Cribriform cells: Does their presence change treatment approach?

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.

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.

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.

Oh thank you. Wasn’t aware of this group but will dial in. Many thanks!

I am Gleason 4+3=7 with some cribriform cells but localized tumors. Am hoping for focal treatment, waiting to hear from Dr Scioniti’s group.

I had my RALP 2 years ago. 4 + 3 Gleason. Report said Cribriform present. No intraductal cancer. Lymph nodes and margins clean other than one 1mm micro margin. Cancer contained to prostate. No radiation recommended. 2 years cancer free.

Excellent.
Finally, finally, have my PSMA PET scan scheduled for December 12. Given that my PSA has remained stable over the past 4 months, and given that no evidence of metastasis was found on a CT as well as a bone scan, I hope that the cribriform damage is limited. Unfortunately, given I had CABG surgery 11 years ago, I was told RALP was too risky for me. So radiation and Brachytherapy, with a side of ADT just to spice things up, is my menu. It feels almost as if my body wants to experience all medical emergencies before expiring. Perhaps a stroke for dessert next...

Your pathology report sounds almost exactly the same as mine!

How has your PSA been since surgery? What PSA threshold are you being tested at?

I’m one year out from surgery and PSA < 0.006. Fingers eternally crossed.

I am not at the eradication stage yet. But I have been told that a cocktail of radiotherapy with a smooch of ADT would be the preferred approach. It’s hard to maintain a sense of dignity sometimes…

It's below 0.1. Never had the ultra sensitive test. One time my PSA was tested at a lab with a low threshold of 0.03. My PSA was listed as < 0.03. At 1 year out from surgery I requested being put on a PSA test schedule of once every 4 months instead of every 6 months. At two years out I requested to be tested twice a year instead of once a year. My Surgeon/Urologist had no issue with this. Sounds to me like your PSA results have been excellent.