Well, you sure have come up with a mouthful of issues. This sure shows a biopsy can’t find everything, Can’t find anything sometimes it seems.

I don’t know if you noticed us talking about this earlier, but when somebody has cribriform and intraductal There doesn’t seem to be any treatment that really works fully. I’ve been searching all over for this, this year, and have not been able to find a solution to tell people. Nonfocal extraprostatic extension, and multifocal positive margins shows that the cancer is outside the capsule in multiple sites.

Over the last five years, I’ve heard from dozens of people that have had surgery and none of them had the multiplicity of issues you have.

This sure sounds like a case where adjunct radiation would make sense, Not waiting for salvage radiation.

I would think that, even though you are a 4+3 a Genito Urinary Oncologist Would want you on ADT and an ARPI as soon as possible. And that’s the situation you are in you need to find yourself a top notch GU Oncologist To guide your treatment. Having both cribriform and intraductal Would put a five in your Gleason score according to UCSF.

If I knew where you lived I Might be able to give you the names of some doctors in that area. This is not something you can just let go. This needs to be addressed immediately by the right oncologist, and not just a medical oncologist.

Have you had hereditary, genetic testing?

Did you get a PSMA PET scan? That is something you really need to get immediately to find out if that cancer has spread outside the prostate bed. Salvage radiation treats the prostate bed, not tumors, found elsewhere.

You definitely need some expert advice. Tomorrow at 5 PM Pacific time Ancan.Org has their Weekly advanced prostate cancer meeting. They’ve been helping prostate cancer patients for 15 years to resolve treatment of prostate cancer. If you got there 10 minutes early, they would talk with you first and give you advice. You need to install GoTo meeting in order to attend these conferences. You put in answercancer for the name of the meeting, to join.