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Surgery or Radiation if large cribriform found in biopsy?
Prostate Cancer | Last Active: Jul 10 9:39am | Replies (35)Comment receiving replies
@notpetecrowarmstrong
I wish it was that simple. Other tests have shown that surgery works better with cribriform. UCSF had a seminar about cribriform and specifically said there was a problem using radiation. That’s why I mentioned adding brachytherapy to IMRT.
Here is the link to the UCSF webinar were they discussed the fact that radiation is not effective enough.
https://www.urotoday.com/video-lectures/a-journal-club-for-patients-with-prostate-cancer/video/mediaitem/4452-unfavorable-histology-classification-aims-to-reduce-unnecessary-treatment-journal-club-jesse-mckenney-cornelia-ding.html
Replies to "@notpetecrowarmstrong I wish it was that simple. Other tests have shown that surgery works better with..."
@jeffmarc Th link you provided is for a discussion on modifying the grading system. I see nothing in that article on the benefits of surgery versus radiation for prostate cancer with Cribriform. Please post the proper link so that we can see the evidence.
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@jeffmarc I'm certainly not suggesting anything is simple. I think my comment was clear that this is the potential start of a shift but not definitive.
That UCSF webinar predates the studies I cite by a full year, so they were unaware of the findings. The studies also reference RT+ADT, not RT alone.
I've spoken directly with three oncologists who've all said that the findings published in the past several months have had a real -- but preliminary -- impact on how MOs think about treating cribriform.
And for what it's worth, I had surgery myself and then had cribriform glands identified in my post-op slides, but they were not previously IDed on my biopsy and so that didn't factor into my decision-making.