High Grade PIN

What is high grade PIN?

When a prostate biopsy is performed, the results may either indicate benign or malignant tissue. A third possible finding, which is considered a pre-malignant condition, is known as high-grade prostatic intraepithelial neoplasia (or HG-PIN for short.) Up to 10% of all prostate biopsies will contain areas of HG-PIN.

What does high grade PIN mean about my chances of getting prostate cancer?

Exactly how HG-PIN is related to prostate cancer is still controversial. Some experts believe that HG-PIN is a true precursor to prostate cancer, and that over time, the areas of HG-PIN ultimately develop into actual cancer. Other experts believe that HG-PIN is simply associated with prostate cancer, and that HG-PIN and prostate cancer simply co-exist in the same prostate. Regardless of which theory is correct, the experts agree that a finding of HG- PIN on biopsy means that man has a much higher risk of being diagnosed with prostate cancer in the future.

What kind of follow-up is needed?

Exactly how a diagnosis of HG-PIN should be followed up is also controversial. Some urologists suggest an immediate re-biopsy of the prostate. Others suggest a delayed re-biopsy in 6 or 12 months. An increasing number of urologists are NOT suggesting a rebiopsy, and instead, simply recheck the PSA and digital exam several times per year.

What can I do in the meantime?

Regardless of the type of follow-up suggested, a diagnosis of HG-PIN means an increased risk of prostate cancer in the future. Most men are eager to take any steps that might possibly reduce that risk. While there is no prescription medication for treatment of high grade PIN at the present time, modification of diet and lifestyle may have an important role to play.