An on-line calculator can give patients with prostate cancer a highly accurate prognosis – enabling them to choose whether to undergo treatment or not, British researchers announced last night.
The PREDICT Prostate tool has an accuracy of more than 80% and gives patients individual predictions, according to its Cambridge University developers.
This compares with current UK guidelines which offer accuracy of up to 70%.
Patients can ask the tool about the effect of treatment on their survival chances, getting full details of the chances of success and the risk of side-effects.
The researchers reported details of their work in PLoS Medicine last night.
They developed the tool by analysing records of 10,000 patients in a regional registry in the east of England and then validating their findings using a sample of 2,500 patients in Singapore.
They then conducted a randomised study of 200 prostate cancer specialists. This found that doctors were more likely to recommend treatment than PREDICT Prostate – and then reconsidered their treatment proposal when challenged by the tool.
Developer Dr David Thurtle said: “As far as we are aware, this is the first personalised tool to give an overall survival estimate for men following a prostate cancer diagnosis.
“PREDICT Prostate is designed for men who are considering whether to choose to monitor or to opt for treatment. This is the choice that faces nearly half of all men who are diagnosed with prostate cancer.
"We hope it will provide a more accurate and objective estimate to help men reach an informed decision in discussion with their consultant.”
Fellow researcher Dr Vincent Gnanapragasam said: “We believe this tool could significantly reduce the number of unnecessary – and potentially harmful – treatments that patients receive and save the NHS millions every year.
“This isn’t about rationing treatments – it’s about empowering patients and their clinicians to make decisions based on better evidence.
"In some cases, treatment will be the right option, but in many others, patients will want to weigh up the treatment benefits versus the risks of side effects. It will also show men who do need treatment a realistic estimate of their survival after treatment.”
Individual prognosis at diagnosis in nonmetastatic prostate cancer: Development and external validation of the PREDICT Prostate multivariable model. PLoS Medicine 12 March 2019
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002758
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