Intraductal Pattern 1 and Pattern 2?

[petabyte]

Hi,

In this study they talk about Intraductal PCa patterns : Pattern 1 and Pattern 2 (with Pattern 2 not responding well to the treatment, but Pattern 1 only a little worse than "normal" PCa.

onlinelibrary.wiley.com/doi...

After PSM, our first cohort included 108 patients with similar baseline characteristics. Among them, 50% (54/108) were diagnosed with IDC-P, with 22.2% (12/54) having IDC-P pattern 1 and 77.8% (42/54) with IDC-P pattern 2.

"Further analysis showed comparable outcomes for IDC-P pattern 1 but significantly worse prognosis for IDC-P pattern 2"

I already asked my urologist what type my IDC-P was (there was an earlier paper by the same researchers) and he emailed the pathologist. At my next appointment, he had no answer (twice). I will escalate this but need some info...

I have little understanding of the histopathology of intraductal/cribriform (which I have) but hoped someone here could answer  Tall_Allen ?😉

My questions:

1) Are pattern1 and pattern 2 recognized pathologies or are they something invented by the researchers? I'd like to know so that when I write to the head of pathology I don't ask something stupid (again).

2) Is it normal that biopsy samples are no longer available for genetic testing (maybe they use all parts of the core for diagnosis?)

p.s. I hope I have pattern 1 🙂, pattern 2 sucks.

thanks ❤️

[Tall_Allen]

I'm not a pathologist. But since you are already taking abiraterone, you will find out how long it lasts.

[ulfhbg]

Hi !

If I understand the study you are looking into they are testing Abiraterone on METASTATIC prostate cancer patients and that’s not you from what I know.

You’re T3BN0M0, you’re on ADT, you have done a very good radiation treatment with boost to the prostate and seminal vesicles and also WPRT to the pelvic area I suppose and then added Abiraterone later on and now your PSA is < 0.1 less than 6 months after radiation. That in itself is a good prognostic factor for long term remission and WHO knows what the future holds😀

From a layman perspective, don’t you think that this study is perhaps not representative of you; no METS, you’re on ADT, you’ve had a very good radiation therapy and THEN you add Abiraterone 😉 Just saying

Best wishes - Ulf

[petabyte in reply to ulfhbg]

Thanks Ulf

It is certainly not representative of me (but could be in future) and it is also true that older treatments which these studies inevitably are not as good as current SOC.

I'm not trying to be negative about my prospects, I just want to be prepared for all eventualities so I can make informed decisions if the time comes. When I first got the diagnosis I was overwhelmed and knowing what I know now I would have maybe chosen different things. IDC-P was a further kick in the teeth (when I found out about it) and I avoided even learning about it since it made me depressed and worried.

So it is just to be prepared...

[dhccpa]

Good questions all around. Thanks for posting.

[Vegeguy]

hi I sent message to oncologist about this and he said that it is not normally noted on pathologies - I really think pathologists need to explain the IDC a bit more on the path reports (ie how much IDC, pattern etc) because there are too many unknowns about it and it creates anxiety for all of us