How Many Ductal Prostate Cancer Fight... - Advanced Prostate...

Advanced Prostate Cancer

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How Many Ductal Prostate Cancer Fighters are Here?

TottenhamMan profile image

Just wondering how many of us here have been diagnosed with Ductal Prostate Cancer? I was diagnosed with Ductal Adenocarcinoma in Oct. 2020 and I’m curious as to how other Ductal brothers are faring out there.

32 Replies

Of all the Ductal Cancers[Ductal, Intra-Ductal, Cribriform]--->represent @ 3.2% of all Pca Cancers, other studies indicate that Adenocarcinoma Represents 99%, And there is also a very small % of Small Cell/Neuroendrocrine--->upon DX.So how does 99% and 3.2% add up to 100%??? Plus less than 0.2% for Small Cell type.

The answer is those that are DX with Ductal's also have Adenocarcinoma, at the same time.

So a good Mathematical Estimate is that you are in the 3,2% of all men that have Ductal, but you also have in your Pathology Report Adenocarcinoma, as well---concluding that out of the 12,000 Members Here--->@ 380 have Various Ductals.

Best initial treatment is no doubt a Prostatectomy-->I prefer Open verses Robotic -->and that is another subject. There is enough information, indicating the Ductals have an ability to have a higher % of cancer cell survivors after a full course of Radiation. Some may go dormant in their protection mode, or just shield themselves by some unknown process. Oh you will kill 90+% of them, but the remaining Ductals I call super survivor Pca Cells/or they are Stem Cells.

Even though there are differences of opinion, I am on the side of those that when having both Adenocarcinoma and Ductal Pathologies---that movement of the cancerous cells act differently, in terms of their movement out of the Prostate, to infect other parts of the body.

This difference, is that Adenocarcinoma tend to move much faster than Ductal---that if lets say your Pca infected your Seminal Vesicles as just one example---you usually find that it was the Adenocarcinoma that did the infecting, and that the Ductal's remained behind. If one waits too long the Ductals will move on out also-->and this becomes a real problem, as they tend to morph into Neuroendrocrine Pca Cells-->not Good!

As I indicated, in past responses not in any of my posts that I was DX with Ductal Cribriform, along with Adenocarcinoma. Even though I had escape of Adenocarcinoma, what is called Micro-Metastasis, most likely, I Pray, we got the Ductal thru Open Surgery, when the prostate and anything else that was suspicious was removed. The rest of me was treated systemically with Drugs and Supplements. The Surgeon took good Lymph Nodes in the Surrounding area for caution[Just In Case]. And 6 years later still holding fine, using an in and out Vacations/ADT program---with over 75 Straight PSA readings, of being Undetectable.

I have a bit of an Advantage---as my Head of my Pca team MO--his Father has Ductal Pca, and based on DNA Mutation evaluations, my Doc. has a 50% chance of also acquiring it---so my MO, has his Father in Remission, now 8 years. God has Blessed me in leading me to the right MO.


DMohr011 profile image
DMohr011 in reply to Nalakrats

Good info Nal. Who is your Dr? Seems you are in great hands! Also looks like you are the supplement King from other posts. If you were limited to 10 supplements, what would those be? Probably been a post out there already you can link to?

Nalakrats profile image
Nalakrats in reply to DMohr011

He is Head of Prostate Cancer Research and Development at the Levine Cancer Institute in Charlotte, and his large group of dedicated Medicos to Pca, work closely with J. Hopkins and Duke--->especially with Dr. Denmeade on BAT, and with Dr. George, on Glutamine Inhibitors, and other things--one I cannot discuss, as the First patient in the world, is going to start a treatment using Levine, as the Apex.

As to top 10--I get about 40 requests a year for something like yours or the best supplements to use, or what my program is. And I do not usually respond---I respond to individual supplements that a member here may want to discuss. There is a reason---we are all different, and what I use--is--->or what I believe my needs are--or what I am targeting, would be different for you, or anyone---granted there would be lots of overlap, but Priority Might be Different---and the Supps. I use are married to off label drugs.

So it gets complicated--and I cannot just throw things out.


Thanks for the information Nal, you are an icon here and a shining light for the Ductal team. You give us all hope.

MateoBeach profile image
MateoBeach in reply to Nalakrats

Wise judgement 🙏

Nalakrats profile image
Nalakrats in reply to DMohr011

pjoshea13, is a great source, and if you think I am king, than Patrick, is for sure is a major source. The man has over 1,000 posts? I do not think he would give you a list either--but you can try---why are you doing TURPS, when the whole Gland probably needs to come out? You do not want your Ductal Cancer part of your Pca, to escape to outer regions outside of the Capsule.


DMohr011 profile image
DMohr011 in reply to Nalakrats

Appreciate the honesty and totally understand.

Turps were needed to keep me pissing as umor had givin my eurethra a bend and blockage. Non operable due to it being stuck to or grown into the rectum. No separation can be seen. Big bulge that I could feel, and easily seen from the signoid scope.

After three months of ADP, the do not feel the bulge., and that is a positive.

My first follow up scans are scheduled for next week.

Nalakrats profile image
Nalakrats in reply to DMohr011

That is good news---taking out part of the rectum, is not something that you would want to go thru.


I looked at my initial pathology report and it was as follows:

Grade group: 4/5

Gleason score:4+4 =8

Cribriform Pattern: Absent

Intraductal Carcinoma: Absent

Periprostatic Fat Invasion: Absent

Cancer Extent: 60% of of all tissue

Pattern 4 accounts for 100% of tumor

There is abundant papillary projections with pseudostratified nuclei consistent with Ductal morphology. Immunostains confirm prosaic origin (AMACR, PSA, and NKX3 1+). Although PIN and HMK show scattered basal cell staining, given the extent of the tumor and the absence of discrete confined ducts, a diagnosis of Ductal adenocarcinoma, gleason pattern 4 is preferred.

Extensive multi focal T2 hypointense tumor with restricted diffusion. Seminal vesical insertion bilaterally as well as the periprostatic fat, invading the left neuromuscular bundle, but no muscle invasion.


Seminal Vesicles: bilateral invasion of the of the bases of the seminal vesicles.

Neurovascular bundles: Definite left neurovascular bundle invasion at the base and apex.

Bladder neck: Normal

Membranous Urethra: Normal

Lymph Nodes: 0.9 cm enlarged lymph node along the right internal iliac vascular bundle.

Bone Marrow: Normal

Rectal Plate: Normal

As with the DMohr011 post, no one explained this to me despite me asking a number of times with the the urologist and the oncologist.

Any help with the translation, other than I have Ductal cancer, would be helpful.

Sometimes it is a blessing to be unknowing. Just know your cancer is aggressive, and standard SOC, that most Doctors will use to treat, may be of little to some moderate success. if the Ductals get out of the Capsule, and enter other body areas, there will be a war, to overcome them.


Thanks for the upbeat positive message. Should I blow my brains out now?

Best to know, you are not dealing with a scratch on your arm. I had to swallow hard when it was told to me. Yet I pulled up my big boy pants, and using my educational background, and the Holy Spirit of God, I had to go to war. No, do not blow your brains out. There is a whole quiver filled with treatment options.


Nalakrats, Did you purposely pick that MO after a search or was it fate? I am looking for a MO and I am really stressing out over it. I know I want one that is really specialized in PCa but apart from looking at the research pubs and seeing what articles they put their name to, I feel like i am flying blind.

Yes I did pick him! For you; where do you live--we might have someone here, or I might know someone that would be able to provide a referral for you.


Thank you. I live near Philadelphia. My pathology from Fox Chase read “mixed ductal and acinar types”. Its being stubborn.

Try Dr. E. Trabulski--at Jefferson University Hospitals/Sidney Kimmel Cancer Center

I think from old notes the number is 800-533-3669--if wrong you can look it up---he is co-director--and his specialty is Prostate Cancer.


NOCanceros profile image
NOCanceros in reply to Nalakrats

Hello your narrator is a very rich in information thanks. Georgeהעלא דיין דערציילונג איז דאַנק צו זייער רייַך אינפֿאָרמאַציע.


One of my 4+3 cores Epstein said had intraductal. and another core had cribriform. None of my doctors has ever said much of anything about it. Transurethral Ultrasound didn't do it for me, knocked it down a good bit, tried to fit Cinderella's shoe on without success. Now doing radiation and 6 months ADT. Hoprefully that's a better fit. I was told by a urologist that intraductal tends to stay in the prostate longer. As Nalakrats mentioned. Otherwise I have not gotten a lot of feedback from doctors, probably because they don't know. Also, I don't know the difference between ductal and intraductal. Ductal cancers have a little less success than the most common prostate cancer. But yet better than some of the others.

I too have ductal adenocarcinoma. A pissing problem led me to finally see a Urologist who did biopsy confirming Gleason 9. And google kept telling me it was BPH! So the internet was wrong about my symptoms, hopefully the internet is wrong about ductal survivorship!

It wasn't until I went for a second opinion at Mayo did anyone explain this rare cancer type. Met with the head proton Dr who was brutally honest, but in a positive way. Good to have a care team who has treated this type of cancer often and good to have a care team that were at the top of their class!

Do you know what they call the medical student that barely passed med school? -----> Doctor!

So onward we go, and glad to see there are many of us in this forum to share the past and present.


Intraductal nuroendocrine GL 9 here

Ductal hystoligy....gl9 6 cores ...mets

You can see my history but 18 months in i have had ralp/early salvage/lupron. I had one year of undetectable that just recently ended. My pathology after ralp was “mixed ductal and acinar types” although when i sent the slides to Epsteins lab there was no mention of ductal.

My husband is a gleason 10 , ductal type. His report reads Prostatic Adenocarcinoma, Ductal type , gleason score 5+5=10, with foci of comedo type necrosis.

RP in 18' with post surgical pathology identified +IDC-p

Anyone done genetic testing ? I knew 8 years ago I had Lynch syndrome, inherited from moms side. I have messed up MSH2 & EPCAM genes. Always thought my cancer would be colon. Dr said I was doomed at birth, and my cancer can be traced to the Lynch genetics. So much for those books that blame poor diets or environment.

My husband had intraductal carcinoma present in 2 of the 25 cores, along with acinar in 17 of 25.

None of the doctors have seemed concerned about the intraductal component. When I have specifically asked they said it didn’t mean anything. I find this confusing.

Anomalous profile image
Anomalous in reply to bethdavis

More or less the response I got. And when I asked the pathologist on call at JH when I had my second opinion done he wasn’t particularly clear about it either. “Controversial” i think is the word he used.

My husband has intraductal, Gl 8, extensive cribriform and comodenecrosis. Mixed with adenocarcinoma. Diagnosed with bone mets in July 2020.

I was diagnosed with Ductal Prostate cancer in January 2016, T3N1, G4+4. My PSA was never that high (4.7 at the time of diagnoses). Had surgery (even though it was regionally metastatic), external radiation and a little over two years of Lupron and Zytiga with prednisone. Went into NED at the end of 2018.

I was a Gleason 8 ductal adenocarcinoma with 2mm focal margin. PSA 5.2 before surgery. PT2 on pathology. It’s been 3 years for me and I now get PSA tested every 6 months. <0.02 ng/ml so far. I read that ductal adenocarcinoma can give off less PSA than acinar adenocarcinoma and PSA may not be a good indicator of spread so I requested an MRI of my prostate bed 2 months ago on my 3 year anniversary just to confirm no spread. Nothing found. My decipher score was 0.61.

Two out of biopsy samples showed intraductal cancer, one with GS 4+3 the other 3+3. I have GS 4+5 in the tumor core. Doc has not commented on the IDC yet.

I came across this research article and thought I would post. It pulls together all prior ductal research and attempts to summarize. Recently dated too.


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