It depends on what type of cribriform It is. If it is over .25 mm It is large cribriform, and that is quite aggressive.

Some doctors do recommend surgery for it, Though others recommend radiation with ADT.

Studies, such as the ProTecT trial analysis, indicate that radiation therapy paired with neoadjuvant androgen deprivation therapy (ADT) may be more effective for cribriform-positive cancer, with a 15-year metastasis risk of 8% compared to 26% for surgery.

Are you sure none of these other things were 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 as well.

If it is not large cribriform Than either treatment usually works fine. My brother had small cribriform And three years later after SBRT radiation, he’s doing fine.

There are other things that can make prostate cancer aggressive. What was his Gleason score? Did he have a clear PSMA PET scan? What was his PSA and how quickly was it rising?