Researchers at UT Health Science Center in San Antonio have recently updated a calculator designed to help men and their doctors assess their risk of prostate cancer. The new update, as well as its official launch on the internet, is not only helping men, but also their doctors in better understanding a patient’s risk of developing the disease. A description of the recent update’s features and benefits was recently published in the online version of the Journal of the American Medical Association.
“The prostate cancer risk calculator has been updated using current risk factors and a better interface; the current version gives a more nuanced result that helps understand a man’s risk of prostate cancer,” said Ian M. Thompson Jr., M.D., director of the Cancer Therapy & Research Center at the UT Health Science Center, who helped develop the risk calculator and co-authored the commentary.
The calculator, which is free on the Health Science Center’s website, provides information on a man’s risk for both low-grade prostate cancer — which may not require treatment — and high-grade prostate cancer within minutes. Through an “emoji” graphic readout, it turns the numeric percentages into a visual graphic. Moreover, it also provides the likelihood of a man having no prostate cancer at all, both in numbers and emojis.
“What is important are the three numbers,” Dr. Thompson explained. “For doctors, it makes for a more challenging conversation with the patient. For the patient, it gives him better information so he can decide how he wants to move forward.”
Obviously, assessing prostate cancer risk is important mostly for detecting high-grade, high risk cancers. “The prostate cancers you want to find are the high-grade cancers,” Dr. Thompson said, “because then we can take action to prolong and even save a man’s life.”
“On the other hand, in some men, a prostate biopsy will far more commonly find a low-grade cancer. These cancers have such a low risk that many men who take the time to fully understand the options, decide to simply monitor them,” says Dr. Thompson. “For many men who have been diagnosed with these low-risk cancers, they wish they’d known about that before they had a prostate biopsy; many, in retrospect wish they’d not had a biopsy in the first place. This new risk calculator helps them understand that risk in advance.”
The risk calculator is based on data collected from the 18,882-man National Cancer Institute’s Prostate Cancer Prevention Trial (PCPT), a national multi-site study of which Dr. Thompson was principal investigator. The first risk calculator was available in 2006, but Dr. Thompson reported that, as screening and treatment affects more and more people, the risk factors that affect the calculations change. Hence, the CTRC scientific team has continued to work on updates to the calculator ever since 2006.
“The new calculator should provide a more accurate prediction of the outcome that a man would expect on biopsy because it incorporates a substantially larger amount of patient data than the original calculator,” said Donna Ankerst, Ph.D., research professor of Urology at the Health Science Center and professor of Mathematics at the Technical University in Munich, who also helped develop the calculator. “It also uses an advanced statistical model to distinguish the prediction of low-grade and high-grade disease.”
The new calculator builds on the knowledge from PCPT data, but it incorporates data from a separate study conducted by Dr. Thompson as well. The San Antonio Center of Biomarkers Of Risk for Prostate Cancer (SABOR) provided the researchers with a new biomarker called percent-free PSA.
“Step by step, we are assembling the tools to help men work with their doctors to make better-informed decisions about their treatment,” Dr. Thompson said. “And, as steps go, this is a big one.”