Diagnosed Gleason 8 Biopsy 7/2022 Ductal PC sent out added Cribform Architecture. Anyone here with PC w/ Cribform Pattern?

[Shorehousejam]

Read many papers on it…I would like to Scream my Head off Now!

F@c# this Cancer!

Husband negative for BRCA2 mutations but 80% of men with cribform pc are positive, we are completely blind sided by this new horrendous information

Anyone here have any information / studies if docetaxel is successful on treating this type of AMPC? Or are we just spinning our wheels in this sledge of crap.

Diagnosed

By PSA Score 942.40 06/24-2022-07/06/2022

Advance Metastatic Prostate Cancer with Ductal subtype

with focal cribform architecture in carcinoma (it is rare, unfortunately aggressive)

4 cores out of 15 with another questionable core with necrosis and questionable atypical cells

Stage 4 Gleason 8 3 Lytic Lesions (unusual or rare)

CT Scan, Pylarify Pet Scan, Bone Scan,

3T 3D guided MRI with write over

07/15/2022 Transperineal Biopsy

Started Firmagon 7/6/2022

Zytiga with Prednisone 7/20/2022

and Docetaxel Chemotherapy on 08/11/2022

PSA 942.40 07/2022 to 0.24 10 /18/2022

[Shorehousejam]

Thank you for your reply.

[Hidden]

I also have cribriform histology. Over the years there have been various studies showing a rather tenuous association with a more aggressive phenotype.

Some if not most of these studies grouped cribriform with ductal .

One study actually examined pure cribriform versus a mixed ductal cribriform subtype and found an aggressiveness association only with the mixed type.

These studies are not equivocal and in my opinion are poor retrospective analyses.

I wouldn’t worry about it too much. Treatment protocols are not any different.

[Shorehousejam in reply to Hidden]

Thank you, yes we realized treatment protocol is the same, I guess my next question is if time to castrate resistant progression is shorter, what medications have been formulated to have the cell reversed that.

[Hidden]

None that I am aware of. There is a lot of work going on in the area of BAT .

Some tentative indication that it may resensitise hormone resistant cancer to Enzalutimide.

This treatment is being studied in various clinical trials.

Plenty of discussion on this site if you search.

[Shorehousejam in reply to Hidden]

I think, assume, that BAT would not be a great choice for my husband as any error may have his pca spread like wildfire

[Tall_Allen]

It is good that there are no BRCA mutations. BRCA cleans up precancerous DNA, so it is best if it is intact.

[Shorehousejam in reply to Tall_Allen]

My husband’s BRCA test came back and our MO states it’s negative, with a mutation for BLM.

Everyone has two copies of the BLM gene, which we randomly inherit from each of our parents. It’s call Bloom syndrome if we had a child, something to that effect.

Mutations in one copy of the BLM gene can increase the chance for you to develop certain types of cancer in your lifetime.

And here we are with a certain rare type of prostate cancer…

So, my husband is BRCA Negative but with BLM one copy gene mutation

Does that mean he is not eligible for a PARP inhibitors?

[Tall_Allen in reply to Shorehousejam]

I don't know - I've never seen it clinically tested. He can get Olaparib because of the ATM mutation - but it probably would do him little good, and it is toxic. The combination of a PARP inhibitor + second gen. hormonals, immunotherapies, radiopharmaceuticals, or other growth inhibitors are being tested in dozens of clinical trials. Some may work with BLM or ATM.

[Shorehousejam in reply to Tall_Allen]

Thank you for your valuable insight

[Tall_Allen in reply to Shorehousejam]

BTW- see this for ATM:

prostatecancer.news/2022/06...

[Shorehousejam in reply to Tall_Allen]

Thank you so much

[Shorehousejam]

yes, it would be…long overdue

[tango65]

They are doing studies in other cancers with BLM mutation using keytruda or similar drugs and olaparib or similar drugs.

mycancergenome.org/content/...

[Shorehousejam in reply to tango65]

Thank you for sharing the link

[Gl448]

I have similar diagnosis (stage 4, GL8, ductal, mets in bones and lymph nodes) made just one month after you husband's.

He got all his treatments so fast! Firmagon and Zytigia within two weeks. Chemo started within in a month? I won't even have all my testing done until two weeks from now. He's lucky to have such quick action, I see lots of people here and on Reddit going at least a couple of months before getting a serious start.

I think his PSA drop is a great sign, rejoice in it.

[Shorehousejam in reply to Gl448]

Hello, sorry to hear about your status, and yes, of course we are thrilled about my husband’s response to treatment

I’m his wife and I’m having a hard time with the unknown and the anxiety of it all…We are both fixers. I’m a solution finder type…and this cancer, has no definitive solution or cure…

[Shorehousejam]

Tall_Allen Hello we both have this question about ATM?

[Tall_Allen in reply to Shorehousejam]

It says: "A more granular analysis [of MAGNITUDE] of specific DNA repair genes suggest there may be a benefit (sample size is low) in men with defects in ATM.

meetings.asco.org/abstracts...

It also shows a possible benefit in the HRR-Falconi group which seems to be connected to BLM.

[Shorehousejam in reply to Tall_Allen]

Thank you for the clarity

[DMohr011]

My cancer is a ductal form, but not cribform.

Gleason 9/10, grade 5. RO said I had a 15% chance of being around in 5 years. Tumor attached onto rectum. Aggressive it was, as it spread to a muscle before they could radiate. Genetics show broken MSH2 gene. Lynch syndrome runs in my family and I knew 10 years ago I was positive for it. Went thru quite the treatment summer of 2021, but at the end of the radiation, I was back to walking and pissing. Not sure if it was the Proton beam radiation or Keytruda, or probably both.

One year later, PSA undetectable, Cancer is undetectable. Removed from all treatments 3/2022. Now on a surveillance.

I wish you the best!

Dave