Here is Djin’s response...
Hi Runnerf. The question I'll ask is What has been your PSA history the past 8 years? I would think that you would have had imaging or additional biopsies if your PSA trend was of concern. Are you being followed by a urologist? In any case, here are links to recent papers on your question:
Relationship between prostate cancer and atypical small acinar proliferation [2018]
https://www.annalsmedres.org/articles/2019/volume26/issue5/850-853.pdf"CONCLUSION
In our center, prostatic adenocarcinoma was detected in 34% of the follow-up biopsies of ASAP-diagnosed cases in the first biopsies. In 38% of cases, cancer localization and ASAP are in different parts. Consistently with the literature, this situation shows that recurrent biopsies in ASAP cases and biopsies performed from different localizations are significant in catching malign cases"
CLINICOPATHOLOGIC IMPLICATIONS OF ATYPICAL SMALL ACINAR PROLIFERATION (ASAP) IN THE ERA OF ACTIVE SURVEILLANCE [2019]
https://www.auajournals.org/doi/abs/10.1097/01.ju.0000555451.53862.08"CONCLUSIONS:
Approximately 75% of patients with ASAP show either no cancer or active surveillance-eligible disease in this cohort, with implications for the work-up of atypical foci. As the overwhelming majority of patients who showed GS ≥7 cancer on subsequent biopsy had dominant anterior tumors at RP, increased attention to the anterior prostate should be a routine part of the management of patients with an ASAP diagnosis."
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) path neg. for PCa
6-06-17 Nodule on R + PSA rise on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
Bone scan, CTs, X-rays: neg.
8-7-17
open RP, Duke Regional
SM EPE BNI LVI SVI LNI(5L, 11R): neg., PNI+
pT2c pN0 pMX, G9 (4+5) 5% of prostate
Decipher 0.37 Low Risk uPSA, 0.010 (3 mo)…0.015 (2 yr 4 mo)
Post Edited (DjinTonic) : 12/28/2019 11:49:08 AM (GMT-7)