What the Kattan Nomograms Can Tell You
The so-called “Kattan nomograms” on the Memorial Sloan-Kettering Cancer Center web site are a set of tools that allow you and your doctors to do three 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 pre-radical prostatectomy nomogram can predict (a) the probability that you will be progression-free (i.e., no rising PSA) at 5 and 10 years and (b) the probability that you will not have died of prostate cancer at 10 and 15 years after you receive a radical prostatectomy (surgery).
- If you have been treated with a radical prostatectomy of any type, and your PSA level drops to < 0.1 ng/ml after the surgery, the post-radical prostatectomy nomogram can predict (a) the probability that you will remaining prostate cancer recurrence-free at 2, 5, 7, and 10 years and (b) the probability that you will not have died of prostate cancer at 15 years after you receive a radical prostatectomy.
- If you have had a radical prostatectomy and your PSA initially fell to < 0.05 ng/ml, but your PSA is now starting to rise again (a “biochemical recurrence” of your cancer), the salvage radiation therapy nomogram can predict the likelihood of success for salvage radiation therapy at 6 years post radiation.
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 third one.
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 nomograms themselves.)
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 selected interventions in the treatment of prostate cancer.
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 a “Trifecta” nomogram: a tool that may allow surgeons to predict the probability of freedom from cancer, recovery of continence, and recovery of sexual function for individual patients. But this last nomogram is not yet integrated into the on-line nomograms.
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.