brachytherapy plus proton OR radical prostatectomy FOR Intraductal cribriform cancer Gleason 7

[-db123_]

brachytherapy with proton therapy

OR

Radical

Prostatectomy for intraductal cribriform pattern cancer Gleason 4+3=7

[rosenjpj]

not a lot to go on based on your profile. Would help to provide a bit more info. Meanwhile, have you considered SBRT? Depending on your specific case it may be as effective with a much shorter time commitment for treatment and fewer side effects compared with Brachy and Proton. Also, proton has not been shown to be any better than standard photon based radiation. RP has higher incidence of urinary incontinence and ED compared with radiation.

[Cyclingrealtor]

UCSF Dr. Matthew Cooperberg just moderated a talk with some docs looking at a new grading that's under research.

They focused on cribriform/ intraductal patterns and what they consider a high likelihood of metastasis.

It's worth the watch and consideration.

___________________________________

Prostate Cancer Journal Club For Patients

How can we predict how aggressive a localized Prostate Cancer will be and, based on the results, decide the most appropriate treatment?

Learn about a new groundbreaking study by Cleveland Clinic lead investigators Jane K. Nguyen, MD. PhD. and Jesse McKenney, MD. The Prostate Cancer Journal Club for Patients (PCJCP) is hosted by UroToday, the Prostate Cancer Foundation, and the University of California, San Francisco (UCSF) Patient Advocates. The paper will be discussed by Cornelia Ding, MD, and the discussion will be moderated by Matthew Cooperberg, MD, MPH from UCSF.

The study has identified microscopic features in prostate tumor tissue which can predict which patients are likely to progress to metastasis independent of Gleason grading. No patients in the study without these features progressed to metastasis. The pathology analysis was conducted on post-prostatectomy tissue.

Dr. Matthew Cooperberg zoom meeting.

[KeyboardGuy in reply to Cyclingrealtor]

Looks like this just happened on Friday (3 days ago) so the replay hasn't been posted yet. Do you remember if less aggressive GP4 was discussed? I am meeting with Dr. Sartor at the Mayo Clinic tomorrow morning and would like to discuss this with him.

[Cyclingrealtor in reply to KeyboardGuy]

I'm sorry I don't recall the exact points but it had to do with the size of the cribriform pattern.

Look up the docs or the clinic and reach out and share with your doc.

[Cyclingrealtor in reply to KeyboardGuy]

I forgot that I had a few screenshots from the meeting.

Screen shot of zoom meeting

[Seasid in reply to Cyclingrealtor]

It sounds like the Prostate Cancer Journal Club for Patients event, moderated by Dr. Matthew Cooperberg, provided some valuable insights into a groundbreaking study related to prostate cancer. The research, led by Cleveland Clinic's Dr. Jane K. Nguyen and Dr. Jesse McKenney, focuses on identifying microscopic features in prostate tumor tissue that can predict which cases are more likely to metastasize, even beyond the Gleason grading system.

The study's significance lies in its ability to pinpoint high-risk patients by examining tissue from post-prostatectomy specimens, with a particular emphasis on cribriform and intraductal patterns. These patterns have been associated with a higher likelihood of metastasis. The fact that no patients without these features progressed to metastasis suggests that these microscopic traits could serve as a more reliable indicator of cancer's potential to spread, offering new directions for patient management and treatment decisions.

If you're interested in prostate cancer and how these findings could impact future care, watching the discussion would likely provide further understanding of this emerging approach.

ChatGPT said

[Conlig1940 in reply to Seasid]

Are you familair with the " miR Sentinel Test " ?

[Seasid in reply to Conlig1940]

No

[-db123_ in reply to Cyclingrealtor]

I tried to find the video

[Cooolone]

IDC-p isn't an identifier for may particular cancer therapy. It is an averse feature tracked and associated with patients who do not respond as well to typical therapies as patients absent the feature. It is even considered controversial in some groups.

So what you're asking is difficult to answer!

But being as my diagnosis (RALP Pathology) had identified the same thing, along with every other adverse features. I discussed this with my team immediately thereafter when my PSA was persistent prior to chosing treatment options. As such, I decided to try an "aggressive" path... and that should be an option for any patient diagnosed with adverse features.

Best Regards

[Volcanologist]

I would consider HDR Brachytherapy only if it is localized and accessible. Otherwise SBRT would be something to consider. Radical prostatectomy is archaic, high morbidity, and almost guaranteed to end in incontinence and ED. Quality of life is much better with radiation vs. RP. Confer with a prostate cancer oncologist, rather than a urologist who is a surgeon, before making your decision. Urologists are surgeons and they'll want to operate.

[-db123_ in reply to Volcanologist]

Have you had radiation? Brachyboost?

[Volcanologist in reply to -db123_]

I had HDR Brachytherapy for a localized 2 cm lesion that so far has been successful.

[Garfield-_1234]

Gleason 9.

My wife did extensive research on the various methods of combating prostate cancer. Her opinion, which I am following, is Proton therapy at San Diego Scripps (there are other Proton centers). I haven't started yet, so I have no actual results. However, in my opinion, surgery is the least desirable option. Have you read "You Can Beat Prostate Cancer" by Robert J Marckini? Very good resource that helped me chose the type of therapy. Has other helpful suggestions.

[-db123_]

yes to all however show me in the book where it lists intraductal with cribriform pattern cancer

[Cyclingrealtor]

Here's the link to the paper I spoke of the other day that looks at features for the possibility metastatic disease. Very interesting findings in their research. Obviously, it's still in the research phase but worth reading and discussing with your care team.

onlinelibrary.wiley.com/doi...