Does a rare histology prostate cancer, such as ductal or mucinous, change your typical management recommendations?
In particular would it affect the decisions for brachytherapy or androgen deprivation?
How do you monitor for treatment response since they may not make PSA?
Answer from: Radiation Oncologist at Academic Institution
Intraductal cancers are often associated with Grade 4 prostate cancer and getting a mpMRI and performing a fusion TRUS/mpMRI bx of any PiRads 3, 4 or 5 cancer to r/o Grade 4 would be of value to recommend treatment as opposed to active surveillance in an otherwise Gleason score 6 PC. If Grade 4 is c...