Prostate Cancer Survivors






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Re: Reassuring?

Guys, I'm not very good with statistics or figures, so be patient with me.

What I saw in the figures from Henk's Pub Med extract was that in recent years (2002 to 2006) there has been an "exact correlation" of GS between biopsy and RP of 75% over all. That looks good to me because a man can fairly safely say that if he is diagnosed with PC at a certain GS then that is most likely what he has. Then he can go on to take Henk's advice and WW until he either does or does not get symptoms. Or he can go on to one of the treatments we all know about.

Terry's example of how a pathologist would feel if he took a flight knowing that the pilot only had a 25% success rate in landing, is not quite fair in this case. If a pilot only had that chance of landing safely, the patient would stand a good chance of dying on touch down. However a 25% error in GS between biopsy and RP is not likely to kill the patient, but it will give him a 75% chance of deciding on an appropriate course of action.

In relation to our recent discussion with California David, the Pub Med piece says that undergrading was more likely in GS 6 or less (35%). In the document Terry linked to they refer to the advisability (in a slightly different context, it is true) of having different pathologists review specimens.

So my point here is that biopsy GS grades ARE sufficient to be a guide to action (especially when coupled with percentages of numbers of needles involved). It may be however that the action we should be guided to is more Active Surveillance than surgery or radiation, whereas most of us - me included - possibly come off AS too soon.

Like I say I am not too good with these statistical things so I would be very grateful if one of you could point out what I may be missing here.

Ted from the snow in England

Re: Reassuring?

Thanks for the article Terry and for the nice comparision with a plane landing. It would be the end of flying for sure.

The conclusion of the concordance article should have been as follows:

" Since after 15 years our biopsy results are still wrong in 25% of cases, we have decided to close the clinic."

Best reagards,

Henk Scholten