01 March 2019, Tim Burton -
Mr David Thurtle is a researcher with The Urology Foundation and urology registrar in Cambridge. Using funding from TUF, David has developed the Predict Prostate tool which went live on an NHS website on 13 March, alongside an existing breast cancer tool.
It is hoped that this tool will empower prostate cancer patients to make the decisions that are right for them and give clinicians confidence that they are counselling patients appropriately.
You can use the Predict Prostate tool here: https://prostate.predict.nhs.uk/
Every patient who is diagnosed with localised prostate cancer has to make a decision about what to do next, whether to monitor the cancer carefully or to pursue upfront treatment. If treatment is chosen, more decisions need to be made about which treatment is right.
Providing accurate survival predictions is one of the hardest things a clinician is asked to do. As part of his research David surveyed nearly 200 prostate cancer specialists to assess perceptions around survival following prostate cancer diagnosis, and likelihoods of recommending treatment. The results demonstrated huge variations in clinician perception of long term survival, with predictions of prostate cancer death ranging from 5-95% in some clinical scenarios. Unsurprisingly, the likelihood of recommending treatment varied significantly too. Counselling patients with the best information available isn’t always straight-forward, but David’s tool hopes to inform and standardise that process.
The Predict Prostate model has been developed from data from the National Cancer Registry and survival data from the Office for National Statistics. Alongside risk communication experts from the University of Cambridge they have converted the model into an easy to use web-tool. The tool is intended for use within a consultation between a patient newly diagnosed with prostate cancer and their doctor or specialist nurse. The model asks for information on everything about their cancer from PSA, BRCA status, tumour stage, Gleason score, and biopsy characteristics, and also information on their age, whether they’ve been hospitalised for other reasons and for any significant comorbidities, such as a previous heart attack, kidney failure, diabetes, or other cancers.
Once all the information has been entered, the Predict tool will provide an estimate that is based on data from more than 10,000 case studies from Eastern England. The results look at the long term chances of survival for patients with initial monitoring or radical treatment. So, for example, the tool could suggest that a patient has a 67% chance of survival over ten years with surveillance, and a 75% chance if treated with radiotherapy or surgery. The tool will also provide a prediction for 15 years and provide information on potential side effects too.
David, a member of the Academic Urology Group in Cambridge, hopes the Predict tool will empower patients to become more involved in their treatment decision process. By providing men with more personalised information, it’s hoped patients can have more informed discussions with consultants and nurses, as well as with friends and family on what the best choice for them might be. Free online access also enables men from any part of the country to have the same access to evidence-based, standardised information.
The website is freely available for use by anyone. The breast cancer tool is currently accessed over 20,000 times a month globally and similar interest is expected in the Predict Prostate tool. If you would like to use the Predict Prostate tool, you can find it here: https://prostate.predict.nhs.uk/
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