@scary1
I would definitely want to get a second opinion on this. IMRT radiation may make more sense based on the problems your husband has. Cribriform is Probably going to make it so that his cancer will come back if he has not treated To the prostate and the prostate bed and lymph nodes in that area.

That is a very young RO you are working with you really need to speak to someone else that has a lot more experience with what’s going on. If you can’t get that answer at Duke, you need to go somewhere else. Here is the name of a top notch Oncologist that is not far from you. It will be worth going the couple hundred miles to see this doctor and get an Opinion from an expert.

Bethesda Maryland
Sibley memorial hospital
Johns Hopkins, school of medicine
GU Oncologist
Dr. Channing Palmer

With all the cribriform Your husband has a Gleason nine you need more choices. They say T1c But the cribriform Makes it much more aggressive.

Were any of these things found in the biopsy intraductal, ductal,, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer much more aggressive. You need to take a close look at the biopsy and see if any of these are found.

Orgovyx and Nubeqa Are a good choice with the serious case he has. I’ve had prostate cancer for 16 years had surgery and radiation and three more reoccurrences after that. I’ve been on a few different drugs and then now on Orgovyx and Nubeqa And that has kept my PSA undetectable for the last 28 months. I do have a genetic problem, BRCA2, Which keeps my cancer coming back. If you can’t get Nubeqa (Darolutamide) Approved apalutamide Would be another good choice and would definitely be approved. It has more side effects, but works very well for most people.

Has your husband had a hereditary genetic test? Is there a breast cancer, Prostate cancer, or Pancreatic cancer in his family. Those can be the cause of genetic problems. You don’t mention his age and that is a definite factor in treatment. Genetic problems can lead to early reoccurrence.