What is Prostatic Intraepithelial Neoplasia?

Dulce Corazon

The prostate gland, part of man's reproductive system, mostly produces fluid that nourishes the sperm cells. When cells in the prostate undergo abnormal changes, this often results in prostate disorders. One of these is known as prostatic intraepithelial neoplasia (PIN). This condition is generally considered a precancerous condition, which means it has a tendency to develop into prostate cancer. Cancer of the prostate is prominent among elderly men.

A man's prostate is part of his reproductive system.
A man's prostate is part of his reproductive system.

Screening procedures for prostate cancer such as the prostate specific antigen (PSA) blood test and digital rectal examination (DRE) cannot usually detect the presence of prostatic intraepithelial neoplasia. Most men with this condition do not develop symptoms. This abnormality in the prostate gland is frequently found during a biopsy, or removal of prostate gland tissues, due to other reproductive problems, like benign prostatic hyperplasia (BPH). BPH usually occurs when there is enlargement of the prostate gland. Men with this condition often experience frequent urination and interruption in the flow of urine.

Prostate cancer refers to a cancerous growth that begins in the prostate gland.
Prostate cancer refers to a cancerous growth that begins in the prostate gland.

Prostate tissues from a biopsy are processed in the laboratory and analyzed by a pathologist for the presence of abnormalities. Pathologists are experts in studying blood and tissues in order to determine the cause of disease. When a prostatic intraepithelial neoplasia is found, it is then described as either low grade or high grade, depending on its appearance as compared to the normal cells. This categorization is also frequently important in the management of patients.

In a low-grade prostatic intraepithelial neoplasia, the appearance of abnormal cells have only a slight difference from that of the normal prostate. Most urologists, doctors who treat men with reproductive organ disorders, may ask patients to have another check up and a biopsy a year later for monitoring. Studies have indicated that about 16% of low-grade PIN can lead to prostate cancer.

Men diagnosed with a high-grade prostatic intraepithelial neoplasia, however, are often managed differently. This is because the abnormalities in cell appearance are usually more pronounced in a high-grade prostatic intraepithelial neoplasia. Monitoring of patients is commonly done every six months, when they may undergo a PSA test, a DRE, and a repeat prostate biopsy.

It is estimated that about 30% of men with high-grade prostatic intraepithelial neoplasia may be diagnosed with prostate cancer during a repeat biopsy. If no cancer is found after the first two years of regular check up, patients are usually scheduled for a once-a-year visit. When cancer is found, appropriate treatment is then given.

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