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Doctors Lounge - Oncology Answers
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| bertie
- Mon Oct 05, 2009 1:33 am |
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i had an enlarged prostate, and the doctor said, after a biopsy, that there was a slight change on the cellular level. he prescribed avodart, and after 3 months it (PIN)was gone, prostate much improved( i also take saw palmetto). he suggested i continue with the avodart, but i would like a second opinion as to whether i must continue or can i stop taking avodart.
is this a "maintenance" issue, like controlling one's high blood pressure, that requires continued use of avodart? or once the PIN goes away, is it done with. and if returns in a similar manner, will resuming avodart remedy the situation once again.
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| Dr.M.Aroon kamath
- Fri Nov 06, 2009 11:19 am |
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 Hi,
It would have been very helpful if you had told us whether the Prostatic intraepithelial neoplasia (PIN) that was identified in your prostatic biopsy specimen was low grade or high grade.I have to assume it to be high grade as you have been advised 'avodart'.
(PIN) is classified as 'low grade' and 'high grade'. The high grade variety is the one which is believed to increase the risk of prostatic cancer.Also, Multifocal PIN perhaps, has the highest risk.
It appears that in patients with high-grade PIN, the chance of developing prostatic cancer is about 35 to 40 percent in a five-year period.
In patients with low-grade PIN, it appears that the risk of developing cancer is about 15 to 20 percent over a 10-year period (some believe that this type has no increased risk at all).
In patients whose biopsies didn’t show any PIN, the chance of developing cancer in the future is about 10 percent.
Many would agree, i believe, that currently there is no approved treatment for risk reduction in prostate cancer
Some workers may recommend prophylactic drug therapy (chemoprevention) in men who have high risk indicators
such as
age, suspicious findings on rectal exam,high PSA level,a high BMI [body mass index], a positive family history,etc.
If PIN(high grade) is present, then the risk period for development of cancer is quite long - even upto 10 years. PIN might regress on chemoprevention, but whether the risk also decreases.....only further studies ought to reveal!
Your doctor should be the one to decide whether to stop it or to continue.
Best wishes!
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