Cribriform cells

Posted by hanscasteels @hanscasteels, 20 hours ago

Does anyone have any insight on how cribriform presence changes approaches or treatment? Are there time constraints? Radiation suggestions that would optimize the destruction of these cribriform - is radiation therapy an option for cribriform cancer in the prostate?

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jeffmarc | @jeffmarc | 19 hours ago

Cribriform greatly increases the aggressiveness of your cancer. If the size of cribriform is greater than .25mm it is even more aggressive. If your Gleason score is 9 or 10 it increases the chance of getting metastasis and affects overall survival. Radiation can destroy cribriform but so can surgery. It would’ve been useful to know what your Gleason score is and your current PSA.

Do not wait long for treatment because you don’t want the cancer getting out of the prostate. If you do delay it for a while get on ADT, which will stop it from growing.

Where are you going for treatment? It’s important that you have a good team working on your treatment. Going to a center of excellence can increase your overall survival.

Get a PSMA pet scan before going on ADT to see if you have Spread of the cancer.

Here Are some slides from my recent presentation I saw that discussed cribriform.

hanscasteels | @hanscasteels | 18 hours ago

Thank you very much. (Un)fortunately I am located in Canada, hence left to the whims of local administratia. They seem to take their sweet ol’ time. PSA score was 26 the first time around in July, 21 in September and 25 in November. 3+4 Gleason score. 5 cores out of 12 positive. CT scan and Bone scan showed no apparent metastasis. Been told by the urologist that brachytherapy combined with EBRT and short-term anti testosterone therapy is the way to go. Now just endlessly waiting for a PSMA PET scan… it’s taking forever and while we won’t go bankrupt due to medical bills here in Canada, we might well expire before treatment. It’s agonizing.

jeffmarc | @jeffmarc | 17 hours ago

In reply to @hanscasteels "Thank you very much. (Un)fortunately I am located in Canada, hence left to the whims of..." + (show)

It is good to see your PSA did not rise. It actually fell a little And has not risen Much at all. As they said in the meeting, I went to a Gleason, seven is not the same if you have Cribriform, But you are holding well. That is almost definitely why they are not being real aggressive about treatment.

You might attend an Ancan.org meeting to get an opinion from some real experts about treatment. Because you would be new, they would talk to you first and give you advice. They’re quite familiar with Canada and its limitations, You could always ask for different treatment. The next meeting is Monday December 2nd at 8 PM Eastern time, It lasts two hours. Just yesterday, one of the attendees, I referred from Mayo, said that he was really thankful that he had attended meetings there, that he had learned so much and even thanked me for getting him there.