What is PIN and is it a precursor to cancer? What is its relationship to cancerous tumors and to the prediction for such tumors developing?
A. Prostate cancer is caused by changes (mutations) in the DNA that affect the regulation of the growth of normal prostate cells. It is probable that several mutations (at least 5 or 6) have to occur before a full-blown cancer occurs. These mutations may accumulate over time, causing the gradual progression to prostate cancer. It is likely that certain mutations may cause a precancerous condition called prostatic intraepithelial neoplasia (PIN). PIN is also found as a satellite lesion surrounding a prostate cancer or elsewhere in a cancerous prostate gland. Approximately 30% to 50% of men who have an elevated PSA level and high-grade PIN are subsequently found to have prostate cancer within four years. Accordingly, repeat biopsies are routinely recommended in men with PIN.
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