Decision Matrix_Prostate Cancer
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Weighted Decision Matrix - Which Treatment Option is Best for AB?
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AB's Best Treatment is: Laparascopic/Robotic ProstatectomyDate last saved: Mar-4-2019
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Decision FactorsWatchful Waiting (Gleason = 7)Radiation (Overall)Surgery (Overall)Retropubic Prostatectomy (Gold Standard)
Perineal ProstatectomyLaparoscopic/Robotic ProstatectomyAndrogen Deprivation Treatment (ADT) + Radiation or Surgery (adds 3-10% survival and reduces progression)Which treament is best for you? The pros and cons of prostate cancer treatment are mutli-factorial. The best treatment depends on a cobination of objective medical outcomes, and how you value particular factors. The scale for this decision matrix is +5 = best outcome to -5 worst outcome. In other words, it is a 10-point scale adapted to show negatives. If you are not sure how to rate a factor, place the value on a 1 to 10 scale, and then adapt it to a -5 to +5. For example, a score of 1 = -5; 2= -4; 3= -3; etc... The ratings in the first four (4) criteria are derived from the scientific literature. Do NOT change these. The ratings for the last three (3) criteria are personal. Adjust these as needed.
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CriteriaWt.CriteriaDefinition
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20-year survival rate from PC5.0000.3320.4700.7700.7700.7700.7700.83520-year survival rate with this optionLikelihood of being alive 25 years after treatment (i.e., not dying from this cancer)
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15-year survival rate rate from PC5.0000.6500.8280.8900.8900.8900.8900.95515-year survival rate with this optionLikelihood of being alive 20 years after treatment (i.e., not dying from this cancer)
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10-year survival rate from PC10.000.930.990.960.990.990.991.0010-year survival rate with this optionLikelihood of being alive 10 years after treatment (i.e., not dying of this cancer)
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5-year survival rate from PC
15.001.001.001.001.001.001.001.005-year survival rate with this optionLikelihood of being alive 5 years after treatment (i.e., not dying from this cancer)
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5- year progression-free survival 15.000.000.870.900.900.900.900.895-0.93Risk of recurrence/spread of the tumor with optionLikelihood of tumor returning or spreading
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Quality of life years (QALY) gained15.000.010.720.860.860.860.870.75-0.9QALYQuality of life gained for years after diagnosis
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Treatment curative success rate ( 1 - failure rate)15.000.000.870.950.950.950.950.895-0.984Treatment success rateLikehood that the treatment offers a cure of the current tumor
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Sub-Total Survival80296874747474
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No new disease/side effects3.0-5.02.03.64.03.04.0Side effects of optionLikelihood of acquiring undesirable side effects as a result of treatment
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Low infection rate3.05.05.02.03.02.04.0Infection rate of optionLikelihood of acquiring a new infection as a result of treatment
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Minimal/no pain1.04.04.01.01.02.02.0Pain associated with option that exceeds standard oral managementNot being in pain during treatment or after, where pain cannot be controlled by regular dosing of oral pain medicine
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Additional diagnostic value of option (i.e., staging, genotyping, node sampling, etc...)3.0-5.02.05.05.05.05.0Additional diagnostic value of option (i.e., staging, genotyping, node sampling, etc...)What else can be learned about this cancer as a result of treatment
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Future treatment options available after taking this option (e.g., all, one, none)3.0-1.0-5.05.05.05.05.0Future treatment options available after taking this option (e.g., all, one, none)In the event of a recurrence or spread of this tumor, the number of treatment options that remain available
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Minimal/no regret: Feeling less masculine0.05.02.9-3.1-3.1-3.1-3.1
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Loss of libido1.0-5.0-2.0-1.8-1.8-1.8-1.8
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Sexual function1.0-5.0-2.00.40.40.40.4
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Urinary function
3.04.03.00.40.40.40.4
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Cancer worry1.0-5.0-2.00.60.60.60.6
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Needs to void on a toilet and avoid bed pans2.05.05.04.04.04.05.0Needs to void on a toilet - Dealbreaker aversion to bed pansProtect privacy and dignity of bowel movements by using a toile;, no bed pans
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Travel to Buffalo in April and Switzerland before Dec 20193.05.05.05.05.05.05.0Travel to Buffalo in April and Switzerland before Dec 2019Able to travel safely without risk of lymph edema and sit comfortably on long-haul drives and flights after post-treatment recovery period
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Able to sit comfortably on a stool and play music within three months3.05.04.03.03.02.05.0Able to sit comfortably on a stool and play musicAble to sit comfortable on a stool as needed to play music gigs after post-treatment recovery period
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Return to playing music within three months3.05.04.04.04.04.05.0Return to playing music within three months or less of treatment Return to playing music in the same amount of time or less as after knee surgeries
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Sub-Total Needs and Values30382629312937
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Total Score6794103104102110Note on calculationThe formula for weighted scores uses a Sumproduct formula and has conditional formatting applied. Please check that the formula and conditional formatting includes the correct cell ranges if you add or remove any rows or columns.
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INSTRUCTIONS:
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Select and insert a score of -5 to +5 for each criteria. The score will be multiplied by the weight to arrive at the total weighted score.
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Keep the first column for status quo (i.e. do nothing) and score the options against the status quo.
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KEY TO COLOR CODING:
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Survial
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Objective criteria
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Subjective criteria
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