August 13, 2023

Cell Changes (PIN and ASAP) are they prostate cancer?

Written by
Edward Calleja
Prostate Cancer
Prostate Conditions
Wave Blue

What is PIN?

PIN stands for prostatic intraepithelial neoplasia, where the cells may grow differently than normal prostate cells.

Is PIN prostate cancer?

PIN is not prostate cancer but is often found in men with prostate cancer. It is important to note that most men with PIN do not develop or require treatment for prostate cancer.

What is ASAP?

ASAP stands for atypical small acinar proliferation. The cells in the prostate gland are uncertain if they are cancerous. Additional tests, such as prostate biopsies, may be recommended for individuals with ASAP to monitor any further cell changes and detect potential cancer early.

Is it possible to have both ASAP and PIN in the prostate?

It is indeed possible to have both ASAP and PIN in the prostate. When both conditions are present, the risk of prostate cancer is generally higher than having only one.

Are PIN and ASAP indicators of prostate cancer?

While PIN and ASAP are not prostate cancer, their presence may indicate an increased likelihood of undetected prostate cancer.

3 in 10 men with a significant amount of PIN and around 8 in 100 men with ASAP will be diagnosed with prostate cancer after a second prostate biopsy.

Do PIN and ASAP alter the PSA?

Both PIN and ASAP, or a combination of both, do not alter PSA. So, this blood test is not the most sensitive way to monitor them.

What are the symptoms of PIN and ASAP?

PIN and ASAP do not cause any symptoms, and they are often diagnosed during tests or treatment for other prostate issues.

On the other hand, if the cells become cancerous, symptoms such as urinary problems may arise.

How are PIN and ASAP detected?

PIN and ASAP can only be found by looking at prostate tissue under a microscope. This may happen after a prostate biopsy to check for prostate cancer or a surgery called a transurethral resection of the prostate (TURP) to treat an enlarged prostate gland.

Are PIN or ASAP a common finding?

1 in 20 men (5%) who have had their prostate tissue examined under a microscope have a PIN, while about 1 in 50 men (2%) have ASAP.

Black men are more likely to develop PIN than white men and have a higher incidence of prostate cancer. However, further research is needed to understand the reasons for these disparities. The prevalence of PIN and ASAP in Asian or mixed-race men has not been studied extensively.

If my biopsies show PIN or ASAP what are the next steps?

No specific treatment is required for PIN or ASAP, but regular check-ups may be necessary to monitor any potential cancer cells that may have been missed during the biopsy.

These check-ups may include regular PSA tests, digital rectal examinations, prostate MRI and possibly another prostate biopsy. The frequency and type of tests will depend on the individual's situation. There are no national or international guidelines, so variation in follow-up between hospitals and countries is expected.

Can a diet prevent or treat or reverse PIN or ASAP?

There has been no research on this topic.

Many men diagnosed with prostate cancer follow a lycopene-rich diet.

Reflection by a consultant urologist

PIN and ASAP are cellular changes in the prostate that require microscopic examination for diagnosis. While they are not prostate cancer, their presence may indicate a higher likelihood of undetected cancer.

Understanding these conditions and undergoing regular check-ups are essential for monitoring and timely detection of any potential cancerous changes in the prostate.