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Posted by Dr. Stephen Scionti on Apr 23, 2014 12:15:12 PM

Prostate Cancer Navigator

Charting The Decision-Making Course

  • In Christopher Columbus' day, navigating unknown seas was done by a process called dead reckoning. That method involved starting from a known point, such as the port of departure, and at the end of each day calculating their location based on direction (by magnetic compass) and distance traveled (by timing velocity) to be able to stick a pin in a map to mark where they were. That pin became the starting point for the next day's journey. And so on, until they (hopefully) arrived at their destination. Celestial navigation, or the method of using the stars to pinpoint location and route, was just being developed by the Portuguese. It wasn't in Columbus' directional toolkit, just as there were not complete maps of the Atlantic Ocean assuring they would actually make landfall, or how long it would take.Not so very long ago, choosing a treatment for localized prostate cancer was like using dead reckoning to travel one of three roads: surgery, radiation, or active surveillance. Moving toward the destination was like making the journey one unknown leg at a time. It was hard to take the next step because it wasn't always clear where you were. There wasn't enough diagnostic information, and the roadmap was oversimplified with insufficient detail about the larger terrain.

    I have long been committed to using minimally invasive treatments, and have personally contributed to improvements in both cryotherapy and HIFU technologies.  I have also kept records on my success and side effect data, thus adding to the cumulative knowledge base about what works and what doesn't. During the same period, I have witnessed significant improvements in diagnosis that provide precise details on each patient's disease, even at the genetic or molecular level. The advances in treatment and diagnostics often overwhelm patients at the start of their search for treatment. I began to ask myself, "How could I help guide my patient toward choosing the best treatment course for his unique disease profile?"

    It's often said that a picture is worth a thousand words. I wanted to create a navigational tool that would act like celestial navigation, giving a sort of global snapshot from above so an individual could begin to identify exactly where his prostate cancer put him on the disease spectrum, and which treatments might offer him the best chance of cure with the least side effects.

    I developed and copyrighted my Prostate Cancer Treatment Navigator, an at-a-glance matching tool. As with any "shorthand" system, it is not intended to be 100% precise for each patient. Rather, it is intended to overcome the arduous dead-reckoning decision process by paralleling the degree of disease aggression with the range of best-suited treatments and their likelihood of lifestyle impact. Simply put, my goal was to help patients grasp which options are most likely to succeed in meeting their needs.

    You can find my Navigator in the right column on my home page at www.drscionti.com. The Navigator helps to guide you in selecting a treatment strategy that matches the severity (or risk) of your prostate cancer.  My philosophy is that prostate cancer treatment must be personalized and not be a "cookie cutter" or "one size fits all" approach. Clicking on the icon will lead to a link where you can download a pdf version of the Navigator.  Print it up and employ this tool as you navigate the confusing waters of prostate cancer treatments. I hope you find it helpful and healthful!

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