Accuracy of risk assessment, Han, Partin tables?

[FMOH_N]

How reliable are these risk assessments and tables, any experience?

hopkinsmedicine.org/brady-u...

[Tall_Allen]

About 70% accuracy - more or less depending on how common the risk factors are. I use the MSK nomogram a lot:

mskcc.org/nomograms/prostate

[FMOH_N in reply to Tall_Allen]

TA you are an extreme valuable and knowledgeable person in this forum. I highly appreciate and read all your posts.

shall we also add Y-A-L-E formula

evidencio.com/models/show/699

[Cooolone]

Numbers? What are numbers?... These collections of statistical probabilities. How do they resonate with our heterogeneity and how cancer has shown that it "IS" different for every individual patient. So we subscribe to numbers, a collection of previous examples to compile within neat little boxes of labels and assign them to groups. These groups then are bunched into risk stratifications for simplicity. But we aren't that simple, not at all. We have yet to experience and enjoy true individual diagnosis and treatment based upon our heterogeneity, based upon what "WE" truly are in regards to "OUR" cancer. Especially at the introductory levels of diagnosis, for first line therapy, our best chance at a cure. Studies are the same and research, well research in a laboratory use just specific cell lines, is it the same that you have? There are dozens of Prostate Cancer Cell type(s), see my point? Genomics, well, there's hundreds of markers today identified as being associated with PCa, few are actionable (approved drugs), so what then does any of those numbers associated with these statistics mean to us as patients. Is it false hope that we follow when we drum up these dice rolling computer programs that allow input and then computate a statistical probability based upon a certain set (small) of information we enter? How can we rely upon study data when dismissed is the selective criteria studies use to allow certain cohorts of patients to enter a study, but then apply it to the greater whole that encompasses a much wider range of patients? Studies that are stopped die a number of factors, and how sometimes, studies are done which are focused and reach preconceived conclusions. 70% is interesting, another number that seems consistent across our path as we travel this journey as a group. Basically 1/3 failing primary therapy, and of those moving on to secondary lines, 1/3 of those failing and moving on to advanced disease, etc. Dismissed in all this is also the associated causation of the fact(s) that the therapy itself can cause the disease to advanced, or, induce somatic changes to the cells.

I remember reading almost 6 years ago, a post on a site I came across, yananow, by a long time survivor, and he noted that numbers "lie" and to not get too hung up on them. His post though caused me to look under the covers and into the deep end of the pool, to try and reveal and realize what you have, where you are, and where you might be going, all as an individual, not some collection of numbers!...

Apologies if this seems a bit jaded, but all "my" statistical probabilities meant nothing, so far... and yes, after years of failing each step and learning my PCa is pretty unique, yeah, I'm one of those, I walk my own path. So I talk from experience! Let alone these entire risk stratification boxes that the medical community use to place patients into, I feel do us all the greatest disservice. We must strive for individuality in our diagnosis, must fight that we be looked at as the first and only patient an oncologist has, fight that out Cancer be looked at for what it is, to the fullest and most complete diagnosis possible, prior to making a single decision. It's like studying speech, and how many while listening to another talk, don't truly hear all that is said, because once a few trigger words are processed they're formulating a response in their mind which is preoccupied with what to say in response. A doctor, upon seeing some of the easiest and early diagnosis information, already has you going into one of those neat little boxes and what will be best for you! Usually done without deep detective work on what you have, and how it applies to you.

That all said, I used the MSKCC nomograms as well, others too. But those numbers couldn't tell me what cancer cell type and how it would behave. It have me numbers that showed what thousand of other patients experienced, based upon some clinical assignments attached to their diagnosis.

Lol, just wanted to share my thoughts and opinion on the subject. So outside all the numbers is the real question, or, How can I get the Best results possible in receiving treatment? Well that there is by getting to a MAJOR Cancer Center and one rated in Excellence! Travel of you must, and don't skimp! Get to the Best of the Best and usually, you will enjoy being looked at as an individual, being in the best hands and have access to the newest and best available therapies. Come what may...

All the Best Regards!