High grade Prostatic intraepithelial neoplasia (PIN) is the most significant risk factor for prostate cancer. PIN is strongly predictive of adenocarcinoma and if its identified in a biopsy specimen then it warrants repeat biopsies to check for cancer. This preinvasive cancer does not seem to have an impact on the levels of PSA scores.
All doctors can do now is the watch and wait method with those diagnosed with PIN. A preliminary study has shown that Toremifene can decrease the incidence of prostate cancer in men diagnosed with this precancerous condition.
A study was done with 514 men who had been diagnosed with PIN and had no evidence of prostate cancer. They were randomized to daily treatment with Toremifene or placebo for twelve months. The researchers concluded that 6.8% of every 100 men had their prostate cancer prevented with Toremifene.
Having a precancerous condition is very stressful. Its like the sword is just hanging over your head waiting to drop. This medication and its use with PIN to prevent prostate cancer is in its early stages but it is hopeful because at the current time there is no treatment for PIN available.
1. Thanks for bringing this to our attention, Kristina.
It is at least plausible that taking 5 mg of finasteride daily would also help, as it resulted in a 25% reduction in prostate cancer in the huge (about 18,000 men) and long (about seven years) Prostate Cancer Prevention Trial. Recent analysis also proved that finasteride is safe, a news item that the media has missed in a major, disgraceful media blunder -- no Pulitzer Prizes for that coverage. I've written an article about it from my survivor's viewpoint, drawing on information in the paper and accompanying analysis in the Journal of the National Cancer Institute, that is posted at http://www.mycancerplace.com/forum/?action=view_topic&id=43&fid=18. One of the leading experts in prostate cancer whom I follow confirmed to me that it is great news.
The questions are whether finasteride would work as well (or perhaps even better) in men diagnosed with PIN, and how it would work in conjunction with Toremifene. Finasteride just became generic in the past few months; all my previous prescriptions have been for its predecessor, Proscar. A closely related but much newer drug, Avodart, appears to be even more promising, with reductions in prostate cancer incidence at around the 50% mark per preliminary research with relatively few patients.
Jim (Web Page at http://www.mycancerplace.com/profile.php?id=147)
Posted at 6:43PM on Sep 27th 2006 by Jim Waldenfels