PC Tools II (PCT II)

An Introduction to PC Tools II (PCT II)
The Concept of Applied Science for Prostate Cancer
Stephen B. Strum, MD, Glenn Tisman, MD, Will Connell

The Prostate Cancer Research Institute offers education to prostate cancer patients, their families and friends, and their physicians. We want to work with you and your healthcare team to smooth out confusion that may result from:

• Lack of education regarding prostate cancer
• Anxiety and fear
• Your doctor's heavy workload
• Possible inherent biases or conflicting motives

The PCRI Helpline staff is available to assist you in understanding these tools. Our approach is to be as objective as possible and to individualize the information we provide you. You are a unique patient and deserve to be treated as such. The information we share with you is mostly derived from peer-reviewed published literature. This literature involves human experiences, gathered from some 20,000 patients who have experienced what you are now going through. It is not theoretical or laboratory information, but data obtained from human, clinical studies. It is also important to understand that these data come from prominent university centers, rather than small community practices.

In the past, medical information as it applies to prostate cancer had not been presented in a user-friendly format conducive to aiding management of the new prostate cancer patient. Our first experience relates to the landmark publication by Partin, et al, in 1993. These tables incorporated the variables of PSA, Gleason score and clinical stage estimation, and related these findings to the outcomes for men who were subsequently treated with a surgical radical prostatectomy (RP). This was the first significant database that could aid our approach to men with prostate cancer. In the early years of volunteering on the Prostate Cancer Forum of CompuServe, I coined the term "Partin Tables", and have referred to these tables repeatedly ever since. Understanding the importance of these tables and how they apply to your treatment decision is your first step in your decision process. Partin tables represent the foundation for your successful treatment choice.

Partin, et al, later published another landmark paper that relates the risk of local or confined disease versus a systemic condition where a recurrence of disease has occurred after a radical prostatectomy. I called this analysis "Partin II" to distinguish it from the original Partin Tables. Partin II used the Gleason score at the time of surgery, the presence or absence of lymph node and seminal vesicle involvement at RP, and the PSA velocity after surgery to assess local versus advanced systemic disease. This tool is critical in directing patients toward or away from local salvage radiation therapy. Rarely is it used by radiation oncologists, urologists or medical oncologists. It was clear that these analyses, incorporating many statistically significant variables obtained from thousands of actual patients to define outcomes, provide risk assessments that must be individualized for each unique patient.

This is the essence of real medicine.

Doctor Glenn Tisman joined my medical oncology practice in 1996. He was a valuable addition to the team that already included Dr. Mark Scholz. Glenn's expertise in software programming resulted in the creation of PC Tools software. This represented the first generation of software programs used to aid the new patient and his physician in staging and treatment management determination. PC Tools is currently on the PCRI Web site and can be downloaded free of charge. We invite you to use it.

Over time, additional publications comparable in value to the Partin publications have appeared. A leader in this realm has been Doctor Anthony D'Amico. Further contributions relating to combined variable analysis have been made by Kattan, Klein, Narayan, Pisansky, Lerner, Pound, Gilliland and others. We have, through the renewed efforts of Dr. Tisman, created a new software package called PCT II, now on our Web site

We would like to see this concept of a combined variable analysis become a routine part of the "homework" that patients and physicians do in understanding the biology of prostate cancer as it applies to each individual patient.

We believe that the concept of multiple variable analysis can be taken to a new level. This effort analyses data from as many patients as possible to arrive at a consensus opinion- a sense of what is appropriate for each unique patient. In the medical literature, when multiple papers are reviewed on a particular subject, this is called meta-analysis. We believe that a meta-analysis combining all variables as it applies to diagnosis, staging, PSA recurrence, etc., is the most important task that confronts the patient/physician team.

This tool can be used by you and your team to derive a risk assessment (RA). Correct assessment should allow you to further refine your pathology (lab or tissue) and radiology studies (scans, CT, MRI, conventional X-ray, bone densitometry, etc.) to more clearly understand your medical picture. This new clarity will then allow you to make wiser, more confident medical decisions, which will lead to an optimized outcome for you.

This is the goal of PCT II, the PCRI and its staff and many caring physicians throughout the world.

Your decision on how to treat prostate cancer may be the most important one you will make for the rest of your life. It must be dependent upon the clinical impressions we derive from examining:

• The biologic expression of your disease
• The refined studies we advise to further evaluate your particular status
• Your priorities that influence the decision on what local therapy to choose, such as,
  
  
  • Radical prostatectomy (RP)
  • Radiation therapy (RT), whether it be external beam RT, seed implant RT, high dose rate (HDR) RT, or combinations of these
  • Cryosurgery
  • None of these, but instead either watchful waiting or the use of androgen deprivation therapy, as advised

It is our opinion that the patient has a "medical Miranda", a patient "Bill of Rights", which involves his right to be fully educated on these matters. Once the new patient is educated he will have the ability to make an informed, confident treatment decision. With additional input and support from his circle of family and friends, he will gain confidence that will improve his therapeutic outcome.

Use these tool and the other information on the PCRI Web site and move to a new high ground in your understanding of prostate cancer.

Together we can beat this disease!

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Program Description

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To Download the Program:

   Click this link to download “Prostate Cancer Tools II”

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Installation Instructions:

• Download PCTIIv23.zip (Prostate Cancer Tools II) to your desktop now if you have not already done so.
• Unzip the PCTIIv23.zip file (In Windows XP just double click on the file).
• To run the program, open the resulting folder, and double click on "Project1.exe".

 

 

Prostate Cancer Research Institute (PCRI)
 

Material provided by PCRI is intended for educational purposes for discussion with your physician and should not be considered as medical advice. Information and opinions expressed on this website are not an endorsement by PCRI for any treatment, product or service.