Partin Tables - how good are they?
Clarence Crow
I've seen a lot of posts re the Partin Tables and never really
bothered to check them out.
I did this about an hour ago, plugged my Data in and was horrified by
the Calculation it spat out.
I don't have too long to go, according to that, and I'm only STARTING
my treatment (relatively).
They don't even require you to input your age. (that would make it
worse)!
Here's my Data on entry to treatment:
PSA 21.0
Gleason Score 8 (4+4)
Clinical Stage T2C
Other:
Age: ~70
Other Medical History: NIDDM, OA, HTN/Cholesterol, IBS, Overweight.
OA in legs and feet limits walking to short distances only. (1/2 a
spoke away from a wheel-chair).
Treatment Regime:
ADT2 10 wks from Nov 2004, continue on ADT1 (Lucrin) up to 18 mths.
3D CEBRT for 5-6 wks (23 sessions) commencing March 21, 2005.
3 Fractions HDRBT over 48hrs commencing July 12, 2005.
Resume ADT1 for further 12 mths.
-- Reader to complete...
-- Please reply to this ng as my email adress is fake:
-- Regards
-- CC
James A Honeychuck
the situation at diagnosis with the situation as found definitively in
the post-operative pathology report.
What it means for new individuals who come along is of course the
$64,000 question.
jimhoney
Leonard Evens
> Hi again all
>
> I've seen a lot of posts re the Partin Tables and never really
> bothered to check them out.
>
> I did this about an hour ago, plugged my Data in and was horrified by
> the Calculation it spat out.
> I don't have too long to go, according to that, and I'm only STARTING
> my treatment (relatively).
> They don't even require you to input your age. (that would make it
> worse)!
You have to understand just how the Partin tables were constructed and
what they are supposed to predict. Patin and his colleagues compared
presurgical diagnostic criteria to postsurgical patholgy reports. On
the basis of their data they came up with numbers supposedly giving
estimates of the likelihood, based on stage, PSA, and Gleason score, of
various outcomes in the postsurgical pathology. We all know that if the
cancer has metastasized to distant sites before treatment, neither
radiation nor surgery will cure it. The Partin tables don't directly
tell us the likelihood of such metastasis, but of course if it is found
in the seminal vesicles or more important the lymph nodes, metastasis
is more likely. The Partin tables may also give some idea of how likely
it is that there will still be some local spread left after treatment,
but again no direct information. Remember that the pathologist only
looks at the prostate and has no idea what is happening in the rest of
your boody. Even if cancer is found in the lymph nodes, it may have
stopped there, for example.
>
> Here's my Data on entry to treatment:
>
> PSA 21.0
> Gleason Score 8 (4+4)
> Clinical Stage T2C
In your case, the Partin tables' estimate is that there is a 53 percent
likelihood cancer would be found in either the seminal vesicles or lymph
nodes if you had surgery. The chances that it would have been found to
be organ confined is very small. Note however, that there would have
still been a 47 percent probability that the pathology report would have
not found it in the seminal vesicles or lymph nodes. But there is also
some considerable possible variation in that estimate, so there is still
a lot of uncertainty.
>
> Other:
> Age: ~70
> Other Medical History: NIDDM, OA, HTN/Cholesterol, IBS, Overweight.
> OA in legs and feet limits walking to short distances only. (1/2 a
> spoke away from a wheel-chair).
Given this diagnosis, few urologists would be willing to consider
surgery. However, if you were relatively young, it might still be
considered worth trying. So that is the way age and general health
might enter the calculation.
>
> Treatment Regime:
> ADT2 10 wks from Nov 2004, continue on ADT1 (Lucrin) up to 18 mths.
> 3D CEBRT for 5-6 wks (23 sessions) commencing March 21, 2005.
> 3 Fractions HDRBT over 48hrs commencing July 12, 2005.
> Resume ADT1 for further 12 mths.
Your doctors apparently decided to try radiation supplemented by hormone
therapy. The Partin tables don't give a precise indication of whether
or not metastasis has already occurred. Other research, however,
suggests it is too high to risk surgery, which wouldn't make as much
sense in a man your age anyway. But there is still some reasonable
chance the radiation may cure you, or, if not, greatly extend the period
of time before clinical recurrence.
If I were you, I would try to be optimistic. It is certainly far from
hopeless and you might even be cured. If not, there is a reasonable
chance that with appropriate treatment you will live out your normal
life before the prostate cancer can get you. As my urologist said
"Those are statistics and you are only one person; either it happens to
you or it doesn't." You might as well assume the worst won't happen to
you. That would not be irrational under the circumstances.
Clarence Crow
Additional Pre-Treatment info:
Firstly, the Uro only Staged my Tumour at T2A, (by DRE). He referred
me for the Biopsy and after reading the report, frowned and referred
me to a female Radiation Oncologist. He didn't even mention the
Gleason Grades. He didn't give me a copy of the Biopsy report either.
He did say that Radiation was the better option for me, given my Age
and other pre-existing health conditions.
I fired the female RO as she didn't even have a copy of my Biopsy
report. I had to get the Hospital Receptionist to get it out of the
Computer and demanded a Copy for myself.
By that time I had subscribed to this ng and had begun researching the
web for other PCa info.
So I was in the wilderness for a week or so and then applied to get
into a Clinical Trial at SCGH. (advised by someone I met in this ng).
I had to pre-qualify for the Treatment I mentioned in my previous
post. So I had another week of intensive Tests, involving Bloodwork,
Chest & Spinal X-Rays, a CT Scan (with Iodine) and a Full Body Bone
Scan. This was mainly to determine the Tumour was still
Organ-Confined. The results were favorable (no Mets and no Seminal
Vesicle invasion) and I was accepted.
The Chief Radiation Oncologist at SCGH re-staged my Tumour from T2A to
T2C from the Biopsy report details, showing high Gleason scores in
Both R & L lobes.
My Treatment Regime was then Randomised into 1 of 4 Arms.
I got Arm 3, which is as posted previously.
The first 2 Arms were for less aggressive Tumours and only 6 months
duration.
Arm 4 only added Bisphosphonate (Zometa) to Arm 3's Treatment for
persons considered to have Bone Mineral Density problems.
I have since re-visited the Partin Tables website and realised that
they were formed as a guide only from historic info and may even
require updating. They also seem to target somewhere in the middle of
a broad range of Data.
In summary, I'll just soldier on, within the frame I've been assigned
and see what the outcome is. I cant see many other options.
Thanks for your inputs.
I. P. Freely
climb the Empire State Building stairs at present), and just quit looking.
The Partin tables and some other prognosis nomograms are valid, but they
readily admit that a few people die much earlier than projected and another
few live far longer than projected. Once we choose and pursue an initial
treatment, the rest is primarily about which side of the bell curve fate
puts us on and how much crap we want to put up with for a few extra months
of heartbeat. Makes me damned glad I retired so early just in case some BS
like this came along.
I.P.
Alan Meyer
One thing going for you is that the bone scan and other
tests done by the clinical trials people came up clear. That
doesn't mean you really have no metastases, but at least
you're not in the category of men who are known to have
them. Perhaps that puts you a little closer to the lucky
side of the Partin statistics than the unlucky side.
Hope your luck holds. Hope all of our luck holds.
Alan
I. P. Freely
SV involvement makes quite a difference in prognosis, but the biggie is
still the Gleason grade.
I.P.
"Clarence Crow" <cr...@perch.biz> wrote
> The results were favorable (no Seminal
> Vesicle invasion)
Steve Kramer
less than yours. But, in reality, what you and I did in our first 50 is
probably most important. The other 10-15 are icing on the cake.
--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3bN0M0
Seminal Vesicle involvement, Neg margins
PSA .1 .1 .1 .27 .37 .75
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05
PSA .07 .05 .06 .05
non Illegitimi carborundum
"I. P. Freely" <fuhghed...@noway.nohow> wrote in message
news:wwpWd.34650$Z35....@fe06.lga...
Clarence Crow
<fuhghed...@noway.nohow> wrote:
>That's what my docs said pre-op, also. Post-op pathology proved 'em wrong.
>SV involvement makes quite a difference in prognosis, but the biggie is
>still the Gleason grade.
>
>I.P.
Apart from the neg involvement of the SVs, forgot to mention similar
for the LNs.
I'm quite well aware that the G scores are right up there, as soon as
they mention "poor differentiation", meaning the active cancer cells
could already be circulating in the bloodstream, seeking a new home!
So I'm still in a "cross-your-fingers" mode.
Seeing I'm on Rad, I'll never get to see a Post-op pathology report.
All "fuzzy data"!!
keit...@webtv.net
no reason to pay attention to them as fact but could use them as a
guide.
Keith Lundy/So. California
40 Proton Beam Radiation Treatments
Loma Linda Univ.Med Ctr..3/03-5/03
Leonard Evens
> Persons of color were not included or involved in the studies and have
> no reason to pay attention to them as fact but could use them as a
> guide.
Are you sure about that? I thought the research was done at Hopkins
which is in Baltimore. Baltimore has a substantial African American
population, and I would be suprised if only men of European descent were
included in the study.
James A Honeychuck
was not large enough to be statistically valid for that group.
http://urology.jhu.edu/prostate/partintables.php
jimhoney
Baltimore
Johns Hopkins patient
keit...@webtv.net
an extremely useful tool for empowering patients and doctors but the
accuracy and revelance to african americans have been debated...there is
a discussion in the JAMA 1997 Letter to the Editor; 278:981 "Predicting
pathalogical stage of prostate cancer" J.A. Petros....BUT...I can't
access the darn thing...it is my understanding that A.W. Partin has a
written response to the issue.