I was 4+# w/cribiform. I spoke with 5 doctors. Each explained to me that the cribiform took me out of AS possibility. However, my circumstance, (PSA 8.6, 5/15 positive, all in identified lesion area and only 2 that were 50% 4, and a primary single lesion of 3mmx3mmx7mm , negative PSMA, intermediate decipher, no mutations on germline tests, it was felt that ADT wasn't necessary.
The cribiform was definitely a negative, but combined with other "positive" factors, it was felt that SBRT at 37.5 gy should provide sufficient tumor control.
PSA has not behaved like I had hoped.- a 3 point spike immediately after treatment, then a 60% drop by 6 months, followed at one year by the "radiation bounce" but the trend has overall been down, so MO and 2 RO's feel that at this point treatment was effective, but I may need 2-3 years to nadir.