Tumore della Prostata
Introduction For many years scientists, pathologists, urologists, and oncologists have been trying to understand what causes prostate cancer. What we do know is that before there is a prostate cancer cell in your prostate there must be something else. In other words, prostate cancer cells do not suddenly spring into existence fully formed and without any sort of explanation.
In other words, before patients pin prostata 2 prostate cancer, many of them may get either a condition called prostatic intraepithelial neoplasiacommonly abbreviated to PIN or a condition known as atypical small acinar proliferation ASAP.
ASAP is dealt with on another page. For a detailed discussion of PIN, with many images and references, we recommend that interested readers refer to the article by Dr. Bostwick that appears on the Bostwick Laboratories web site. However, human nature being what it is, some of these other names continue in use today. Therefore, any particular urologist or pathologist may use one of the following terms to mean PIN:. If you imagine that there is a continuous range of identifiable situations related to prostate pin prostata 2 — from the very first biochemical event or mutation that leads to the development of the very first malignant prostate cancer cell right through to the extensive growth of bone metastases, then at least some type or types of PIN may well be the first of these situations that a pathologist can actually see under the microscope.
Many years ago, Dr David Bostwick suggested that there is a close relationship between the age-related prevalence of PIN and the age-related prevalence of prostate pin prostata 2. Figure 1, which has been adapted from material published by Dr Bostwick, clearly indicates that the occurrence of PIN seems to parallel the occurrence of prostate cancer, with prostate cancer lagging about 20 to 30 years behind the appearance of PIN.
This suggests that if one carried out prostate cancer screening in younger and younger men, we might find lots of cases of PIN. Figure 1. The relationship between prevalence of PIN and prevalence of prostate cancer. Adapted from Bostwick DG. PIN is divided into two types pin prostata 2 grades: low grade and high grade.
It is enough to say that just as pathologists tell one Gleason grade from another on the basis of cell structures and their interrelationships, the same is true for PIN. PIN can pin prostata 2 discovered in exactly the same way as prostate cancer. A man comes in for a check up. The doctor does a biopsy. When the pathologist looks at the biopsy specimen, he or she can find no sign of cancer, but there is a clear occurrence of PIN.
For the physician and the patient, pin prostata 2 is only one important question. Now what do I do?
Figure 2. Two ducts with high grade prostatic intraepithelial neoplasia PIN. From Chitale A, Khubchandani S. Interpretation of prostatic biopsies: a review. Internet J Urol. It is worth pointing out that at the moment there is no clear relationship between PSA levels and the occurrence of PIN.
Nor are there any indisputable data indicating a clear relationship between the occurrence of PIN and the presence of prostate cancer. However, if the pin prostata 2 is told by the pathologist that there is high grade PIN pin prostata 2 the prostate, it is generally agreed that the patient is at significant future risk for prostate cancer. First, it should be made very pin prostata 2 that a diagnosis of low grade PIN is not considered to be significant.
In other words, if your doctor finds only low grade PIN in the biopsy specimen it is recommended that he just send you home while telling you to come for your next check up a year later. However, if there is high grade PIN in the biopsy specimen then a number of further steps should be taken:. The general expectation which is being followed here is that high grade PIN found as a consequence of an elevated PSA is a very close predictor for small foci of localized prostate cancer.
Thus, multiple biopsies should be carried out over time to ensure the identification of the cancer and appropriate treatment. At the moment, there is no evidence that PIN can be successfully treated. Specialists currently recommend that identification of high grade PIN should not in any way affect the treatment of a patient, except that that patient should be regularly rechecked for signs of prostate cancer as discussed above.
Having said that, there are several pin prostata 2 trials that are seeking ways to prevent PIN from transforming into prostate cancer see ClinicalTrials. For access to the full list of CureTalks on Prostate Cancerplease click here. News and information provided on this site should not be used for diagnosing or treating any health problem or disease.
It is not engaged in rendering pin prostata 2 advice or professional services and is not a substitute for professional care. If you have or suspect you may have a health problem, please consult your healthcare provider. Blog at WordPress. WP Designer. The "New" Prostate Cancer InfoLink has been developed to become a primary source of accurate, current, pin prostata 2 topical information about prostate cancer for patients and their families.
Prostate Cancer International. However, if there is high grade PIN in the biopsy specimen then a number of further steps should be taken: First, the pathologist should re-examine all of the original biopsy tissue with the greatest care for any traces of prostate cancer tissue. Second, assuming that there is still no trace of prostate cancer, the urologist should give you another PSA test and carry out a second biopsy.
If cancer is found on the second biopsy, then the patient should be treated accordingly. If there is still no cancer after the second biopsy, your doctor should ask you pin prostata 2 come back every 6 months or four times in the next 2 years for a repeat biopsy and PSA test. If there is still no sign of cancer after 2 years, then your doctor is advised to ask you to return once a year for pin prostata 2 next two years for biopsy and a PSA pin prostata 2.
Can PIN be Treated? Content on this page last pin prostata 2 and updated January 28, Like this: Like Loading Post to Cancel.
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