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TAKE CHARGE of your prostate cancer and future - ASK QUESTIONS
Prostate Cancer | Last Active: 4 days ago | Replies (23)Comment receiving replies
Well more stupid questions, I really don't know what intraductal is? I am assuming it's all the duct work that go from testicle around bladder as well as seminal vesicles that eventually connect to prostate?
Not sure how to ask for review of biopsy as KUMC pretty much just don't respond to my questions anymore. I just hope they did good the first time. It seems the MRI, biopsy and PSMA all point to the same thing.
Edited= I have asked if there is a way to get second opinion on biopsy. The guy I sent request to does sometimes answer, he is a PA-C. He actually did the biopsy. I doubt it makes any difference as I said MRI, PSMA and decipher all say about same.
Replies to "@jeffmarc Well more stupid questions, I really don't know what intraductal is? I am assuming it's..."
No question is ever stupid IMHO. Only stupid people think that they know everything and do not ask questions ; ).
Prostate gland has myriad tiny ducts inside the gland that collect excretions before it is moved out of the gland and into much bigger ducts. When cancer cells invade those tiny ducts it is called IDC.
And one more thing - cribriform and IDC are completely different things and they do not always come together , actually have nothing to do with each other.
Regarding cribriform - those are also formations, they are not cells per se. Cancerous cells change the morphology and look part "empty" and make small circles that are "sieve like" - those are so called "cribrifom glands" or "sieve like glands" . Those circles can be measured under the microscope and the bigger the "circle" the worse it is since more mutations happen which in return cause that unusually big formation.
So - bottom line, one can have small cribriform, (not a big deal), big cribriform (big deal) and IDC alone or in combo with cribriform (big deal).
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@diverjer Well...rather than write yet another thesis, and to get a short, specific answer, I "asked Siri", who said succinctly:
"Intraductal carcinoma (IDC) of the prostate is a type of prostate cancer where the cancer cells grow within the ducts or "acini" of the prostate gland. This type of cancer is usually associated with a high-grade Gleason Score, large tumor volume, and advanced stage." The ducts themselves are responsible for transporting/moving prostatic secretions to the urethra. The ducts connect the glandular acini to the urethra allowing for the release of seminal fluid during ejaculation. The acini themselves produce the prostatic fluid which is the liquid component of semen. The fluid contains enzymes and citric acid. The acini themselves are lined with epithelial cells that secret the fluid into the ducts. IDC happens because of genetic mutations to the key regulatory genes that control that epithelial cell growth. Of note: A person can be initially diagnosed as low as a Gleason 3+3=6 on biopsy, but upon surgical dissection and microscopic examination of the entire tumorous areas of the prostate, will be reclassified to a Gleason 8 or 9 if IDC is detected. Yet another example of how, as I have coined:" The Gleason Score is just the tip of a large and looming iceberg, most of which is not seen or known until it is all examined on post-RP examination of the entire prostate.
Makes me wonder how many men with a Gleason 3+3=6 or 3+4=7 are, with misguided, overly-confident assumption, put on Active Surveillance, only to discover further down that two-year journey, that they have suddenly doubled, tripled, or quadrupled their PSA and have become a Gleason 8 or 9 after a second biopsy, and now have fewer viable options for successful treatment and longevity.