Cribriform cells: Does their presence change treatment approach?

What was your pre-RP PSA?
Decipher score?
Thanks

First one in July was 26.3. Second one in August was 21.6. Last one in November was 25. No decipher score was set in any event.

I was a PSA 37 at my first test and then did the antibiotic protocol and only dropped to 33.7.

Did Prolaris and not Decipher. Was a 4.0 which is borderline high on their scale.

PSA < 0.006 since surgery, which was 11/30/23.

3.46

First of all, many thanks and my sincere appreciation to all that responded and provided insight and suggestions to my previous questions. I now have to come to peace with what I think is the best approach for me to deal with this thing.

My understanding is that Cribriform cells in prostate cancer are associated with more aggressive tumor behaviour and a higher risk of recurrence compared to other histological patterns. Their presence often correlates with worse outcomes, even in the absence of metastatic disease, as they can indicate a higher likelihood of local invasion and micro-metastasis. The question, then, is how effective is EBRT and Brachytherapy plus Firmagon when cribriform cells are present?

While that will work quite well to try and completely eliminate the cancer, there is no way to know how well it works. Everybody is different than there is no way to definitely promise you that it will eliminate your cancer. Same with surgery.

The company that makes the PSE test says that after treatment, they can tell whether there’s still cancer in your body. It’s not FDA approved for this, but you could at least try it out.

Thank you, again. I am assuming that since this tumor grew within a naturally low testosterone environment, the aggressive nature of this tumor was probably as a result to seek out testosterone alternatives. If it naturally is already used to a testosterone-challenged environment, surely there must be other components contributing to its growth. Not sure (but hope) that ADT might take care of some of the growth factors. I am banking on brachytherapy and EBRT to do the rest. Que sera, sera.

I was interested whether or not the PSE test could help inform my decision to remain on ADT - so I asked the company and here was their response

Thank you very much for your interest in the EpiSwitch(r) Prostate Screening (PSE) test. PSE was developed and validated as a prostate cancer detection test - not, as a residual or recurrent disease test.

However, i suspect that for legal reasons they may have no choice to respond otherwise. I emailed my MO and posed the same question. I’ll see what he has to say.

It seems that every time something out of the ordinary becomes individual reality. For instance, I have lived with naturally low testosterone levels forever. Yet, this tumor grew in this environment and became aggressive - I am assuming because it needed to find other forms of “nourishment”. I get dismissed every single time I mention it. Because… it’s not part of the usual narrative.

It is interesting that someone in here brought up the fact that they had a non-FDA approved way to find out if there is still cancer in your body.

Guess they are not ready to admit that yet, If they ever did bring it up.