We talked to BOTH - surgeon AND radiologist, BOTH said RP is a better plan for localized cancer with cribriform and IDC , of course given that person is healthy enough to go through surgery and recovery.

Cribriform cells are highly aggressive and very changed in morphology. Their DNA has many mutations and can evade radiation. IDC presentation is also rare and complicated formation and points to aggressive nature of cancer. All in all, it is better to physically remove those if at all possible before they spread outside of the prostate gland.

Also, if one has such an aggressive cancer it is comforting to know that IF down the road cancer appears again, one has back up line of defense- radiation. Once you have radiation you can not have it the second time. Radiation can fail first time around, the same way RP can fail in eradicating cancer, but after failed RP one has radiation as an option IF needed.