What the Kattan Nomograms Can Tell You
The “Kattan nomograms” are a set of tools that allow you and your doctors to do four different things, depending on where you are along the possible pathway from initial diagnosis to hormone refractory disease:
- If you have been diagnosed with prostate cancer but you haven’t been treated at all, the nomograms can calculate the probability that you will be progression-free (i.e., no rising PSA) after you receive any one of the three most common treatment options — prostatectomy, external beam radiation therapy, and brachytherapy.
- If you have been treated with a radical prostatectomy of any type, the nomograms can predict your probability of survival for up to 10 years.
- If you have had a radical prostatectomy but your PSA is now starting to rise again (a “biochemical recurrence” of your cancer), the nomograms can predict the likelihood of success for salvage radiation therapy at 6 years post radiation.
- If you are no longer responding to hormone therapy (including orchiectomy and/or medical castration), the nomograms can predict 1- and 2-year survival.
With any luck, you will never need to use more than the pre-treatment nomogram and will never have to even think about using the last one.
To use these tools prior to treatment, you will need to know at least your PSA level, your clinical stage, and your Gleason grades and score. (If you have more information, such as the number of your positive and negative biopsy cores, the accuracy of the nomograms will be increased.)
To use the nomograms after initial treatment, you will need to know additional information which is explained in detail on the Kattan nomogram web site.
How the Nomograms Work
The really great thing about these nomograms is that all the work has been done for you! You just enter your data into the calculators at the Kattan nomogram web site, and presto: out pop “your” results!
Unless you are a statistics buff or a computer analyst, you don’t even have to think about it. Isn’t that just great! (You will have to agree to the terms on the disclaimer before you get to the calulator itself.)
For a list of published papers that supprt the development and use of the Kattan nomograms in the management of prostate cancer, simply click here.
These nomograms are based on the work of many, many people under the continuing guidance of Michael Kattan, PhD (lower right) and Peter Scardino, MD (upper right). By collecting enormous quantities of detailed information from work carried out by Dr. Scardino’s own group (initially working at Baylor College of Medicine in Houston, Texas), and then adding to their database with information from centers as widespread as Cleveland, Los Angeles, and Baton Rouge in the USA and other centers in Australia, Germany and The Netherlands, they have developed and validated a sophisticated mathematical model which is able, with considerable accuracy, to predict the outcomes of all sorts of interventions in the treatment of prostate cancer. The value of this database to prostate cancer patients and their physicians, as it continues to grow, will only increase.
The first evolution of these nomograms was published by Kattan, Wheeler and Scardino. in 1999. By April 2008, less than 10 years later, Eastham, Scardino and Kattan had published what they are referring to as the “Trifecta” nomogram: a tool that may soon allow surgeons to predict the probability of freedom from cancer, recovery of continence, and recovery of sexual function for individual patients. This last nomogram is not yet integrated into the on-line nomograms, but we can probably look for it in the not too distant future.
It is worth noting that Dr. Kattan himself has now been working for some time on the development of such nomograms for people with other forms of cancer too.