Prostate Cancer
The EPIC-26's four-week recall plus the pad count, hot flash, and PSA dread of every day in between.
Prostate cancer generates daily symptom data across urinary, sexual, hormonal, and pain domains. The EPIC-26 captures it well, on a four-week recall, a few times a year. Between those questionnaires, the 3-pad day that felt like a victory, the hot flash that soaked the sheets at 2am, and the PSA result that consumed a week of dread never reach the chart. Forma keeps the EPIC-26 and adds the continuous signal underneath it, so the score arrives with the daily reality already attached.
Forecast
Based on prior Topics logging
Topics
How it works
15 seconds of speech. 25 data points.
Forma runs between the EPIC-26 assessments, not instead of them. By voice or text, patients log daily pad counts, urinary episodes, hot flash frequency and severity, PSA results with anxiety scoring, bone pain location and intensity, sexual function changes, fatigue levels, and cognitive fog in under a minute. No forms, no four-week recall to reconstruct. Voice matters here because many of these symptoms are ones men won't write down but will say out loud. The result is a structured, longitudinal dataset that maps onto every EPIC-26 domain and fills the gaps between scores: pad count trajectories paired with activity levels, ADT side effects tied to treatment timing, and PSA anxiety quantified alongside the numbers themselves.
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Forecast
Based on prior Topics logging
Topics
Structured, coded, longitudinal
- Timing
- Infusion time:2:00 PM yesterdayNausea onset:8:00 PM
- Severity
- Nausea symptom:PresentNausea severity:6/10Emesis count:2 episodes
- Actions
- Treatment:ChemotherapyCycle number:3rd infusionAnti-emetic:ZofranAnti-emetic dose:8 mg
- Outcome
- Appetite:Absent
From data to insights
What the data reveals
Daily voice logs compound into actionable insights, for patients managing their condition and for researchers running studies.
For Patients
Is my continence actually recovering?
Your pad count dropped from 5 to 3 over 3 weeks, on track for your surgery type. Setback days (golf day 6, lifting day 18) spiked pads but your baseline keeps dropping. You held a cough on day 13, that's pelvic floor strength returning. At this rate, you should reach 1 to 2 pads by week 12.
Daily pad count
Should I worry about this PSA?
Your PSA is 0.04, well below the 0.2 threshold for biochemical recurrence. Your anxiety score was 8/10 the day you got results but dropped to 3/10 by day 5. This pattern has repeated each PSA cycle. Over 3 tests your PSA has gone 0.06, 0.05, 0.04, a downward trend.
PSA history
What activities trigger leaks?
Sneezing caused 62% of your stress incontinence episodes. Golf (sustained walking plus twisting) triggered leakthrough on your first attempt but not the second, so your endurance is improving. Heavy lifting remains a trigger. Kegel consistency correlates with better days: your 3-pad days all followed 3+ Kegel sets.
Leak triggers
Summarize my recovery for the urologist.
Week 6 to 10 post-prostatectomy. Pad count: 5 down to 3 average. Best day: 3 pads with golf completion (day 21). Worst: 7 pads after first golf attempt (day 6). PSA 0.04, stable. Erectile function: absent but anxiety decreasing. Pelvic floor PT progressing, cough control achieved day 13. Sleeping through night by day 25.
For Researchers
What is the real post-prostatectomy continence trajectory?
Across 67 radical prostatectomy patients, daily pad count shows a non-linear recovery curve: rapid improvement weeks 4 to 8, plateau weeks 8 to 12, then slow gains to month 6. 78% reach ≤2 pads by week 12. Daily data detects stalled recovery 3 weeks earlier than biweekly clinic assessments, enabling earlier pelvic floor intervention.
Recovery curve
Trend
How prevalent is PSA anxiety and what drives it?
87% of surveillance patients report anxiety scores ≥5/10 on PSA result days, even with favorable values. Anxiety duration averages 4.2 days per PSA cycle. Portal-checking behavior (>3 checks/day) correlates with higher anxiety (r=0.62). Voice-logged PSA anxiety is 2.4x higher than paper-reported, so men disclose more by voice.
PSA anxiety cycle
Trend
What ADT side effects go unreported?
Nocturnal hot flashes average 2.1/night in ADT patients, and 73% go unreported at clinic visits. Cognitive fog affects 64% of patients daily but only 12% mention it to their oncologist. Sexual function logging by voice captures 3.8x more data than questionnaires. Body composition concerns are logged by 58% of patients but discussed at 8% of visits.
Unreported symptoms
Trend
Can daily data strengthen EPIC-26 endpoints?
Daily pad counts correlate r=0.89 with the EPIC-26 urinary domain, so the two track the same construct, and the daily stream flags clinically meaningful change about 18 days before the next questionnaire captures it. Paired with the EPIC-26, a daily 3-domain composite (urinary + pain + vitality) raises response sensitivity (SRM 0.94 vs. 0.62 for the questionnaire alone). The continuous log also removes the four-week recall gap that drives retrospective PRO error.
Endpoint sensitivity
Trend
The raw signal
11 days of raw patient data
The day-by-day voice log behind the insights above, and the detail that periodic check-ins can't capture.
Week 6 post-op. Used 5 pads today. Leaked twice walking to the car. Started Kegel exercises. Physical therapist showed me this morning.
PSA came back at 0.04. Doctor says it's excellent. I know I should be relieved but I just keep checking the patient portal.
Only 4 pads, best day yet. Sneezed and leaked at lunch but otherwise dry. Walked 20 minutes, no issues.
Tried to golf for the first time. Had to stop at hole 6, leaked through pad and shorts. Embarrassing. Used 7 pads total today.
Linda and I tried again last night. Nothing. I know it's early but it's getting to me. Back to 5 pads.
Pelvic floor PT session. She said my control is actually improving, I just can't feel it yet. Did 3 sets of Kegels on the drive home.
3 pads today! Walked 30 minutes, no leaks. Even coughed and held it. Linda said she can see the difference.
Follow-up with urologist. He's pleased with recovery, said pad count trajectory is right on track. Mentioned penile rehab program.
Bad day, 6 pads. Lifted a box moving furniture and leaked heavily. Frustrated after the progress.
Played 9 holes of golf, made it through! Wore a heavier pad just in case but only used 3 pads total. Best day since surgery.
Averaging 3 pads a day now. Slept through the night without getting up. Still no erectile function but feeling less anxious about it.
Key insight
Over four weeks, Tom's daily logs fill in the recovery trajectory that a single EPIC-26 score compresses into one number: a pad count dropping from 5 to a stable 3 by day 25, with the setbacks that matter. A golf attempt on day 6 exposed stress incontinence under exertion, a lifting episode on day 18 spiked pads back to 6, and the PSA anxiety on day 2 persisted despite a favorable 0.04 result. By day 21, he completed 9 holes of golf, a functional milestone the next questionnaire will never see.
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