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Nomogram (on Web) predicting outcome
of Zoladex [or Lupron - ed.] as treatment of rising PSA associated with
and without metastatic disease. (November 2002)
Click onto "prostatecalculator.org" and
you are immediately into the web site for the "Artificial Neural Networks
in Prostate Cancer Project", whose principle investigator is Dr. David
Crawford with support from the Veterans Administration and the NCI. The
information sources seem very credible to me.
Of the five nomograms currently listed, the two that are that are probably
useful to both MDs and patients are those concerning the likelihood of PSA
rise post primary surgery, and the probability of survival post initiation
of androgen ablation therapy. The latter nomogram requires information
about pre-treatment PSA, PSA after 8 weeks of ant androgen therapy, and
whether the disease is overtly metastatic. This data could very well be
encouraging to patients whose PSA falls nicely after ant androgen therapy,
which is the majority of patients. Since patients with rising PSA's, very
high PSA's, or metastatic disease are understandably pessimistic, they
will be encouraged, I think, by the data on the nomogram.
Here are some examples. Nomogram 1 - a patient showing a rising PSA post
RP whose PSA has risen to 12 and who achieves a 8 week post Zoladex PSA of
.2 ng/mL has a 70% likelihood of surviving 37 months. Nomogram 2 - a
patient who initially presents with the PSA of 2000 and bone metastases
and whose PSA falls to .2 in 8 weeks has a similar likelihood of surviving
37 months. These estimates do not take into account any current treatments
to improve survival.
After exploring this entire web site with its presentation of basic data
and useful web links, I decided that this would be a good site to
recommend to patients.
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