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I'm struggling with diagnosis.

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User
Posted 25 Sep 2025 at 14:38

Hi All,


I've just been diagnosed after a psa test recorded a 10.1.


My biopsy gave me 10 positive cores from 15, Gleason 3+4 stage 2 T2 but worryingly I have cribriform and interductal cancer as well according to the report. However my MRI showed my pelvis clear on any spread to bones and lymph nodes.


I'm being offered ADT and RT or a RALP.


My understanding is that with cribriform and IDC my chances are pretty slim as reccurance is very likely with one report I have read says average reccurance is 34 months.


This has been a total shock and I'm really struggling mentally at the moment as I had no symptoms suggestive of this wretched disease.


With such a bad prognosis I'm wondering which way to go.


Any feedback would be welcome.


Thanks.

Edited by member 25 Sep 2025 at 18:17  | Reason: add information

User
Posted 25 Sep 2025 at 20:36

Hi Steve.


I'm sorry that you've had to join the club, but welcome to the forum, mate.


Initial diagnosis is often the most difficult thing to deal with. Most of us had no symptoms and it is frightening to be told that you have cancer. You get various levels, scores and stages, thrown at you and you haven't got a clue what they mean. 


In the grand scheme of things your diagnosis is not bad. Your PSA is elevated but not drastically so. Your cancer is prostate confined and your Gleason score is intermediate, which is good news. I wouldn't over concern yourself with cribriform and intraductal factors.


In your case the majority of your cancer cells are 3 and you have a smaller proportion that are 4. Normally at Gleason 7 (3+4) you may have been deemed suitable for active surveillance but your cribriform/intraductal factors rule out this option. Dr Scholz explains this here:


https://youtu.be/-bgmkwpD4Zo?si=YpJkNmvgGxS7K9R5


Hopefully, whatever primary treatment you chose, will do the trick. Please don't start worrying about recurrence before you've even been treated. Just focus on, and deal with one thing at a time. 


You'll get lots of support here.


Good luck mate and please keep us updated. 👍

Edited by member 25 Sep 2025 at 23:48  | Reason: Spelling

User
Posted 25 Sep 2025 at 22:57

Hi Steve,
I admit I've never heard of cribriform and interductal cancer and I note your thought of having surgery for fast action and the possibility of RT later.  That's what I did and don't regret it.   On the other side the ability of RT to focus on the main while also treating outside the area might take out any stray cells.  For severe cases taking strong action can be a good response, such as RT, hormones and chemo, sometimes 3 strong drugs, triple therapy, if you can take it. If not dropping one.


I don't know why those variants of cancers have a tendency to come back if they're contained and you're a T2/3+4 which doesn't normally seem too bad.  My usual response to a question is to search the Dr Scholz, Prostate Cancer Research, channel on YouTube as he's more level headed than many.  There's nothing worse than people who give you extreme cases that make you anxious.


Diagnosis is always a stressful time and you can only take it as it comes and keep looking to getting past the next hurdle.  Knowing where you're going and having confidence in the decision can be a good stage and you might ring a nurse at Prostate Cancer UK or take time out from thinking too deeply if you can.  All the best, Peter


 

User
Posted 26 Sep 2025 at 00:28

Steve, you are most definitely in a position where successful treatment is possible.


Almost all of us, when first confronted with this reckon surgery is the first choice and particularly when the cancer is contained, this is a fair call. The option of surgery followed by RT if there's recurrence isn't quite as simple or clear-cut as it looks. If the recurrence happens to be in the prostate bed, or nearby, RT can be used to deal with it, which is fine. Also to be considered is that in the time it takes for recurrence to occur the spread might be in the form of mets more widely spread in the body and that's hard to treat. Intraductal prostate cancer seems more likely to spread in that manner.


Please seek the opinion of an oncologist as well as a urologist. Radiotherapy, perhaps combined with brachytherapy first up might be the option that treats the primary cancer and reduces your chances of recurrence to the greatest extent. The "best" recurrence is that which turns up in your prostate or prostate bed 10 years on and can be treated with focal therapy of some sort. The least desirable recurrence is that which occurs relatively quickly as widespread mets.


Jules

Edited by member 26 Sep 2025 at 01:03  | Reason: Not specified

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User
Posted 25 Sep 2025 at 20:36

Hi Steve.


I'm sorry that you've had to join the club, but welcome to the forum, mate.


Initial diagnosis is often the most difficult thing to deal with. Most of us had no symptoms and it is frightening to be told that you have cancer. You get various levels, scores and stages, thrown at you and you haven't got a clue what they mean. 


In the grand scheme of things your diagnosis is not bad. Your PSA is elevated but not drastically so. Your cancer is prostate confined and your Gleason score is intermediate, which is good news. I wouldn't over concern yourself with cribriform and intraductal factors.


In your case the majority of your cancer cells are 3 and you have a smaller proportion that are 4. Normally at Gleason 7 (3+4) you may have been deemed suitable for active surveillance but your cribriform/intraductal factors rule out this option. Dr Scholz explains this here:


https://youtu.be/-bgmkwpD4Zo?si=YpJkNmvgGxS7K9R5


Hopefully, whatever primary treatment you chose, will do the trick. Please don't start worrying about recurrence before you've even been treated. Just focus on, and deal with one thing at a time. 


You'll get lots of support here.


Good luck mate and please keep us updated. 👍

Edited by member 25 Sep 2025 at 23:48  | Reason: Spelling

User
Posted 25 Sep 2025 at 20:56

Adrian,


Thank you for your support and wisdom. I needed it as today has been particularly tough mentally.


I'm seeing my surgeon to discuss RALP next Tuesday so I will report back.


My thinking is if I do RALP first there is a chance to rid myself of the cancer and still leave other options open should it re occur.


I understand the potential implications of this and a 3+4 tilts me toward RALP.


Thanks again.


Steve

User
Posted 25 Sep 2025 at 21:27

Steve.


If you are considering surgery, this video may be helpful to you.


https://drive.google.com/file/d/1fyYTLZpxnB9HaR7O4xQ5Ff58Pj4Cn6ZB/view?pli=1


This one covers all treatment options and is worth viewing.


https://youtu.be/zYTU94-8pTc?si=1Z29_l8rbTwF6DHl


 

User
Posted 25 Sep 2025 at 21:35

Thanks Adrian,


I'll give these a look tomorrow.


Thanks mate.

User
Posted 25 Sep 2025 at 22:57

Hi Steve,
I admit I've never heard of cribriform and interductal cancer and I note your thought of having surgery for fast action and the possibility of RT later.  That's what I did and don't regret it.   On the other side the ability of RT to focus on the main while also treating outside the area might take out any stray cells.  For severe cases taking strong action can be a good response, such as RT, hormones and chemo, sometimes 3 strong drugs, triple therapy, if you can take it. If not dropping one.


I don't know why those variants of cancers have a tendency to come back if they're contained and you're a T2/3+4 which doesn't normally seem too bad.  My usual response to a question is to search the Dr Scholz, Prostate Cancer Research, channel on YouTube as he's more level headed than many.  There's nothing worse than people who give you extreme cases that make you anxious.


Diagnosis is always a stressful time and you can only take it as it comes and keep looking to getting past the next hurdle.  Knowing where you're going and having confidence in the decision can be a good stage and you might ring a nurse at Prostate Cancer UK or take time out from thinking too deeply if you can.  All the best, Peter


 

User
Posted 26 Sep 2025 at 00:28

Steve, you are most definitely in a position where successful treatment is possible.


Almost all of us, when first confronted with this reckon surgery is the first choice and particularly when the cancer is contained, this is a fair call. The option of surgery followed by RT if there's recurrence isn't quite as simple or clear-cut as it looks. If the recurrence happens to be in the prostate bed, or nearby, RT can be used to deal with it, which is fine. Also to be considered is that in the time it takes for recurrence to occur the spread might be in the form of mets more widely spread in the body and that's hard to treat. Intraductal prostate cancer seems more likely to spread in that manner.


Please seek the opinion of an oncologist as well as a urologist. Radiotherapy, perhaps combined with brachytherapy first up might be the option that treats the primary cancer and reduces your chances of recurrence to the greatest extent. The "best" recurrence is that which turns up in your prostate or prostate bed 10 years on and can be treated with focal therapy of some sort. The least desirable recurrence is that which occurs relatively quickly as widespread mets.


Jules

Edited by member 26 Sep 2025 at 01:03  | Reason: Not specified

User
Posted 26 Sep 2025 at 07:03

Thank you.


Steve.

User
Posted 26 Sep 2025 at 07:04

Thank you.


Steve.

 
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