The results are about the same with either RARP or Radiation, But how old you are could be a factor in what’s the best decision?. Radiation has a chance of causing cancer in other places 10 to 12 years after you get it. If you are in good shape surgery works into the 70’s. If you have radiation, make sure they do nerve sparring surgery, if possible.

There may be options other than surgery, Focal Therapy, NanoKnife, cryotherapy, HIFU,, TULSA-PRO. Not sure if they will be acceptable with IDC, but the doctors would know. You can have radiation after having that, Even surgery.

With IDC, If positive surgical margins or extraprostatic extension are found after prostatectomy, radiation to the prostate bed can reduce recurrence risk.

It would probably make sense to go on hormone therapy after surgery or radiation. You have a type of cancer that Causes reoccurrence. Hormone therapy will almost definitely stop anything from growing for a while. After you are undetectable for a year, you could consider going on holiday. Ask your doctor about these issues, I am not a doctor just things I’ve heard.

One thing you should realize is that there is prostate cancer in your bloodstream. This is one of the things that can lead to reoccurrence and why hormone therapy makes sense.

I’ve read that radiation and hormone therapy drugs are not effective against intraductal and cribriform. Is there any truth to that or is it nonsense?

ive read in a clinical study that adt may not be as effective vs IDC. not sure about radiation. just not a lot of proven idc treatment that i can find.

With those cells and high Decipher score, I would advocate for surgery first. You have to get that gland OUT. Surgical pathology, lymph node analysis will give a better idea of where you really stand.
But if you are in your late 70’s or early 80’s, ADT + radiation might be less traumatic and just as curative considering your expected life span

Hi, my husband has IDC and some cribriform in one single core, so I did bunch of reading. IDC, cribriform and PDA are just recently recognized as special entities with different predictive implications. There are a bunch of studies now done but none have definitive answers YET . One thing that is sure is that all have unfavorable effect and that is because those variants have a lot of mutations present and those cells even possibly form self protective micro environments. All in all , there is a study that supports RP and we will follow that study. Of course there are some studies that show no specific benefit of RP but we will choose RP. Why - because those cells often evade standard therapies due to so many mutations so by using pure logic physically eliminating those lesions might help. I mean, what is person to do at this point ? There is consensus that those cohorts of patients need novel approach but no new or personalized protocol exists at this point. The ONLY concrete study that showed definite result was in comparison of different ADT drugs and conclusion was that Abiraterone is superior to Docetaxel as first-line treatment for IDC-P . I am completely new to this murky world of PC so I have zero knowledge about ADT protocols and I hope others will jump here to explain what Abiraterone is and how it differs from regular ADT.
BTW - this study also mentioned that 28% of IDC-P positive cases on needle biopsy were actually IDC-P negative at the time of RP (?!?????). WHAAAAA Somebody just shoot me already ...

how do you know that your husband foes not have yhe "inherited mutations"?

I didn’t see you say that you had a PSMA-Pet Scan? That will tell you a lot about your cancer, and its spread. Without that, I don’t see how you can decide on your options. If it has spread widely, you might need more systemic choices.

clean pet scan.... whew