PIN: Not Prostate Cancer . . . Yet

Having a biopsy to detect or rule out prostate cancer can be both unnerving and frightening. You probably expect a clear answer: yes or no. Often, however, a biopsy yields an atypical result known as prostatic intraepithelial neoplasia, or PIN. PIN is a noncancerous lesion on the surface of the gland. While PIN is non-cancerous, its presence may herald the development of cancer.

Two types of prostatic intraepithelial neoplasia exist: low grade (LGPIN) and high grade (HGPIN). LGPIN is not associated with prostate cancer. HGPIN is increasingly considered to be a forerunner of cancer. One study discovered HGPIN in 85 percent of radical prostatectomies performed to remove prostate cancer. Clinical trials have indicated that PIN may appear as soon as ten years before cancerous cells develop.

HGPIN is not a disease and has no symptoms. Its presence does not automatically indicate you will develop a malignant prostate carcinoma. That said, however, HGPIN is considered a precancerous lesion that can lead to future tumors. Close monitoring is recommended, and you should have regular follow-up biopsies. Repeat biopsies on men with HGPIN reveal cancerous cells more often than biopsies of men without HGPIN: anywhere between 35 to 75 percent more often, according to independent studies.

If your biopsy revealed cancerous cells and you would like information on the various treatment options.

African American men appear to be twice as likely to develop high-grade prostatic intraepithelial neoplasia as Caucasians. Age also plays a role. PIN levels have been detected in nine percent of men in their twenties, and incidence rates rise with age until, by age eighty, the rate is approximately seventy percent.

The exact relationship between neoplasia and cancer is being vigorously investigated in clinical trials. If a clear relationship between the development of high grade prostatic intraepithelial neoplasia and the onset of prostate cancer can be established, then a new prostate carcinoma screening technique has been found. Prostatic carcinomas are among the most slow-growing of all tumors: early detection and prompt treatment significantly improve survival rates.