Nomograms - ????????

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Radical
Veteran Member


Date Joined Mar 2009
Total Posts : 739
   Posted 3/17/2009 8:25 PM (GMT -7)   
Hi Guys - Whats the general opinion of the Nomograms shown at the Memorial Sloan Kettering web site.  I have put thru my stats, and according to the nomogram my chance of non reocurrance is very high.  Are these nomograms realistic ?  I hope so !.........Rookey
Age 51yrs
DX 11/11/08
6 out of 8 cores positive 3 X 60% / 3 X 10%
PSA 4
Gleason 3+4=7
Stage T1c
Robotic Surgery 24/12/08
Upgrade Gleason 4+3=7
Stage T2c
Three small foci total volume 10%
Neg Margins and Nodes
Nil - Extraprostatic Extentions
Dry less than 1 week (unbelievable)
ED- taking Meds/ No result yet
PSA 28/1/09 0.03
PSA 24/2/09 0.03
"Everyday in Everyway I get better"


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/17/2009 11:11 PM (GMT -7)   
The MSK nomagrams are a compilation of real case data and reflect the percentages in the case similar to the information that you enter. The data is compiled using cases at MSK, and many other facilities.

There is room for error, but these tables are pretty good.

Remember you are not a percentage! Stay positive and get well!

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!


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4168
   Posted 3/18/2009 3:23 PM (GMT -7)   
In some of the stuff I have read the nomograms are about 70% accurate. This is better than anything else we have out there and it helps one make a risk reward decision based on unbiased information rather than someone's opinion.
JohnT

64 years old.

I had an initial PSA test in 1999 of 4.4. PSA increased every 6 months reaching 40 in 5-08. PSA free ranged from 16% to 10%. Over this time period I had a total of 13 biopsies and an endorectal MRIS all negative and have seen doctors at Long Beach, UCLA, UCSF and UCI. DX has always been BPH and continue to get biopsies every year.

In 10-08 I had a 25 core biopsy that showed 2 cores positive, gleason 6 at less than 5%. Surgery was recommended and I was in the process of interviewing surgeons when my wife's oncologist recommended I get a 2nd opinion from a prostate oncologist.

I saw Dr Sholtz, in Marina Del Rey, and he said that the path reports indicated no tumor, but indolant cancer clusters that didn't need any treatment. He was concerned that my PSA history indicated that I had a large amount of PC somewhere that had yet to be uncovered and put me through several more tests.

A color doppler targeted biopsy in 11-08 found a large tumor in the transition zone, gleason 6 and 7. Because of my high PSA Dr. suspected lymph node involvement, 30% chance, and sent me to Holland for a Combidex MRI, even though bone and CT scans were clear.

Combidex MRI showed clear lymph nodes and a 2,5 cm tumor in the anterior. I was his 1st patient to come up clear on the Combidex which has a 96% accuracy,

I've been on a no meat and dairy diet since 12-08 and PSA reduce to 30 while I awaited the Combidex MRI.

The location of the tumor in the anterior apex next to the urethea makes a good surgical margin very unlikely. Currently on Casodex and Proscar for 8 weeks to shrink my 60 mm prostate. Treatment will be seeds followed by 5 weeks of IMRT while continuing on Casodex and Proscar. So far no side affects from the Casodex.

JohnT

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