In need of advise (appreciate it)

After reading some of the posts here, I've realized that I my situation may not be as severe but nonetheless I am extremely worried.
First off I would like to say that I am 53 years old, of cuban descent, my father was diagnosed with prostate cancer and within a span of a 8 year period post diagnosis he passed away.
I recently had blood/urinary work done and within this process it was found that I had blood in my urine. My doctor performed an prostate screenings and the results were that I had stage 1 Prostatic intraepithelial neoplasia (pin), a precursor to prostate cancer. He explained to me that PIN could disappear, stay and do nothing or proceed to cancer dx. At this stage he said that PIN cannot be treated but I would need continuous follow up. I feel like it's obvious that this precursor is giving me a sign that will lead to prostate cancer, my dad had it and I'm getting up there in age where it's coming to me. I feel as if I'm waiting for the cancer to develop in order to do something.
I talked to my family in Cuba and they spoke with doctors there and they said that it can be surgically removed. I would rather have my prostate removed than sit and wait for the cancer to develop.
My question, would it be beneficial for me to remove my prostate now? What are the most concerns with this procedure, etc?
I just need advise on what to do because I cannot sit here and wait for the cancer to develop.

Welcome to our group, sorry that you are so troubled.

Your doctor is correct, if you have PIN only at this point detected, at least here in the US, they wouldn't be justified in removing your prostate by surgery. PIN doesn't always turn to cancer, but it very well can.

In my journey, my first biopsy came back negative for cancer, but lots of PIN. A year later, a second biopsy showed no cancer, but lots of HGPIN, which is high grade PIN, so very close to being cancer. A third biopsy 2 months later, found the cancer, and a lot more HGPIN.

No US insurance company that I know of would agree to pay for surgery at this point. So not sure how to answer that.

Good luck, and please keep us posted.


David in SC

be prepared for the possibilty of side effects. if you're young, in good shape and select a great surgeon there are excellent chances you won't suffer from the side effects many complain about. If you choose to have surgery, you'll probably be just fine within a few months, i am.

Thank you all for the posts, I am thoroughly understanding this disease process so I am appreciative of your inputs.

Tatt;
to me a small chance is still a chance, but your right it may not diverge onto cancer dx, but it still has a possibility - hence Purgatory's post.
My father died at age 77 (2003) and was diagnosed I wanna say a good 7-10 years earlier, the cancer metastasized, unfortunately I have none of his labs results so I don't know what his PCa was..
I am married, with 2 grown children - I am not planning on having anymore kids.

Again that's just my worry, I mean yes it is a very low grade PIN but it will probably develop onto hgPIN and eventually cancer dx, or it may not. My worry is that it WILL develop onto cancer and eventually metastasize, and I don't want that to happen so I want to prevent it now..

Fairwing:
I would not do it here because like you said; too much money and insurance refuses to cover. This is why I would do it in Cuba where neoplasia is considered a cancer dx and it leads to prostatectomy immediately.

Silvestri,

I would suggest you pick up a copy of Patrick Walsh's book "Guide to Surviving Prostate Cancer". Read the whole book, but Chapter 3 in particular discusses in great detail the 2 issues you bring up regarding PIN and family history.

Certainly the fact that your father was diagnosed with cancer is an increased risk. The fact that he wasn't diagnosed until +/- 70 years old makes you much less than some one with a history of Hereditary prostate cancer. My father had prostate cancer at 52. I had prostate cancer at 41. That is Hereditary prostate cancer. My brothers now have an exponentially higher chance of having this curse than the average man. I apologize to them when I see them.

I am not as educated on PIN, but Walsh compares it to "pre-cancerous" cells. Again, it certainly puts you at a higher risk, but by no means is a guarantee. I cannot think of a screening for any other organ that came back precancerous that would be cause for major surgery. I would think that would be less so the case for a cancer as slow growing as PC.

I hate to sound like a hypocrite, because I had surgery within 8 weeks of diagnosis and having as good a recovery as could be expected. That being said, if you practice Active Surveillance before you have cancer, getting frequent PSAs and biopsies, you would be acting very prudently.

Please take the time to be well educated before you make an irreversible decison.

Good luck.