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Ductal cancer Gleason score of 8 Radiation/hormone therapy or surger
I’m looking for advice from anyone who has or has or has had DUCTAL prostate cancer because it is a rare and aggressive type. I’m an active 71 year-old who was just diagnosed with ductal prostate cancer, a rare and aggressive cancer that spreads easily. PSMA scan showed no spread outside of the prostate. The surgeon recommends surgery because he says that leaves the option of radiation after surgery if needed, but that it is difficult/impossible to do surgery after radiation. He said there’s about a 50% chance of the cancer returning after surgery.
The radiation oncologist recommended radiation/hormone therapy for 18 months. He also said there’s 50% chance of reoccurrence/spreading, but that surgery has a 70 to 80% chance of reoccurrence. He also said the surgery wouldn’t be needed after radiation because they rarely see cancer return in the prostate because it usually spreads elsewhere in the body. But if it were in the prostate, he could do more radiation or cryotherapy. Anyone who has had ductal cancer would you please give your input? I need to make a decision soon.
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I would suggest that being reasonably confident with whatever treatment path you choose will be important to your emotional well being as you go forward. Since you're not entirely sure which path is best for you (and I certainly don't know as well) if it's an option available to you I'd suggest getting a 2nd or even 3rd opinion (preferably from a recognized cancer center of excellence). It might give you an additional degree of confidence in whatever path you choose so you can be at peace with it and not have any regrets later. Best wishes to you and yours.
Yes ductal is very aggressive, You don’t mention your Gleason score and that can be a factor in aggressiveness as well. After listening to people with new cases of prostate cancer weekly for four years I have never heard someone say they have ductal cancer, definitely rare. Lots of intraductal, not one case of ductal.
Having surgery removes the ductal cancer, but the chances are you will have reoccurrence if you don’t do more treatment, like hormone therapy. That will give you the best chance of avoiding reoccurrence.