In betting on horses, a trifecta is when one not only picks the top three winners, but picks them in order as well. It now has been adapted to prostate cancer and relates to three important post treatment variables.   That is, how did the patient do in terms of continence, potency and cure of prostate cancer. It is a good analogy because it boils the issues down to the essence of what a patient should be thinking about when making his decision. All of the treatment options should be considered with each of the trifecta in mind and in addition value you them in order of importance. Then which treatment the patient feels will best give him the order of the trifecta most iimportant to him. The complexity of this is clearly delineated the book, ” The Decision.”

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