Diagnosed with prostate cancer recently.

Cribriform pattern is indicative of possibly more advanced disease. If he was getting radiation, they’d boost the radiation to hit it harder and use ADT for a longer period.

What were his PSA and Gleason score?

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?

@brianjarvis
Hi. Thank you for the response. His PSA in 12/25 was almost 4.
The highest Gleason score was a 7.
He has multiple areas of cancer in his prostate and an area of cribiform.
We didn't get much info regarding the cribiform. Or much info at all.
He's scheduled for prostate removal next month.
I'm concerned with the lack of information from the surgeon.

@jeffmarc
Hi Jeff.
I wish I had more information on the biopsy. He recently had a PSMA PET SCAN, no bone spread.
Surgery is next month for prostate removal, lymphectomy
& I'm hoping another biopsy during surgery??
I've scheduled an appointment to discuss this with the surgeon. It's very difficult to get information.
I appreciate your feedback.

@myboo2u It’s important that all lines of communication are open. This is one of the most important decisions he’ll ever make; he’ll have to live with this for the rest of his life.

His urologist should’ve had this level of discussion with him —> This is a 2023 presentation out of Stanford University that’s titled “Penile Rehab: Optimizing Recovery of Erectile Function after Prostate Cancer Treatment.” They talk about things to do before and after surgery: https://youtu.be/aRp1NXjPGLE

@brianjarvis, Hi Brian,
I'm sorry, the PSA was 4.6.
The doctor never gave us much information.
I have to say that I'm scared and I'm not sure how to discuss this with the doctor/surgeon.
He is scheduled for prostate removal and I think that this is the best option. The surgeon is well respected in robotic surgery. I just want to know more.
I appreciate you responding.
Thank you.

@brianjarvis
Thank you Brian. I will look at the research with my partner.
I appreciate your help.

@myboo2u
You can get a second opinion on the biopsy. Does cost $500 but this doctor is an expert at it and can spend a lot of time on the phone with you talking to him directly to discuss what’s going on.

If you decide to get a second opinion biopsy with him, he will take care of getting the tissue that he needs to do the evaluation.

Dr. Epstein biopsy
https://advanceduropathology.com

@jeffmarc
Hi Jeff. Thank you for the information.
The biopsy was done only on his prostate. He will be having prostate removal and a lymphectomy next month.
I really can't believe that I don't know what to ask the surgeon.
The time we are given is so limited.
I know he's a good robotic surgeon. But I hate to be in the dark about so much.
I'm afraid he will be offended if I ask for the biopsy to be sent off..
I was planning to discuss having a another biopsy done during the actual procedure. This was recommended to me by a friend. I'm not sure what size the cribriform is but I will find out. His PSA jumped rather quickly from 3.5 to 4.6 roughly and he's symptomatic.
I think we have spent about 20minutes in total with the surgeon. This includes the a discussion about the biopsy and PSMA results.

Should other areas be biopsied?
PSMA showed no bone spread and lymphectomy will happen during prostate removal.??

I will reach out to the office that you suggested.
Thank you.
I appreciate the help.

@jeffmarc
Hi again, Jeff.
I was looking at the biopsy results for my partner. The cribriform is listed as 3.5 cm. Can this be accurate?
I just got extremely scared.
I'd greatly appreciate your thoughts.
Melinda