Cribriform Pattern 4: What did you learn about this?

Cribiform was present in almost half of my pre-prostatectomy biopsies. I was advised of its nastiness. My Gleason score of 3+4 was, effectively, as my urologist indicated, equivalent to a 4+4 due to the presence of the cribiform. This was part of the decision to remove my prostate. My PSA was 'only' 2.0 pre-surgery. I had cancer in all 15 biopsies. I was 57 years old. Now, 13 months later, with no lingering side effects from the surgery my PSA is back up to 1.0 and my recent PSMA has identified 5 or 6 lymph nodes in the area with cancer. Photon (24 daily doses) and Proton (15 daily doses) radiation with Lupron is being prescribed to eradicate these escapees. Radiology oncologist suggests a 70% chance of no recurrence post-salvage radiation for the next five (5) years. Cribiform is nasty. Expedience is so important. Good luck.

My husband had cribiform pattern too. Oncologist really didn't say anything about it. Don't understand how this impacts treatment/recovery.

It is important because the likelihood of reoccurance after the initial treatment is much greater with Cribriform Pattern 4 present. Treatment could include additional treatment modalities that would likely not be considered in the absence of this morphology. This is what I am reading in the literature and hearing from some Doctors in this field. However, it is clear that this is not universally understood in the medical yet as it is evolving science.

I understand that you might have received information that led you to believe it wasn't important as I had one Oncoligist tell me it meant absolutely nothing - and that is clearly not the case!

I too had cribriform 4 noted on my post prostatectomy biopsy. Nothing was mentioned about it when I saw the Dr. I was 4+3 with tertiery 5. I saw a video with Dr. Mark Scholz of the PCRI and he said cribriform presence he would upgrade Gleason. I haven't found much other info. I'm 7 months out from surgery and PSA is < .1 I hope it stays that way. Thanks for starting this topics. I'm sure may are interested.

I am glad your PSA is staying down and I hope it stays this way! I have watched a lot of what Dr. Scholz has to say and it is very helpful. He is pretty much pro-radiation in lieu of surgery in almost every case. I see you had prostatectomy and I am interested in you reasoning? It looks like I may be looking at both a prostatectomy followed by Radiation and ADT but we will all decide that next week.

I have several links to articles that are current and very informative regarding Cribriform Pattern 4 but the system won't let me post links; however, if you search for Cribriform Patten 4, you will find many articles on studies related to this topic. Even though most articles are techinical in nature, I recommend reading through as there is much information even for a lay person. I only look at studies completed in the past three years or so. If I am able to provide these links in the future I will.

Good Luck, Steve

@stevemaggart, I noticed that you wished to post URLs to articles with your post. You will be able to add URLs to your posts in a few days. There is a brief period where new members can't post links. We do this to deter spammers and keep the community safe.

Allow me to post them for you:
- Cribriform Prostate Cancer: Clinical Pathologic and Molecular Considerations https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9165084/
- Prostate Cancer Morphologies: Cribriform Pattern and Intraductal Carcinoma Relations to Adverse Pathological and Clinical Outcomes—Systematic Review and Meta-Analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10000112/
- Prostate cancer growth patterns beyond the Gleason score: entering a new era of comprehensive tumour grading https://onlinelibrary.wiley.com/doi/full/10.1111/his.14214

I choose surgery due to some pre-existing urinary issues. They were some difficulty starting urination, split stream sometimes during, and sometimes not completely emptying my bladder. I was concerned about radiation irritating and swelling my prostate. I was afraid of the urinary retention that sometimes happens to a small percentage of radiation patients. I also watched a couple of youtube videos of guys who have had to self cath for quite some time. I also wanted the definitive path results that surgery could offer. (cancer was upgraded)I really wanted cyberknife sbrt and was leaning that way. I ended up choosing surgery and am glad I did. It turns out they found a medium lobe of my prostate growing up into my bladder. That's what was causing my urinary issues. After my surgery, I saw another Dr. Scholz video of him recommending a TURP ot the like for people with urinary issues before getting radiation because the tissues don't heal well if you get a procedure after raidiation