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ASAP- atypical small acinar proliferations

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Posted 11/25/2022 6:27 AM (GMT 0)
Hi I am a new here. I am 55, I have a PSA of 27.2 had a biopsy lately, result is ASAP- atypical small acinar proliferations. Did anyone of you had similar diagnosis, please share
Posted 11/25/2022 2:04 PM (GMT 0)
I had it in 2013, though with significantly less PSA than you. I had a second negative biopsy that was negative. After an strange jump in PSA in next test it went back to my previous levels and it stayed stable until 2017. Then, it started to increase and this time I got the cancer diagnostic.
Your high PSA may be due to prostatitis but, with an ASAP finding, I would do anything possible to confirm it is not cancer. You may have another more intensive biospsy and/or a multiparametric MRI test in a few months. Good luck.
Posted 11/25/2022 3:25 PM (GMT 0)
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3242985/

Posted this on another thread, hope it helps.
Posted 11/25/2022 5:32 PM (GMT 0)
Just in case, here is the relevant conclusion from the paper cited by Mumbo:

The diagnosis of ASAP is a strong risk factor for prostate cancer. A repeat biopsy should be performed for the entire prostate subsequent to the diagnosis of ASAP.
Posted 11/25/2022 5:40 PM (GMT 0)
Prostate cancer detection following diagnosis of atypical small acinar proliferation (2017)

"Abstract

Introduction
To report the incidence and characteristics of cancer following a diagnosis of atypical small acinar proliferation (ASAP) and comment on current clinical practice recommendations.

Materials and methods
We reviewed patients that underwent prostate biopsy between 2008 and 2013 at a single institution. Men with ASAP without previous cancer were included. Clinicopathologic features including prostate-specific antigen (PSA), presence of ASAP or cancer, tumor volume, number of involved cores, and Gleason score were analyzed in men that received a repeat prostate biopsy.

Results
Of 1450 men, ASAP was found in 75 (5%) patients. Repeat biopsy was performed in 49 (65%) patients. Fifteen (31%) were diagnosed with cancer, 10 (20%) with ASAP, and 24 (49%) were benign. PSA, age, and number of cores with ASAP were not associated with cancer. Gleason 6 disease was diagnosed in 12 (80%) patients. Gleason ≥ 7 cancer was found in 3 patients, or 6% of all patients with a repeat biopsy. The average linear amount of tumor was 3.2 mm, and the average tumor volume was 14.2%.

Conclusion
In a contemporary prostate biopsy series, the incidence of ASAP was 5%. Among men with ASAP, incidence of cancer at repeat biopsy was 31%, with the overwhelming majority being low grade and low volume. Patients with ASAP may not require repeat biopsy within 6 months in the appropriate clinical context."
Posted 11/25/2022 6:38 PM (GMT 0)
Summary - Koreans are doing worse than Europeans with ASAP

Do a search for "Significance of Atypical Small Acinar Proliferation in Prostate Biopsy" and many papers will be found
Posted 11/27/2022 11:36 PM (GMT 0)

Joe1967 said...
Hi I am a new here. I am 55, I have a PSA of 27.2 had a biopsy lately, result is ASAP- atypical small acinar proliferations. Did anyone of you had similar diagnosis, please share

Hi Joe,

I too am got the results with ASAP few weeks ago, mine only one core, I don't know how many core that you have from biopsy?

With the help and educated information from all wonderful peoples in this forum, my doctor told me if it does come back negative from second biopsy, most likely less than or about Gleason 6, this would qualify us for AS (active watchful eyes).

But i am confident that with a technology now a day, that can help us fight for this terrible desease.

Thank again for all the help all of the peoples in here!
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