Surgery or Radiation if large cribriform found in biopsy?

@sandguy
I would strongly advise to do both genetic tests - one for possibly inherited genes (samples taken by swabbing inside of your mouth) and the second one that checks genetic mutations in prostate gland itself. Ask your surgeon to send pathology samples for genetic testing and also - did you ever have Decipher test done ?
All 3 tests will give you valuable information about the type and aggressiveness of your cancer which will effect choice of treatment IF you ever have BCR. If your cancer has aggressive features regardless of gleason score you might be advised to have perhaps a longer ADT during RT. It is always good to have extra information. ; ) Some treatments work better with certain mutations than others which might get handy in the future.

If you have any upward movement in uPSA, it would be prudent to have test done every month. We did it and it was very helpful in preventing PSA going above 0.2 BEFORE treatment starts. If you wait for 0.2 than by the time they do all preparations and tests your PSA might go up well above famous 0.2 .

Best wishes always 💗 : )))

@sandguy Sandguy, you mentioned that your report on the prostate sample from the prostatectomy indicated that Cribriform glands were present but no indication of size. I had the same type of report from a biopsy. The curiosity and fear of large glands finally drove me to ask the pathologist directly if there were large Cribriform glands in the biopsy slide. I got a revised report, within 3 days, stating that no large glands were observed. I recognize that the biopsy is just a small sample and there may be large Cribriform glands elsewhere, but at least my level of anxiety is reduced.

I think the pathologist was a bit unsettled that the request came from a patient rather than the doctor that performed the biopsy. I considered asking that doctor to make the request but since I had abandoned him due to poor performance on some administrative tasks I thought that was impractical. I am not in the United States, perhaps the protocol in the Untied States is stricter and you may have to ask the doctor that performed the prostectomy to request the revised pathology report.
Regards, Overage

@sandguy
You absolutely should get tested. There’s a high percentage of Ashkenazi Jews that have BRCA.

I’m 49% Ashkenazi, With a father who died of prostate cancer and is Swiss Italian, while, my mother side had both sisters with breast cancer, One dying, a cousin Dying of breast cancer,and My mother‘s father Dying of pancreatic cancer in his 40s.

An hereditary, genetic test is covered by insurance.

I did not find out I had BRCA2 until 10 years after my first treatment for prostate cancer.. You have to realize that there is a future treatment available, a PARP inhibitor, If you have BRCA. You probably don’t want to do that treatment early because the side effects are quite severe. But it’s another treatment that can give you more time.

Finding out if you have BRCA can also explain why your cancer keeps coming back, If it does. Mine has come back four times.

Intraductal & cribriform see PCRI:

@sandguy I would definitely get the Ambry test prescribed, just to eliminate one more question. I did just did that, and it's good to know, not only for me, but my daughters as well