In his latest post on the MedPage Today web site, Howard Wolinsky (a freelance journalist based in the Chicago area), who has been on active surveillance since 2010, writes about the result of his most recent rebiopsy. His last one was in 2013. There was (again) “no evidence of malignancy” in the post-biopsy pathology report.
“Great news,” said the urologist. But there was some high-grade prostatic epithelial neoplasia (PIN) in one biopsy core. Howard wasn’t so sure about the “great news” piece.
It used to be that a diagnosis with high-grade PIN was seen as a big deal because it can be a precursor to prostate cancer. (Note the emphasis on “can be”.) The problem is that some amount of low- or high-grade PIN can be found in the prostates of nearly half the men in America over 50 years of age … and most of those men don’t go on to have prostate cancer. Howard had had high-grade PIN on biopsy back in 2010, and when they found some again in his most recent biopsy, Howard had a period of a little angst.
However, after doing some careful homework, Howard writes that:
I am adjusting to my PIN cells and will stay on course with active surveillance. It was great news after all. … Frankly, my cancer seems pretty laid back right now. I’ll have my next PSA in 2017. I’m back on a biopsy vacation.
We understand that the American Society of Clinical Oncology has invited Howard to be a patient representative on a panel on active surveillance at the annual Genitourinary Cancers conference in Orlando next February. This is the first time ASCO has ever had a patient on a panel at this meeting. We applaud ASCO for taking this step.
Here is a set of links to all Howard’s articles about his journey on active surveillance, in order of their publication:
- Prostate cancer: a patient’s journey
- A conscientious objector in the war on cancer
- Prostate cancer: driving the personalized medicine highway
- Prostate cancer: new directions with active surveillance
- Prostate cancer overload: informed decisions or information overload?
- A patient’s journey: sometimes it’s not all about prostate cancer
- A patient’s journey: can high-grade PIN be “great news”?
Filed under: Living with Prostate Cancer, Management | Tagged: active surveillance, high-grade, PIN, Wolinsky |
THE "NEW" PROSTATE CANCER INFOLINK 
Not on point, but Dr. Myers latest Prostatapedia issue addresses impact of exercise on prostate cancer-specific and overall survival and in particular the benefit to guys on ADT. Purportedly a 50 to 60% reduction in death rate!
Bob:
I haven’t seen the latest issue of Prostatapedia, but Dr. Myers may have been referring to this study that we reported on back in April.
Thank you for your report. I chose WW in 1989 and have conferred with Doctor Carol (UCSF) and Doctor Brooks (Stanford) just to name two; check out “myprostate.eu” and enter xxxcross for my story. As of 2016 I am doing very well. Good luck to you in your journey and I hope that you are able to help many others; I tried however I was not able. My observation was that the newly diagnosed depended on their doctors rather than their own research. It seems that most gentlemen want to return to habits of old, habits that may be responsible for their cancer. Again, I wish you luck.
rich cross
xxxcross@comcast.net