Decision tool for prostate cancer patients helps men customize treatment in anxious time

Information considered is data from the Social Security Administration, actuarial data, and cure rates reported in medical journals.

The model uses a cancer score to examine measures of prostate cancer severity.

The model considers not only the probability of death from surgery and other procedures, but also the likelihood of enduring side effects. The model expresses the possibility of each side effect's occurrence as comparable to a specific reduction in life span. A "multiobjective" model is then used to determine patients' own preferences, allowing patients to combine their concerns about life expectancy and side effects into scores rating each potential procedure. With scores derived for each, patients can more easily compare scores and decide.

The author observes that running the model repeatedly for different types of patients yields several observations. Most controversial, he writes, is that external radiation is used too often to treat prostate cancer.

"Although it can provide a moderate reduction in side effects," writes Simon, "its cure rate is lower than many people believe because many articles on radiation treatments for prostate cancer contain a systematic censoring and backdating error."

Among other observations are that surgery usually results in the highest life score for younger men; seed radiation is occasionally more desirable for early stage cancer; and combining low-dose seed radiation and external radiation might be preferable for patients especially concerned about side effects. Confirming general medical practice, the model suggests less aggressive treatment for older patients.

Dr. Simon and colleagues are currently working on an extension of this research that would provide a decision-making tool for men over 40 in the initial stages of prostate screening. Undiagnosed men in this group often have to make successive decisions about whether or not to have a biopsy and how to interpret PSA results.

For more information on this tool and others related to prostate cancer, visit Soar Biodynamics at http://soarthroughlife.com/.

About INFORMS

The Institute for Operations Research and the Management Sciences (INFORMS®) is an international scientific society with 10,000 members, including Nobel Prize laureates, dedicated to applying scientific methods to help improve decision-making, management, and operations. Members of INFORMS work in business, government, and academia. They are represented in fields as diverse as airlines, health care, law enforcement, the military, financial engineering, and telecommunications. The INFORMS website is www.informs.org. More information about operations research is at www.scienceofbetter.org.