High-Grade PIN experiences

Ah the wonderful rollercoaster world of PC...

As my sig shows, I'm 43 and HAD been diagnosed with early PC in January. Then, the second pathology report came back today from J Hops and showed, in their opinion, no signs of actual malignancy but instead some "atypical glands" next to High-Grade PIN. A second biopsy is now scheduled for next month along with new psa evals.  

Now, I'm just beginning my research on PIN and what excatly that means (in truth, it means you're closer to cancer than not, but you don't actaully have the big C yet).

I'm wondering if anyone has had a similar experience or, at least, was diagnosed with HG PIN during an initial biopsy and what that meant for you. Questions like:

What is your understanding of the meaning of PIN in relation to long-term prostate health?

At what point in time after PIN detection did cancer appear, if ever? Months? Years? Never?

Did you have annual or even bi-annual biopsies going forward?

Did you make - or learn about - any dietary changes to help stave off the evolution of PIN to PC?

In the grand scheme, if my second biopsy shows no PC but HG PIN, is that a reason to celebrate or just means delaying the inevitable?

Better keep an eye on this, HG PIN is more significant than just having PIN. Here is what this article says about it:
(I did a google search, so you can do the same to read more)
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Suspicious results -

Sometimes when the pathologist looks at the prostate cells under the microscope, they don't look cancerous, but they're not quite normal, either. These results are often reported as suspicious. They generally fall into 2 categories -- either prostatic intraepithelial neoplasia (PIN) or atypical small acinar proliferation (ASAP).

In PIN, there are changes in how the prostate cells look under the microscope, but the abnormal cells don't look like they've grown into other parts of the prostate (like cancer cells would). PIN is often divided into low-grade and-high grade. Many men begin to develop low-grade PIN at an early age but do not necessarily develop prostate cancer. The importance of low-grade PIN in relation to prostate cancer is still unclear.

If high-grade PIN is found on a biopsy, there is about a 20% to 30% chance that cancer may already be present somewhere else in the prostate gland. This is why doctors often watch men with high-grade PIN carefully and may advise a repeat prostate biopsy, especially if the original biopsy did not take samples from all parts of the prostate.

Another finding that is sometimes reported on a prostate biopsy is atypical small acinar proliferation (ASAP), which is sometimes just called atypia. In ASAP, the cells look like they might be cancerous when viewed under the microscope, but there are too few of them to be sure. If ASAP is found, there's about a 40% to 50% chance that cancer is also present in the prostate, which is why many doctors recommend getting a repeat biopsy within a few months.

Last Medical Review: 07/30/2009
Last Revised: 07/30/2009
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Not meant to disturb you but for information sake, not all PCa's react similarily, there are around 14 variant types of PCa, then added differences within those including DNA-ploidity on the cell structures....it is complicated and should never be over simplified based upon what is known and proveable at this time in history. See pathology information websites from some of the few experts and learn alot more than you wish to know.













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Scott,
Drs Strum, Scholz and Tisman did a paper on PIN a few years ago:
PIN has three grades, 1, 2, and 3,; High grade PIN is 2 and 3.
HGPIN is a precurser to PC by about 5 years.
Anyone who has HGPIN should be considered to have occult PC unless proven otherwise.
Quarterly PSA tests and annual biopsies are recommended.
Basically you should go on the same program that anyone doing Active Surveillance would do.
I have the paper in hard copy and if you email me your address I'll make a copy and send it to you.
JohnT

I had a rising PSA which went to 6.8 two years ago. Had three biopsies, the last one a saturation biopsy. Each one showed ASAP. The urologist said the chances of me having cancer were small but that the PC could have been missed. Now my PSA is 10.6. The velocity is concerning. Any thoughts on yet another biopsy? I understand that after three biopsies the chances of having PC are slim but my rising PSA is a concern.