← Return to Cribriform cells: Does their presence change treatment approach?

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Profile picture for northoftheborder @northoftheborder

The good news is that Gleason 3+4 is borderline: it's the lowest score that oncologists are even willing to call prostate cancer (it's lower risk than 4+3, which is also Gleason 7).

One likely recommendation is what they call "active surveillance", which means just more-frequent blood tests and scans to keep an eye on it. If PSA hits 10 or so (depending on the oncologist), they might consider trying some medication, but I think it would be less common to jump straight to surgery or radiation with only a 3+4 score.

The other good news is that the long-term survival rate for Gleason 3+4=7 with treatment is somewhere over 99%, I think.

There are probably cancer patients who need treatment urgently being triaged ahead of your husband, so in a sense, it's good news that they're not in a rush to see him, even though the wait is stressful. For me in 2021 it was straight into a hospital bed, being wheeled back and forth on a stretcher for a few days for endless tests and imaging while they tried to figure out what was happening, rushing into the operating room in the wee hours for 10+ hours of emergency surgery, then 3 1/2 months before I was stable enough to be allowed to go back home. Trust me, you don't want to be in a situation where they're eager to take him in a hurry. 🙂

In the meantime, many people in the forum have found this book very helpful for understanding prostate cancer, including your husband's situation. It's well worth a read (even though things have already changed a bit just since it was last updated in 2023.
https://www.amazon.ca/Patrick-Walshs-Surviving-Prostate-Cancer/dp/1538726866

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Replies to "The good news is that Gleason 3+4 is borderline: it's the lowest score that oncologists are..."

Thank you for your reply! So sorry to hear of your sad experiences. Sincerely hope all will be well going forward. Yes you are right about there being others who need the surgery more urgently than us and I do thank God that our case is not so urgent. My huband is very cool about it, atleast outwardly. Que sera sera. I am the worrying proactive one trying to find answers. In the meantime keeping my fingers crossed.

Thank you for the book recommendation. I have so many tabs open on my device from different sites as I research. I hope it has some current information on intraductal cancer. My husband is by nature a non worrier and I want to know everything.

I am diagnosed with GG2 and Gleason same 3+4=7 back in March. I’m just two weeks postop from a RARP. Prior to surgery I had biopsy and 12 of 18 samples were positive. The good news is the borders were clean. The bad news is my morphology are large cribiform pattern 4 and an atypical intraductal proliferation of suspicious nature.
So my provider remarked that this was the best case scenario choosing surgery as my biopsy showed the intraductal but not cribiform. So often PSA’s for a year minimum. My decision was removal, and after finding cribiform I’m convinced as well as my surgeon that if I watched this my outcome would not as good.
Michael Lyons, MBA, BSN, RN