Intraductal prostate carcinoma: What is standard treatment?

Posted by dodgerblue @dodgerblue, May 1, 2023

Seems this diagnosis is rare. E Does anyone know what the “standard of treatment” t” is the best approach to this issue?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

I didn't learn that I have intraductal PC until my recurrence about 10 months after surgery in late-2018. My surgeon never mentioned it. As mentioned above, I was also told that it was a more aggressive form of PC and that it only effected a low single-digit % of men. While having a Gleeson of 4+3=7, my PSA never rose above 2.0 before my surgery. I was told that I was part of a rare group for this as well (not sure if any relation to the type of PC).

I had surgery at Northwestern, then used my local Denver urologist for radiation treatment. I wish at this point I had gone to Dr. Kwon at Mayo, which is where I started treatment after the PC came back after radiation. I believe we should have waited to do radiation until the scan showed the exact location, rather than just radiate the prostate bed. My advice is also to seek the best treatment facility, even if you have to travel, as these care centers are much better versed on the latest tech and PC research has come a long way, even over the last 5 years. Dr. Kwon/Dr. Davis did spot radiation to a lymph node and I am coming off 18 months of ADT. The hope is for a cure or at least kicking the can down the road until the next treatment. Doing pescatarian diet (see the new studies that have come out this year on plant-based diets and PC) and 45+ minute of exercise everyday. Should probably drink less wine and cook more at home, but life needs to be enjoyed!

Hope this helps. I wish you the very best!

REPLY
@colleenyoung

@cheriekhan, I moved your question about intrductal prostate carcinoma to this existing discussion:
- Intraductal prostate carcinoma: What is standard treatment?
https://connect.mayoclinic.org/discussion/intraductal-prostate-carcinoma/

I did this so you can read the previous posts and connect with others with this type of prostate cancer. You might also appreciate this related discussion:
- Proton beam vs IMRT for intraductal carcinoma of the prostate
https://connect.mayoclinic.org/discussion/proton-beam-verses-imrt/

What ADT medication will be used?

Jump to this post

Thank you.

REPLY
@cheriekhan

My husband's biopsy was reread by MSK and one of the cores said the following, "Focally suspicious for intraductal carcinoma (separate core)." He has been diagnosed with stage 4A prostate cancer with one pelvic lymph node involvement that I have written about here. Moving ahead with ADT then internal and external radiation. What does this new diagnosis of 'intraductal carcinoma mean for his treatment, cure etc? TIA

Jump to this post

@cheriekhan, I moved your question about intrductal prostate carcinoma to this existing discussion:
- Intraductal prostate carcinoma: What is standard treatment?
https://connect.mayoclinic.org/discussion/intraductal-prostate-carcinoma/

I did this so you can read the previous posts and connect with others with this type of prostate cancer. You might also appreciate this related discussion:
- Proton beam vs IMRT for intraductal carcinoma of the prostate
https://connect.mayoclinic.org/discussion/proton-beam-verses-imrt/

What ADT medication will be used?

REPLY
@cheriekhan

My husband's biopsy was reread by MSK and one of the cores said the following, "Focally suspicious for intraductal carcinoma (separate core)." He has been diagnosed with stage 4A prostate cancer with one pelvic lymph node involvement that I have written about here. Moving ahead with ADT then internal and external radiation. What does this new diagnosis of 'intraductal carcinoma mean for his treatment, cure etc? TIA

Jump to this post

What type of ADT? Chemical or surgical?

REPLY

My husband's biopsy was reread by MSK and one of the cores said the following, "Focally suspicious for intraductal carcinoma (separate core)." He has been diagnosed with stage 4A prostate cancer with one pelvic lymph node involvement that I have written about here. Moving ahead with ADT then internal and external radiation. What does this new diagnosis of 'intraductal carcinoma mean for his treatment, cure etc? TIA

REPLY
@colleenyoung

@dmd1atl, you're right that there's less information about intraductal prostate cancer. I'm moved your post to this discussion about this type of cancer:
- Intraductal prostate carcinoma: What is standard treatment?
https://connect.mayoclinic.org/discussion/intraductal-prostate-carcinoma/

I did this so you can read previous posts and connect with members like @robertkerr @dodgerblue @spryguy @pauljay @hammer101 @rickp1 to ask questions.

Has you team suggested which treatment would be best for you? Are you looking for a second opinion?

Jump to this post

Dodgerblue here. Last 5 months have been very stressful. I’ll try to shorten it. I was trying to pick from surgery versus radiation for intraductal cancer. Strangely, radiation oncologist suggested surgery, my surgeon suggested radiation because of my age(75) and potential side affects. Second opinion from a leader in robotic surgery suggested since a Psma pet scan indicated I was clear, other than the prostate, he would suggest surgery. Acknowledging, “Yes, I am a surgeon but you will never definitively know what you are dealing with, unless you have surgery to remove and have it analyzed.” He said he had seen Intraductal, but it never ORIGINATED in the prostate. I had surgery and the pathology report came back showing aggressive, high level cancer, but no INDICATION of “INTRADUCTAL carcinoma”. All indications are it was contained within the capsule. Yes, I have side affects (progressing!), but 2 psa blood tests have come back as “non detectable”. I realize this most likely is not the end of the journey, but I am so thankful for what I’m calling divine intervention. I appreciate this forum and will continue to monitor it closely and although I don’t know any of you personally, but my almost 13 year journey and many, many hours spent in a local support group keep me focused and my thoughts and prayers will continue “all of youse directions.”

REPLY
@dmd1atl

Intraductal (IDC-P) treatment options after RP
64 y.o. - PSA 4, five biopsies positive, Gleason 4+3 = 7, elected RP (procedure performed 11/1) - post-op pathology indicated presence of IDP, invasion of both seminal vesicles and one lymph node (8 lymph nodes removed). Started ADT 1-week post-op (Lupron) - referred to radiologist. Not a lot of available info on IDC-P post-RP. What is state-of-the-art treatment (radiology, type of beam, etc) and your experience (if applicable)? Thanks in advance.

Jump to this post

@dmd1atl, you're right that there's less information about intraductal prostate cancer. I'm moved your post to this discussion about this type of cancer:
- Intraductal prostate carcinoma: What is standard treatment?
https://connect.mayoclinic.org/discussion/intraductal-prostate-carcinoma/

I did this so you can read previous posts and connect with members like @robertkerr @dodgerblue @spryguy @pauljay @hammer101 @rickp1 to ask questions.

Has you team suggested which treatment would be best for you? Are you looking for a second opinion?

REPLY

Intraductal (IDC-P) treatment options after RP
64 y.o. - PSA 4, five biopsies positive, Gleason 4+3 = 7, elected RP (procedure performed 11/1) - post-op pathology indicated presence of IDP, invasion of both seminal vesicles and one lymph node (8 lymph nodes removed). Started ADT 1-week post-op (Lupron) - referred to radiologist. Not a lot of available info on IDC-P post-RP. What is state-of-the-art treatment (radiology, type of beam, etc) and your experience (if applicable)? Thanks in advance.

REPLY
@rickp1

Johns Hopkins also noted intraductal and "some large cribriform" on my 2nd opinion. My current urologist hasn't really given much weight to it and said it "doesn't change your course of treatment" . I'm really confused and conflicted over this and not sure how to proceed.

Jump to this post

@rickp1, what treatment will you be having?

REPLY

Johns Hopkins also noted intraductal and "some large cribriform" on my 2nd opinion. My current urologist hasn't really given much weight to it and said it "doesn't change your course of treatment" . I'm really confused and conflicted over this and not sure how to proceed.

REPLY
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