Interesting article. It lays out many of the PCa conundrums in an easy to read, layman-friendly fashion. And, like everything else about
this annoying disease it gets a bit wrapped around itself at times. I found this bit interesting:
Quoting a radiation oncologist at Vanderbilt - Ingram, the article said...
Very few clinical trials have attempted to compare one treatment choice to another, Penson says. He was part of a study about 10 years ago that was designed as a randomized trial to compare surgery with brachytherapy in men with low risk prostate cancer.
“We wanted to put 2,000 patients on the study; we accrued 60 patients,” Penson says. “Men don’t want a computer to make this personalized decision; it’s a very hard sell.
Then near the bottom, talking about
a new study
quoting a different doctor at Vanderbilt-Ingram who is leading a new observational study,it said...
“It’s a complicated study,” Penson says. “What we plan to do is identify which therapies work best in which types of patients. And we’ll help patients identify the kinds of cancer centers and physicians that provide the best prostate cancer care.”
He hopes that the data will become part of an online tool – a decision tree of sorts – that will guide patients through the treatment options and their effects on sexual function, urinary and bowel function, and cancer control “at X, Y and Z hospitals or in Dr. PDQ’s hands.
So the plan here is for a new, whiz-bang computer system where men
will want it to (at least help) make the personalized decision that stymied the randomized study.
I'm not criticizing the effort. With PCa a degree of inconsistency is the inevitable result of hard thought. There are so many conflicting goals in tension and the answer always has to be to seek a balance between them.
My take on their online tool is that it will only work if it is designed to be transparent, so it explains all the decisions it makes, and why it made then, so that the cancer patient will recognize his own thinking, educated and distilled in the result.