Intraductal prostate carcinoma: What is standard treatment?

My husband's biopsy was reread by MSK and one of the cores said the following, "Focally suspicious for intraductal carcinoma (separate core)." He has been diagnosed with stage 4A prostate cancer with one pelvic lymph node involvement that I have written about here. Moving ahead with ADT then internal and external radiation. What does this new diagnosis of 'intraductal carcinoma mean for his treatment, cure etc? TIA

What type of ADT? Chemical or surgical?

@cheriekhan, I moved your question about intrductal prostate carcinoma to this existing discussion:
- Intraductal prostate carcinoma: What is standard treatment?
https://connect.mayoclinic.org/discussion/intraductal-prostate-carcinoma/
I did this so you can read the previous posts and connect with others with this type of prostate cancer. You might also appreciate this related discussion:
- Proton beam vs IMRT for intraductal carcinoma of the prostate
https://connect.mayoclinic.org/discussion/proton-beam-verses-imrt/
What ADT medication will be used?

Thank you.

I didn't learn that I have intraductal PC until my recurrence about 10 months after surgery in late-2018. My surgeon never mentioned it. As mentioned above, I was also told that it was a more aggressive form of PC and that it only effected a low single-digit % of men. While having a Gleeson of 4+3=7, my PSA never rose above 2.0 before my surgery. I was told that I was part of a rare group for this as well (not sure if any relation to the type of PC).

I had surgery at Northwestern, then used my local Denver urologist for radiation treatment. I wish at this point I had gone to Dr. Kwon at Mayo, which is where I started treatment after the PC came back after radiation. I believe we should have waited to do radiation until the scan showed the exact location, rather than just radiate the prostate bed. My advice is also to seek the best treatment facility, even if you have to travel, as these care centers are much better versed on the latest tech and PC research has come a long way, even over the last 5 years. Dr. Kwon/Dr. Davis did spot radiation to a lymph node and I am coming off 18 months of ADT. The hope is for a cure or at least kicking the can down the road until the next treatment. Doing pescatarian diet (see the new studies that have come out this year on plant-based diets and PC) and 45+ minute of exercise everyday. Should probably drink less wine and cook more at home, but life needs to be enjoyed!

Hope this helps. I wish you the very best!

I think Ductal is the rare form of PC - intraductal is more common I believe but not noted on many pathologies?