HGPIN: Do I have prostate cancer?

The HGPIN, which stands for High-Grade Prostatic Intraepithelial Neoplasia, is a condition in which certain prostate cells show abnormal changes, but NOT it is a prostate cancer.

It is defined as a precancerous lesion, i.e. a situation that may precede the development of prostate cancer, but is not a cancer per se.

These abnormal cells are only found within the prostate ducts and glands, without invading the surrounding tissues.

HGPIN is often discovered by chance, during a prostate biopsy performed for other reasons, such as elevated PSA values or abnormalities at the rectal examination.

Is HGPIN dangerous?

Diagnosis of HGPIN should not frighten, but should not be underestimated.

It is not a tumour, but it can be a increased risk signal.

Studies indicate that about 20-30% of men with HGPIN may develop prostate cancer over time.

The risk is higher if:

• The HGPIN is multifocal, i.e. present in several areas of the prostate
• The patient has metabolic syndrome (diabetes, hypertension, obesity, high triglycerides);
• There is a familiarity for prostate cancer.

What to do after the diagnosis of HGPIN?

No invasive treatment such as surgery or radiotherapy is necessary. However, it is important to monitor the situation carefully.

The examinations to be followed include:

• PSA (Prostate-specific antigen): to be checked regularly
• Digital rectal exploration (DRE): to assess possible changes
• Biopsy of controloften recommended after 12 months, especially if the HGPIN is multifocal
• Multiparametric magnetic resonance imaginguseful in some cases to deepen

Follow-up may continue with annual checks, depending on the clinical picture and the urologist's indications.

Need to worry?

No, no cause for alarm. HGPIN is a condition that needs to be monitored, but many men with this diagnosis will never develop cancer. And even in those cases where it does develop, they are often tumours at low risk, which can be successfully managed.

The most important thing is do not ignore the diagnosis and follow medical instructions. A healthy lifestyle, a balanced diet and regular check-ups are effective tools to protect the health of the prostate.

---

To be remembered

• THE HGPIN is not a tumour, but an injury that may precede it.
• The risk of evolution exists, but it is neither certain nor immediate.
• A regular follow-up, but no invasive treatment.
• With care and prevention, one can live peacefully.

References: https://www.nature.com/articles/nrurol.2017.134