Mixed Acinar and Ductal Morphology


My Dad was diagnosed with Prostate cancer last year, Gleason 4+3 = 7 (grade group 3) in 6 out of 12 cores, max 90% involvement. PSA at diagnosis was 3.77. T3a, N0, M0. He is on hormone injections and completed 20 sessions of radiotherapy earlier in the month. His follow up appt is in June, he has already been told he has had the maximum amount of radiotherapy he can have. He needs to do a blood test before his review but it is face to face as they want to review the length of adjuvant hormonal therapy due to Acinar and Ductal morphology. 

I can find information on Acinar and Ductal :( separately however the mix is something that i'm struggling to find information on. The nurse at his last appointment made a comment about a follow up in person due to a funny mix of cells, so i assuming it is because his cancer isnt straightforward. 

I was just wondering if anyone had an insight or experience?


  • I had adenocarcinoma plus intraductal cancer in my prostate. I was told the ductal cancer tends to behave more aggressively and unpredictably. Have a look at my profile. I wish your Dad all the best.


  • Hi RVC 1985,

    I feel your pain. Both are rare particularly Ductal in less than 1% of all prostate cancers. My husband has ductal and adenocarcinoma in his mix but was diagnosed at stage 4 with bone and lung mets last September. With his PSA at 44.4. However he is doing great on Prostap and Zytiga with PSA below 0.1 now and is generally well and still working full time. 
    the good news for your dad is that they caught it early with plenty of options still available to him.

    I think it’s great that your dad is getting face to face appointments and he is being monitored closely. You are the only other person in the group that I have come across to have experience of ductal so I would be interested to hear what they say regarding treatment going forward. keep in louch.

    love from Louli

  • Hi Louli,

    I just wanted to update you that my dad had his appointment today. His bloods and PSA are good and they’ve prescribed him Bicalutamide and Tamoxifen for 2 years. He needs to go to workshops to be monitored and then they’ll go from there. 
    My Mum said the consultant just said the mix of cells meant the more aggressive type needed monitoring which is why they are taking him off the injections and giving him the tablets. I think it’s best due to his age too, or so she thinks.

    I expect when the gp letter comes though we’ll have more info, so I will update you further then. 

    How is your husband doing?

  • Hi RVC,

    Thank you so much for letting me know how your dad got on today. It’s sounds like you have a clear plan now and that’s great that his PSA is good. I’ve never heard of Tamoxifen being used so far in Prostate Cancer but it’s a relatively new area for me and it is used in other hormone depending tumours.

    My husband is still doing great! Working away and apart from the hot sweats and some fatigue he doesn’t complain. PSA undetectable! 

    Keep in touch!

    love from Louli