The question ‘How long have I got Doc?’ is not unusual when one is diagnosed with prostate cancer. Life expectancy will often be expressed in terms of survival rate, that is X percent surviving for 5 years, 10 years, 15 years, 20 years, etc. Needless to say, the earlier the cancer is detected and treatment undertaken, the greater likelihood there is of complete remission or a very long period of being symptom-free.
Nomogram predictive tools
If you are diagnosed as having prostate cancer, your doctor, urologist or cancer specialist will be able to advise you about what life may have in store for you following treatment for the cancer. In forming their views he or she might take into account information that is becoming available through predictive tools referred to as 'nomograms'. These predictive tools have been developed by researchers and medical service providers who have assembled large databases from longitudinal studies of men who have undertaken treatment for prostate cancer. Using correlation techniques the tools can estimate the probability of future events such as continuation of remission after treatment.
The Memorial Sloan-Kettering Cancer Center has such predictive tools. Details are on their web site here.
If the necessary input information is available then it is possible to generate the following estimates using specific prediction tools:
- For men who have received no primary treatment, the statistical probability of a cancer remaining progression-free after receiving one of three treatment options: prostatectomy, external beam radiation therapy, and brachytherapy.
.. - For men who have been treated with a radical prostatectomy, the statistical probability of survival.
.. - For men who have experienced a recurrence of their prostate cancer after being treated with a prostatectomy, the statistical probability of treatment success for salvage radiation therapy (SRT).
.. - For men who have received either prostatectomy or radiation therapy and are considering hormone refractory treatment (HRT), the statistical probability of one- and two-year survival after HRT.
.. - The statistical probability and time to the development of metastatic disease.
Limitations of the nomogram predictive tools
If you run a prediction tool, it is essential that you are aware of the following limitations:
- As is stated by the Memorial Sloan-Kettering Cancer Center ‘The prediction tools ... are for general health information only. The prediction tools are not to be used as a substitute for medical advice, diagnosis, or treatment of any health condition or problem. Users of the prediction tools should not rely on information provided by the prediction tools for their own health problems. Questions should be addressed to your own physician or other healthcare provider.’
.. - The tools have been developed from a database of North American cases. The racial mix of men in that database would be quite different to the racial mix for men in Australia. The health profile, diet, other personal attributes and access/utilisation of medical services may also be quite different. The effect of such differences cannot be determined.
.. - Estimates generated from nomograms are only statistical probabilities of conditions or events occurring in the future for people in the type of population used in creating the tool. What will actually transpire in your case may well be quite different to what is indicated in a nomogram estimate.
You should realise that your prostate cancer is only one factor that will influence your future health and quality of life. Evidence points to the importance of maintaining a positive outlook on life and a healthy life style, including an appropriate diet, regular exercise and having positive inter-personal relationships.
**RETURN TO TOP**