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Do we need more nomograms for predicting outcomes in patients with prostate cancer?

Nature Clinical Practice Urology volume 5, pages 366–367 (2008)Cite this article

Men naturally ask lots of questions when they are diagnosed with clinically localized prostate cancer. Will this disease kill me? Do I need treatment, now or in the future? If I treat the cancer, will it come back? Are there adverse effects of treatment, what are they, and how common are they? What will happen to me if I leave the disease untreated? These questions are all perfectly natural for a man or his partner to ask and worry about. Men will ask everyone they can think of for answers, and often search in books or on the internet for information. Partners can be even more obsessed with finding answers than the patients themselves. The answers are extremely important because they can drive patient decision making.

Although the answers to these questions are important, they are only predictions. None of these questions can be answered with certainty (e.g. you will live or die), and definite future medical outcomes are practically never known for an individual patient. This uncertainty is a fact of life, much like whether or not it will rain tomorrow or whether or not the stock market will go up. Life is full of predictions. Moreover, each patient has a different prognosis and likelihood of particular outcomes, which requires some customization of the answers to these questions. We cannot answer individual patients' questions with a one-size-fits-all solution. Patient heterogeneity should be taken into account when determining predictions for an individual patient.

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  1. Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid/Wb4, Cleveland, OH 44195, USA kattanm@ccf.org

Authors and Affiliations

  1. and Chairman of the Department of Quantitative Health Sciences at the Cleveland Clinic, MW Kattan is Professor of Medicine, Epidemiology and Biostatistics at the Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA.,

    Michael W Kattan

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  1. Michael W Kattan
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The author declares no competing financial interests.

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Kattan, M. Do we need more nomograms for predicting outcomes in patients with prostate cancer?. Nat Rev Urol 5, 366–367 (2008). https://doi.org/10.1038/ncpuro1128

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