Intraductal Prostate Cancer: Any info about recurrence rates?

I'm not completely familiar with that type, but, I'd wager future treatment is largely the same as any form of PC. They'll keep an eye on the PSA if it shows to be trending upward the next step would likely be radiation and / or Androgen deprivation therapy (ADT). At least that's what happened with me. If the PSA gets high enough to indicate it, maybe a PSMA PET scan to check for any spread.

I had a fairly high PSA @13 at time of surgery, Gleason 3+4. Surgery went well, just a little late and the path report showed some Perineural and Lymphovascular invasion. (they also removed the closest Lymph node to check, that was clear.) My PSA started to trend upwards and we went straight to 39 IMRT radiation treatments and 2 years of ADT. From what I'm reading here, some docs like to go to triplet therapy. I'll let you look around for that, I'm not overly familiar.

There are definitely next steps, and a lot of fight left should you need it. Hopefully that's not the case.

Best of Luck to you.

Are you on ADT? People who have intraductal have a shorter life expectancy than those without, though it usually coincides with a higher Gleason score.

Are you seeing an oncologist? If you want to have the best chance of a long life a Genito urinary oncologist is the best to work with, they specialize in prostate cancer. A medical oncologist works with all different cancers and can’t specialize.

Going to a place like the mayo clinic would give you a better chance of long-term survival as they will know the best treatment for you.

Layman out on a limb here: I had extraprostatic extension (EPE) post op pathology. It was a negative finding and in fact my PSA was "persistent " ; not below .19
So I had Salvage Treatment of radiation and short-term ADT and have been undetectable for a year.
Your finding may foretell an ncreased risk of BCR at some time; or not.
Follow the PSA tests and IF your PSA rises then there are treatments.
Hard not to be concerned, but so far so good and it may or may not recurr.
Be positive and enjoy your current status; undetectable.
Best wishes to all.

My pathology also indicated Intraductal was present. I was a Gleason 4+3, Stage 3B. It's been just about 2 years since my surgery. I haven't needed any additional treatments at this point. My PSA tests have remained undetectable since the surgery. However, I'm aware that there is a much higher risk of biochemical recurrence and it's considered a very aggressive type of prostate cancer. At this point, I'm just trying to stay positive and enjoy life.

Thanks so much for your quick response. That is excellent news - glad you are doing well. I was told by Doctors if contained and low Gleason 7, intraductal doesn’t escape prostate? Did you have any other adverse features in pathology? I think intraductal is only aggressive with higher Gleason score? What did your Docs tell you about it? Stay well and I appreciate your support and responses!!

Yes, I did have other adverse features. Cribriform was present. I also had bladder neck and seminal vesicle invasion which is why I was classified as Stage 3B. However, all margins were negative and lymph nodes were clear. After my biopsy and prior to surgery, my doctor said that she was treating me like a Gleason 8 because of the Intraductal and Cribriform even though I was technically a Gleason 4+3. She was able to do the surgery within about 8 weeks after my biopsy. I remain hopeful that the cancer was caught just in time. Stay well too!

I'm 71 and had NS RALP late June 2024 at Mayo Phoenix. My pathology report also showed Cribiform and IDC, 3+4=7 grade 2. But the margins were clean with no invasion or extension. At my 3 month visit my PSA was .04 and the Mayo MD I saw at 3 months (not my surgeon) said I had about a 95% chance of no reoccurrence at 5 years, which was generally in line with the 92% number I got using Sloan Memorials website: https://www.mskcc.org/nomograms/prostate/post_op
I neglected to specifically ask about the Cribiform and IDC at my 3 month visit, but I had already reviewed my pathology report and researched them so I kind of expected it'll come down to seeing whether the PC comes back. With Cribiform and IDC in my pathology report I'll be particularly diligent in getting PSA's every 3 months for longer than normal since it'll be important to not delay if it comes back. However, I'm not a medical professional nor do I have any expertise in this area, so this is just my layman's thoughts on the matter as it relates to my course of action. I invite anyone on this forum to weigh in if they feel I'm off base as I'm just trying to plot the best course I can with the cards I've been dealt. If I'm missing something, I'd really like to know. Best wishes to all.

@biker70, I think one always has a fear of recurrence with cancer. You may also appreciate these related discussion about intrductal prostate cancer https://connect.mayoclinic.org/group/prostate-cancer/?search=Intraductal%20&index=discussions

Last week I attended a seminar with UCSF where they discussed redoing the way the Gleason score is handled. They made the point that if you have intraductal, you almost definitely have cribriform. Was that mentioned to you? There’s also a chance you have large cribriform which is over .25 mm. If they did not mention cribriform you should ask him to review your slides again and look for it. You might get a second opinion on the slides even That is something I did..

They made a point that a Gleason seven is not the same if you have cribriform or intraductal. It is much more aggressive than a seven without it.

I’m Including a slide that discusses it

Is there any way you can send us full slide deck or additional notes from conference? I would like to forward more details to my urologist and oncologist. Thanks