Thursday, May 26, 2011

Prostate Treatment Matrix

It has become abundantly clear to me that there is no "one size fits all" when it comes to deciding the best procedure for treating prostate cancer.  There are too many variables and too many ifs, ands and buts.  I found that I always placed the procedure that I read about last on the bottom of my preferred list because of all the disadvantages.  In order to place some logic in choosing the right procedure for me I decided to create a matrix.

The first thing I had to do was create a list of all the reasonable options I have available.  I am sure I could come up with a list of about twenty options because of all the choices I have within a specific procedure and even the possibility of combining different procedures.  I ended up listing six procedures.   The next thing I did was create a list of  concerns with each procedure and assign a weight for each of these concerns.  For me the most important concern was "what are the chances that this will eliminate all of the cancer cells".  Because this was the most important factor I assigned this a weight of 10.  At the other end I listed external scars as a concern.  Because this is not that important to me I assigned this a weight of 2.

The last thing I did was to rate each of the concerns against all of the options with an input number.  For instance, since a radical prostatatectomy will leave a fairly significant scar around my midsection I gave it an input number of 2.  Robotic surgery will leave small incisions around my midsection I gave it an input number of 6.  This is the most subjective part of this exercise.  I think ranking the concern for each procedure is pretty straightforward but whether an input number should be a 5 or a 6 can always be debated.

Weight Concern
10 Odds of 100% Cancer Removal 8 8 7 7 7 0
8 Minimum Collateral Damage 7 6 4 5 5 10
2 External Scars 6 2 8 8 10 10
7 Leaves other options open 7 7 3 4 7 10

A Robotic Surgery
B Radical Prostatectomy
C External Beam Radiation
D Seed Implantation
E Cryotherapy
F Watchful Waiting

Once all of the input data has been entered I simply multiplied the input data by the weight to calculate a number for each concern for each procedure.  I then simply added these numbers together to arrive at a total score for each procedure.

As you can see from the table below the robotic surgery came out with the highest number which means it appears to be the best option for me.  I am sure that some of my input numbers will change as I learn more about each procedure.  I also suspect that I will add one or two concerns over time but I think this is a good starting point.  My sessions with the specialists in each of the procedures will certainly help me refine my matrix.  I am scheduled to have all of these consultations complete by the first week of July.  After that date the ball will be firmly in my court and I will have a big decision to make.

If anyone has any ideas on how to improve my analysis I would love to hear from you!

Weight Concern A B C D E F
10 Odds of 100% Cancer Removal 80 80 70 70 70 0
8 Minimum Collateral Damage 56 48 32 40 40 80
2 External Scars 12 4 16 16 20 20
7 Leaves other options open 49 49 21 28 49 70
Total 197 181 139 154 179 170