Uropredict nomogram from~Bostwick labs~may be better than Partin tables they claim

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zufus
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Date Joined Dec 2008
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   Posted 3/2/2009 8:12 PM (GMT -6)   
Caveat this is not 100% for anyone, so if you plug in your numbers remember these nomograms are an averages statistical thing. Use it as maybe a guide to confirm otherwise, maybe in conjunction with your doc, assuming they have input data to make staging or assessment variables up for your case. He uses: age, psa, gleason score (overall one you were assigned), T1 or T2, focal or multi-focal cancers.
 
The parameters of T1 or T2 you can learn about staging before you choose one of those for this particular nomograms. Also, the choice of 'focal or multi-focal' means findings to choose from one cancerous spot or biopsy/multiple areas, positive biopsies.
 
 
Also checkout bostwick labs website as for pathology, ploidity, PCA3 urine PCa testing and more on PCa....great site.   yeah
 


 

Post Edited (zufus) : 3/2/2009 7:23:30 PM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 3/2/2009 8:14 PM (GMT -6)   
Your link didn't work for me.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


zufus
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Date Joined Dec 2008
Total Posts : 3149
   Posted 3/2/2009 8:14 PM (GMT -6)   
I had a typo and it is corrected, I had to verify it.
Thanks
 


Ed C. (Old67)
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Date Joined Jan 2009
Total Posts : 2457
   Posted 3/3/2009 1:18 PM (GMT -6)   
Zufus,
Do they have similar thing for T3a?
Age: 67
Retired in 2001 and living in Austin TX.
PSA 3.5 free PSA 11%
Dx 12/30/08
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
Post op Pathology report:
Prostate weighed 57 grams
size:5.2 x 5.0 x 4.9 cm
10-20% involved
Bilateral
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
Lymph nodes: not dissected
seminal vesicles clean


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 3/3/2009 2:11 PM (GMT -6)   
It works well now (the link), didn't like what it said, but like all data, will take it into consideration. In my case, surgery is past tense, so it is what it is, and all I can do is be on guard for the future.

David
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 3/3/2009 5:42 PM (GMT -6)   
Sorry Ed I cannot answer your question, maybe Bostwick can give you and idea, maybe not for free, who knows. Dave we all have to monitor after any treatment, or atleast should, some people may not or let there guard down. While I had my 2 yr. vacation from all drugs recently I enjoyed some of that letting the guard down, but did not leave it all down, I caught the minor psa rises consecutively and resumed. Local hospital has a walkin psa testing deal- $15 and anytime you want it done....I love that option.
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 3/3/2009 5:48 PM (GMT -6)   
thats a real deal for $15
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 6 month on 5/9
 
 


Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 3/3/2009 7:29 PM (GMT -6)   
Interesting to compare this to the MSK Nomagram...The MSK version I believe is more detailed since it's recent update...Check it out...Try entering the same numbers for both.  (also not ethat you can vary the primary and secondary Gleasons and get intersting results...)
 
(This is the pre-treatment nomagram)
 
Tony


Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


zufus
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Date Joined Dec 2008
Total Posts : 3149
   Posted 3/3/2009 7:53 PM (GMT -6)   
David- absolutely the $15 psa test and mailed to you results (to anyone whom walks in-non residents, non-patients etc.) get results within about 4-5 days, and also compare this to the psa tests my doc sends out when I have his appointments, too. Did two psa tests on the same day and only 1-2 hours apart (different labs as mentioned herein) one was .61 and the other .50, just for kicks it is interesting. This was 1-2 months ago now, got lower psa's since then too. (.36 recently)

Tony- that is a good nomogram, if only we could easily interpret those abstracts you can read within their data and know what it says or means to you as the patient, that would help even more. This is good for pre-treatment as you submitted.
 


John T
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Date Joined Nov 2008
Total Posts : 4188
   Posted 3/4/2009 12:38 PM (GMT -6)   
Bob,
Interesting,
I think with scans , color doppler and MRIS with a Telsa 3 machine or even DES MRI I think you can get even closer to determining extra capsular extension and seminal vessel involvement if the tables show a high likelyhood.
This would be important in coming to a final decision on treatments.
JohnT

I had a psa of 4.4 in 1999 and steadily increasing psa every 3-6 months before reaching 40 in 5-08.Free psa ranged from 16 to 10%

I had biopsies every year, 13 total in all. I saw 5 different doctors, all urologists or urological oncologists at Long Beach, UCLA, UCSF and UCI and had an MRIS at UCSF in 2007. All tests were negative and I was told that because of all the biopsies I had BPH and not PC but to keep getting biopsies every year just in case.

in Oct 08 my 13th biopsy of 25 cores indicated 2 positive cores, gleason 3+3 less that 5% in 2 cores. Doc recommended surgery.

2nd opinion from a prostate oncologist, referred by my wife's oncologists said cancer found was indolant and statistically insignificant, but PSA history was a major concern and ordered a few more tests.

Color Doppler ultrasound with targeted biopsy found a transition zone tumor 18mmX16mm, gleason 3+4 and 4+3. CT and bone scans clear, but Doc thinks that there may be lymph node involvement (30% chance) because of my high PSA, and referred me for a Combidex MRI in Holland.

Combidex MRI in 2-09 showed all lymph node clear.

Changed diet and takiing supplements while I wait, PSA dropped from 40 to 29 through diet alone. The location of the tumor next to the urethea plus the high psa make surgery an unlikely option.

Currently on Casodex and Proscar. Consultation with the radiologist suggested adding Lupron for 3 months before IMRT. May use a combination of seeds and IMRT. Radiologist and Oncologist will get together and come up with a joint recommendation next week.

JohnT


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 3/4/2009 7:28 PM (GMT -6)   
Total agreement with you John and suggest other patients that can get such scans consider maybe doing so, so to find righteous assessment levels, huge variable and difference if known and making a decision on surgery or other treatments, too. Dr. Strum even mentions that the normal ct and bone scans being done on typical to even some mid-range PCa patients presentations of disease, is actually monetary wastefulness in resources (insurance etc.) in the treatment of PCa, even my scans were clear with real risky stats.
The sometimes-lower cost and better scans appear to be: Combidex (outside USA), color doppler ultrasound, and probably endorectal coil-MRI.

Anyway all possible knowable factors are a plus as to making the best treatment plan, tailored to a particular patients disease.
 

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