate cancer among African Americans, he notes the need for including these patients in research (including genetic sequencing, and collecting data on clinical and family history) that will define both the significance and types of genetic alterations that are important for patient care and family counseling.