מחשבון

ד"ר אריאלי שלום באתר מרכז הסרטן של MEMORIAL SLOAN KETTRING יש "מחשבון" המתייחס לגידול בערמונית PROSTATE NOMOGRAM מה דעתך על השימוש ב"מחשבון"זה בתודה וחג עצמאות שמח jay http://www.mskcc.org/mskcc/html/10088.cfm NexProfiler™ Tool for Prostate Cancer Type: Newly Diagnosed Options Tool Toolbox Glossary Suggestions Help Log Out Treatment Options Menu | Next Step STEP 1. PROSTATE CANCER QUESTIONNAIRE Welcome to the NexProfiler Treatment Tool for Prostate Cancer. Your treatment options and outcomes reports are based on your answers to the questionnaire below. While you need not answer all the questions, you need to answer questions marked with a red * asterisk to continue to the Next Step and receive your reports. Complete the steps in order, if you cannot answer some questions, or cannot complete the questions, click on Save and your answers will be stored for use when you return to this site. Note: Questions with a red * require an answer to receive your report Questionnaire Assistant Save Questionnaire Personal Information and General Health Information about your general health and activity level are important factors when evaluating treatment options for prostate cancer. When were you diagnosed with prostate cancer? Learn More Select a month January February March April May June July August September October November December Select a year 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 How old are you?* Learn More years How is your general health? Learn More I am in good general health I am in poor or frail health I do not have this information Does your doctor say you are medically fit for surgery? Learn More No, my health does not permit me to have surgery (a poor surgical candidate) Yes, my health permits me to have surgery (a good surgical candidate) I do not have this information What is your activity level and self-care ability? Learn More Able to carry on normal activity (fully active) and to work Have some symptoms of the cancer but able to walk about (ambulatory) and carry out activities of personal self-care and daily living, e.g., bathing, dressing, meal preparation, household chores, etc. Able to care for self but unable to work; occasionally may need assistance with personal needs or activities of daily living Disabled; need special care and assistance with personal needs and activities of daily living Completely disabled with no self-care ability; unable to get out of bed (bedridden); may need hospitalization I do not have this information Extent of Prostate Cancer Determined by Preoperative Tests Clinical stage measures how big the tumor is by means of a digital rectal exam (DRE), and other diagnostic studies such as transrectal ultrasound (TRUS). Biopsy stage is an accurate way to determine how far your cancer has spread by closely examining the prostate biopsy. During a biopsy, the physician will remove several small samples of your prostate, and the pathologist will examine the samples under the microscope to determine the location within the prostate where the samples came from that contain cancer cells; this can identify how far your cancer has spread inside your prostate gland. The pathological stage can be predicted prior to surgery by combining pretreatment factors such as PSA, Gleason score of the prostate biopsy, and clinical tumor stage. After answering the questions below, your pathologic stage will be calculated according to published nomograms and displayed on the next page. This prediction is helpful in evaluating treatment options. Pathologic stage refers to the stage determined by a pathologist's examination of the prostate gland, seminal vesicles and nearby lymph nodes after surgical removal of these tissues. The pathologic stage is generally more accurate than the clinical stage, but not all patients chose to have surgery to treat their prostate cancer. To determine your risk for cancer spread outside of the prostate it is important to know your PSA level prior to any treatment. What is your most current prostate specific antigen level (PSA level)?* Learn More ng/mL What is the clinical stage of your cancer?* Learn More T1a - No evidence of tumor. T1b - Tumor can't be felt in a physical exam, and is found when the prostate tissue is taken for some other reason. The tumor involves 5% or less of the prostate sample. T1c - Tumor can't be felt in a physical exam, but is detected by needle biopsy, or because the patient has a high blood level of PSA. T2a - The tumor involves half or less of a section (lobe) of the prostate. T2b - The tumor involves half or more of a section (lobe) of the prostate, but the other section isn't involved at all. T2c - The tumor involves both sections (lobes) of the prostate. T3a - The tumor has extended outside of the prostate on one side. T3b - The tumor has extended outside of the prostate on both sides. T3c - The tumor has invaded one or both of the seminal vesicles, which are small bag-like organs near the bladder. T4 - The tumor has invaded other nearby organs, including part of the bladder, the sphincter, or the rectum. D1 - The tumor has spread to pelvic lymph nodes or is obstructing the ureters (the tubes from the kidneys to the bladder), or both. D2 - Cancer spread (metastasis) to lymph nodes outside the pelvic area, bone involvement, or spread to other distant parts of the body. D3 - Distant cancer spread as in D2, and the cancer is resistant (does not respond) to hormonal therapy. Additional information can be learned about how far your cancer has spread (stage) by closely examining the prostate biopsy to determine the location of the tumor in your prostate. What is your biopsy based stage (also called pathological stage as determined by biopsy)? Learn More T2a - The tumor involves half or less of a section (lobe) of the prostate. T2b - The tumor involves half or more of a section (lobe) of the prostate, but the other section isn't involved at all. T2c - The tumor involves both sections (lobes) of the prostate. Any T3 - the tumor has extended outside of the prostate on one or both sides. I do not have this information, or not applicable Not all pathologists report percent of cancer in the biopsy. If this calculation was done it will be found on your biopsy pathology report. What was the percent of cancer in your biopsy? Learn More % The most widely used grading system of prostate cancer is called the Gleason system. This system allows the pathologist to look at the prostate tissue under the microscope and grade the cancer from well-differentiated (more like normal prostate cells) to poorly differentiated (least like normal prostate cells). Two or more grades can be seen in a single prostate cancer. The most common grade number (called the primary Gleason grade) and the second most common grade (called the secondary Gleason grade) are added together for the Gleason score. What is your Gleason score?* Learn More 2 3 4 5 6 7 8 9 10 What is your primary Gleason grade? Learn More 1 2 3 4 5 I do not have this information What is your prostate volume measured by transrectal ultrasound (TRUS)? Learn More cc Spread of Cancer The following questions relate to cancer that has spread from the prostate to a different organ or site in the body. This process is called "metastasis". In some cases, metastasis may be discovered at the time of the initial diagnosis. Do you have evidence of cancer spread (metastasis)? Learn More No Yes I do not have this information If you do have metastasis, please check if any of the following areas are affected. You may check more than one. Bone Bowel or bladder Lung Liver Brain or central nervous system Do you have pain from metastasis to the bone? Learn More No Yes I do not have this information or not applicable Presence of cancer in the lymph nodes can be determined at the time of surgical removal of the prostate or possibly through diagnostic studies prior to surgery. Has the cancer spread to your lymph nodes? Learn More No Yes I do not have this information You cannot answer the following question unless you have already had surgical removal of your prostate (radical prostatectomy). What was the surgical margin status? Learn More Negative Positive I do not have this information Additional Information Long-term complications of seed implant therapy may be increased in patients who have had a prior transurethral resection of the prostate (TURP). Have you had a TURP in the past two years? Learn More No, I have not had a transurethral resection (TURP) in the past two years Yes, I have had a transurethral resection (TURP) in the past two years I do not have this information Hormone therapy may be recommended prior to other therapy such as seed implants or cryotherapy to shrink the prostate gland. Have you previously received, or are you currently taking, hormone (endocrine) therapy? Learn More No Yes, hormonal therapy only Yes, before other treatment(s) Yes, after other treatment(s) Yes, before and after other treatment(s) I do not have this information Information for Clinical Trial Participation Clinical trials are scientific research studies designed to test new treatments in people with cancer. The goal of this medical research is to find better ways to treat cancer and improve the lives of cancer patients. Through continuing research into new treatment methods, men with prostate cancer now have more treatment options and hope for survival than ever before. Clinical trials are available for nearly all prostate cancer patients regardless of the cancer stage. You are encouraged to discuss clinical trial participation with your doctor. Are you interested in learning about clinical trials? Learn More No Yes I don't know If you are interested in potential participation in a clinical trial, and have had prior therapy, please complete the additional question below. By providing the following information, you may be found to be eligible to participate in a clinical trial. Are you currently receiving or have you already received any of the following cancer therapies? Have you had previous therapy? Learn More None of these apply Radical prostatectomy only External beam radiation only Seed implants only Radiation and seed implants Radical prostatectomy after radiation or seed implants Radiation after radical prostatectomy If you are finished... ...Click on "Next Step" to submit your answers and continue. If you are not finished... ...and would like to save what you have answered so far click on the "Save" icon at the beginning of the questionnaire. Treatment Options Menu | Next Step Terms and Conditions Privacy Statement Trademark and Copyright Memorial Hospital Jacksonville 3625 University Blvd. S. Jacksonville, FL 32216 Telephone: (904) 399-6111 Fax: (904) 399-6817

jay שלום תודה על המידע. אין ספק שזה מעניין מאד, אבל שנים רבות קיימת מחשבה לבנות רובוט שהאדם יעמוד לפניו יענה לשאלות והרובוט יפלוט את דרכי הטיפול ללא צורך בעצם בבדיקת רופא. הרפואה זה מצד אחד מקצוע ששואף להיות מדוייק ומצד שני זה גם אומנות. לצערי הרב עם ההתקדמות הטכנולוגית אנו הרופאים טובים יותר באבחון המחלה ומאבדים יותר ויותר את הקשר הבן אישי בין הרופא לחולה. לרופא מנוסה יש לפעמים " תחושות בטן" או חוש שישי לגבי דברים מסוימים ולא תמיד ניתן ע"י הדמיות ומדידות להוכיח זאת. היה לי חולה עם סרטן הערמונית גרורתי במצב גרוע מאד שאמרתי לו פעם ש" הטיפול יעזור לו כי נתתי לו אותו באהבה".לזמן המוקצב שהיה לו עוד לחיות כאשר שאלתי לשלומו ( ומצבו הביוכימי - ביולוגי היה רע מאד) ענה לי תמיד : " אני מרגיש מצויין כי התרופה שנתת לי ניתנה לי באהבה". האם אתה חושב שלאותה התרופה שהומלצה ע"י מכונה הייתה אותה השפעה???? בינתיים רק חומר למחשבה...............ביי ד"ר אריאלי