HELP, Intraductal with Cribriform 4+3=7 treatment options

[-db123_]

69 years, good health, no medications.

4 cores 3+3=6 Adenocarcinoma

2 cores 3+4=7 intraductal with cribriform

2 cores 4+3=7 Intraductal with cribriform (50%).

MD anderson surgeon said he could not get good margins. Suggest radiation. Radiologist wants to use Brachytherapy plus proton beam, which will treat the prostate bed and lymph nodes. A total of 72GY. NEOADJUVANT THERAPY; Firmagon plus Apalutamide (erleada) for 3 months.

John’s Hopkins surgeon said the exact same radiation treatment, including the Brachytherapy However, pre-medicate with firmagon and Xtiga 3 months. BOTH RADIOLOGIST AND SURGEON DEEMED ME FAVORABLE CANDIDATE FOR SURGERY . IN FACT THE SURGEON SAID I WAS NO CHALLENGE because of my prostate size is small.

Currently I am premedicated with Firmagon. I’m awaiting shipment of Apalutimide.

I know nothing about the above drug commonly known as Erleda.

I want to know if radiation treatment is better than a radical prostatectomy.

Concerning the double dose of drugs prescribed, is this a unfavorable factor in regards to surgery.

Is an open recession better? You can feel the lymph nodes,, possibly other benefits.

I need some HELP PLEASE!

Doug

[Lizzo30]

You should post this on the advanced prostate cancer community hopefully you will get some helpful advice or people with similar situations may share their experiences

[NPfisherman in reply to Lizzo30]

Lizzo30,

Funny you mention that advice... It is the same advice that they give when people try and access this forum... You see, it is because we are "unmoderated" and yet moderated by the individual(s) that sent the "Dog and Fish" show to this forum..

In fact, when I used to post, I could do a search on google, and the titles that I give some of my posts could be seen right away on a search of a key concept of my post title. Such is no longer the case for a while..

So, the only logical theorem that I can figure is that the algorithm is no longer Fish friendly... As I always say..."It is what it is..." Thus, my stopping posting and following this forum's activities anywhere near as much as I used to previously... Offering to be moderator was rejected... Perhaps, some of you others could offer that have an interest...

For the Terror Dog and I.... we can not direct message others... while our voice is not totally silenced, it is certainly limited... such is life on a forum...

DD

[Lizzo30 in reply to NPfisherman]

Yes I totally get what you are saying

I moderate my replies - I would like to say more but I don't want to get banned bc I come here alot and learn alot from many different communities

[NPfisherman in reply to Lizzo30]

Thanks for your reply...

The fact that "you get what I am saying" and moderate your replies out of concern for your ability to participate should speak "volumes" to the staff of HU... however, they are not our "regular" moderators here on our "unmoderated" forum... and "other" moderators maintain the "status quo"...

You just can't hide some things...

DD

[NPfisherman]

db123,

Sorry that I missed your post a few days ago... I am hardly here these days very much... I do not have intraductal, but I was diagnosed as cribiform on my biopsy, confirmed post RALP... 4+4..

The medication is a solid concept with a chance to put your disease in check while you make your own decision. My brother was advised to do radiation, but he chose to do RALP based on my history (joint family history-Father), and his own concerns instead of the radiation that was offered. Post RALP, they believed they had got everything....no nodes involved with nodal sampling...Two years later, he has had BCR--lymph node near surgical area....now done the radiation post BCR-30 treatments at Cleveland Clinic..

I was on apalutamide prior to surgery (part of a study), and I tolerated it well... It is easier than abiraterone which has left me a prediabetic... I would take the Erleada... Holding your disease in check is a sound strategy(again), and should help your status before surgery (sounds like you are leaning that way) or radiation...

You have an aggressive form of PCa, and there are so called "experts" on some of these forums that will tell you that all you need is the radiation..... Ultimately, it is your choice, and all these "experts" can pound sand... Taking out the "Mothership" will allow you to get the tumor out.... get nodal sampling.... and further confirm your status.... whether you choose an open prostatectomy vs RALP is also your choice... If you choose surgery, do the research on robot assisted laparoscopic prostatectomy (RALP) vs open surgery...

I will be 66 soon, and I am approaching year 8... The anxiety can be a killer....try and relax.... being at centers of excellence is the key to getting top quality care, and you have chosen well...

Best of luck,

Fish