Sloan Kettering Prostate Cancer Nomogram

Risk Of Dying Of Prostate Cancer In Men With A Rising Psa After Radical Prostatectomy

This nomogram can be used by patients to estimate the risk of dying of prostate cancer if their cancer recurs, signaled by a rising PSA, after radical prostatectomy. The nomogram predicts the likelihood, in a man initially treated with surgery, that he will die of prostate cancer five, ten, and 15 years from the time his PSA begins to rise.

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You add the alternative treatments I have used/use then I feel these are the things needed in order to manage prostate problems. This total program may not help all men but I feel it will help most men. It takes determination,dedication,& discipline to follow this program. Im not making any shortcuts or trying butter things here either. Sloan Kettering Prostate Cancer Nomogram

If you want your health back & keep that health then youd better get ready for that drive. It takes years for our prostate to get in bad health & sometimes it takes a long time to get it back. If you make that determination & drive yourself to get better then it can happen. Its not going to happen overnight for sure. I suffered off & on for 18 months but now for the past 6 months or so I can honestly say I have no symptoms for prostate problems. Article Source: http://EzineArticles.com/2610529

While these Non Objective treatments have had varying levels of success, Washington University scientists who have spent over 15 years studying volumes of clinical research discovered a solution that FORCES your enlarged prostate to go back to a healthy size.

All without resorting to prescription drugs, risky surgeries, or continuous injectionsSloan Kettering Prostate Cancer Nomogram

And the solution is surprisingly simple we can protect ourselves without risky medication:

Do This and automatically reduce prostate inflammation Like 12k People Did.

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I have always been an active person all my life. I grew up playing various sports & was active all the time. I played some type of sport almost every day. If I wasnt playing one of the major sports I was either hunting or fishing.

However, after our son was born in 2001 those things changed. I basically quit playing sports & all other activities. My life had changed & it seemed like I didnt have time for any sports or regular exercise. I found out that was a big mistake in my life. You can make time for things that make you more healthy.

I also was the type that didnt seem to watch what I ate. If I was at home Id eat too much junk food. If I was out on the road Id eat too much fast food. I really wasnt eating healthy at all but didnt realize it because I didnt have any health problems. Sloan Kettering Prostate Cancer Nomogram

I never have been a soda person but did drink Sprite at times. I only drank one cup of coffee in the mornings. I was the type that always thought I needed a meat with every meal. I ate meat with breakfast,lunch,& supper. If I didnt get meat then I wouldnt get full, right? Well, thats not the case & this is far from the truth about eating healthy.

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Study Design And Participants

This prospective phase two single institution study enrolled patients with high-risk prostate cancer for 18 months . Patients were eligible for the study if they met the following inclusion criteria: histologically confirmed adenocarcinoma of the prostate, high risk disease 20 g/L, Gleason Score 810 and/or clinical stage T3-T4), and conventional staging imaging negative for distant metastases . Exclusion criteria included: previous pelvic radiotherapy, history of prior malignancy within the last 5 years , Eastern Cooperative Oncology Group performance status2, or any contraindication to insertion of intra-prostatic fiducial markers or planning MRI prior to RT simulation. All patients were administered a total of 18 months of ADT in the form of Leuprorelin 22.5 mg every 3 months.

All patients gave written informed consent. The study was reviewed and approved by the Hunter and New England Human Research Ethics Committee . The trial was registered with ClincialTrials.gov .

How The Nomograms Work

The really great thing about these nomograms is that all the work has been done for you! You just enter your data into the calculators at the Kattan nomogram web site, and presto: out pop your results!

Unless you are a statistics buff or a computer analyst, you dont even have to think about it. Isnt that just great!

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Predictors For Early Bcr At 2 Years After Rp

We statistically analyzed 174 patients who did not lack any of the clinical and pathological factors and were followed-up for more than 2 years after RP. In univariate analyses, pT3 , RM , EPE , SVI , ly and LVI were found to be significantly associated with early BCR. Multivariate analysis was performed using these significant variables with the exception of LVI in univariate analyses, because LVI overlapped with ly. Multivariate analysis identified RM and ly as significant predictors of early BCR after RP .

What The Kattan Nomograms Can Tell You

The so-called Kattan nomograms on the Memorial Sloan-Kettering Cancer Center web site are a set of tools that allow you and your doctors to do three different things, depending on where you are along the possible pathway from initial diagnosis to hormone refractory disease:

• If you have been diagnosed with prostate cancer but you havent been treated at all, the pre-radical prostatectomy nomogram can predict the probability that you will be progression-free at 5 and 10 years and the probability that you will not have died of prostate cancer at 10 and 15 years after you receive a radical prostatectomy .

• If you have been treated with a radical prostatectomy of any type, and your PSA level drops to < 0.1 ng/ml after the surgery, the post-radical prostatectomy nomogram can predict the probability that you will remaining prostate cancer recurrence-free at 2, 5, 7, and 10 years and the probability that you will not have died of prostate cancer at 15 years after you receive a radical prostatectomy.

• If you have had a radical prostatectomy and your PSA initially fell to < 0.05 ng/ml, but your PSA is now starting to rise again , the salvage radiation therapy nomogram can predict the likelihood of success for salvage radiation therapy at 6 years post radiation.

With any luck, you will never need to use more than the pre-treatment nomogram and will never have to even think about using the third one.

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The Initial Causes Sloan Kettering Prostate Cancer Nomogram

One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.

Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.

If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.

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You can eat various types of other meats. I suggest to eat chicken,turkey,& lots of fish. I buy all natural chicken, all natural turkey,& wild caught & fresh fish.

I eat as much as I want of these type meats. I never thought Id like grounded turkey. I can honestly say that a turkey burger is much better than any hamburger I ever ate. I wouldnt have thought so but it honestly is a better taste & health option.

I eat all the chicken I want. I suggest you to bake it & not fry it in oils. If you do fry then please use Extra Virgin Olive Oil. I add Mrs. Dash seasonings to all my meats. This is an all natural source for seasonings. There are many different flavors by Mrs Dash.

I also eat all the fish I want. I suggest eating salmon,flounder,tilapia,pollack,catfish,trout,& many other fish. Try to eat the oily type fish. Salmon & trout are two of the top oily fish on the market. Here too I suggest baking instead of frying.

Now, I want to move onto another area of the diet. I will be discussing the importance 0f fruits & vegetables. Fruits was definitely a foreign word to me before prostate problems. I did eat limited amounts of veggies but not enough. I made that change as well in my life. Its very important to eat fruits & veggies to have a healthy diet. Sloan Kettering Prostate Cancer Nomogram

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Simulation And Planning Protocol

Radiotherapy commenced after 6 months of neo-adjuvant ADT, in keeping with the results from the TROG 96.01 randomised trial showing superiority of this duration verses 3 months or no ADT . Following insertion of three intra-prostatic gold fiducials, all patients underwent CT simulation in the supine position with customized immobilization. Patients were instructed to have a comfortably full bladder and an empty rectum for simulation and treatment. A 3-tesla non-contrast planning MRI scan using 2 mm slices and T2 weighting was completed on the same day and co-registered with the simulation CT by matching to the fiducial markers.

A standardized planning guide was developed and used to direct contouring of target volumes and organs at risk on the CT and MRI imaging. Target volumes were contoured as listed in Table . Elective irradiation of extra-capsular disease extension, proximal seminal vesicles, and/or pelvic lymph nodes was completed if the risk of involvement of each respective region exceeded 15 %, as estimated by the MSKCC nomogram.

Table 1 Contouring protocol for target volumes

What You Need To Know About The Prostate Memorial Sloan Kettering Cancer Center Prostate Nomogram

The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. During puberty, the body produces semen in a large number of cases, including enlarged prostate. This fluid causes the prostate to swell and cause a number of bladder-related symptoms. This is why the prostate is important to the body. It can be caused by many factors, including infection and inflammation.

A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.

While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.

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The Initial Causes Memorial Sloan Kettering Cancer Center Prostate Nomogram

One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.

Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.

If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.

What You Need To Know About The Prostate Sloan Kettering Prostate Cancer Nomogram

The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. During puberty, the body produces semen in a large number of cases, including enlarged prostate. This fluid causes the prostate to swell and cause a number of bladder-related symptoms. This is why the prostate is important to the body. It can be caused by many factors, including infection and inflammation.

A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.

While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.

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I was not drinking water before I started having problems. The only time Id drink water was when Id be really thirsty. That was rarely because I had quite playing sports & other activities that involved exercise. Water is a major player in prostate health & health in general terms. Did you know that water is the most natural cleanser for the body?

You should drink 8-10 glasses a day of water. If youre not getting water or enough water then this should be a change you need to make immediately. I now drink over 10 glasses of purified/bottled water daily. A lot of prostate sufferers are scared to drink more because theyre afraid it will make them go to the bathroom too much. I was there & didnt want to make things worse.

I was wrong in my thinking because drinking more water actually made things much better after a while. At first upon water increase I did see a spike in symptoms but that was part of the cleansing process for a few weeks.

New Nomogram Improves Post

BOSTONInvestigators have developed a preoperative nomogram they believe is more suitable than previous nomograms for predicting metastasis after radical prostatectomy for localized high-risk prostate cancer , according to a presentation at the American Urological Association 2017 annual meeting.

The nomogram, which incorporates age, ethnicity, PSA level, Gleason grade, clinical stage, and number of positive biopsy cores with Gleason 810 disease, has greater predictive accuracy for metastasis than the Cancer of the Prostate Risk Assessment and Memorial Sloan Kettering Cancer Center nomograms, Lamont Wilkins, a medical student at the Lerner College of Medicine at the Cleveland Clinic in Ohio, and colleagues reported.

Metastasis developed in 123 men . The metastasis-free probability at 5 years was 86.5%.

The area under the curve for predicting metastasis was 0.75 for the new nomogram compared with 0.67 and 0.66 for the CAPRA and MKSCC nomograms, which the investigators noted were developed based on cohorts of primarily low- and intermediate-risk men.

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Data Collection And Analysis

Genitourinary and gastrointestinal toxicity were assessed on a weekly basis during radiotherapy, at 1.5 months and 4.5 months post radiotherapy, then at 6 monthly intervals thereafter. Scoring of toxicity was completed using the Radiation Therapy Oncology Group acute and late radiation morbidity scoring criteria.

Efficacy of treatment will be assessed by biochemical no evidence of disease as defined by the ASTRO Phoenix definition . bNED was and will be assessed at each post-RT review. Treatment efficacy outcome results will be presented at a later date when longer follow-up has been achieved.

Evaluation of compliance with the trial protocol for nomogram-directed target volume delineation, contouring, and dose constraints were conducted after the final patient completed radiotherapy. To demonstrate feasibility, we aimed to achieve 90 % protocol compliance rate with each of these parameters.

Up to seven target structures were generated for each patient according to the protocol outlined in Table . At the time of analysis, each patients plan was reviewed to determine whether appropriate target structures were treated according to the threshold of 15 % risk of involvement as estimated by the MSKCC nomogram. Each target structure was assessed for strict adherence to the contouring protocol by a third party not involved in the original planning process . This assessment was repeated for contouring of OAR.