A systems account, phase by phase .
A white paper, five foundational papers, and eighteen framework papers, organised into five phases and three layers of intervention. The shape of an individual's disease, not the average of a cohort, is what the framework is built to describe.
The disease has a shape.
- 01
Pre-disease
The biology that will either permit or resist future disease is already being shaped, long before any diagnosis arrives.
- 02
Indolent
Disease is present, but for most men it will remain exactly where it is, quiet, slow, and requiring understanding far more than it requires intervention.
- 03
Inflection
Something in the underlying biology has shifted, and recognising that shift early, before PSA makes it obvious, is where individual monitoring earns its value.
- 04
Active
The disease is moving, and the decisions made now, about what to treat, how, and in what sequence, will shape everything that follows.
- 05
Refractory
When standard approaches lose their hold, the biology hasn't failed, it has adapted, and understanding how it adapted is where the next decision begins.
Intervention, layered.
Terrain
The biological ground the tumour grows in; metabolic, hormonal, inflammatory. Most interventions act here, and most are underused.
Signal
Tumour behaviour depends on inputs the system receives. Changing the signal (androgen, growth-factor, stress) changes the trajectory.
Selection
Chronic intervention selects for resistance. Oscillating intervention does not. Timing is itself a therapeutic variable.
Where to start.
If you are a patient or a family member, start with the book A Calm and Intelligent Guide to Prostate Cancer. It was written for readers who have been diagnosed and want to understand what is happening without wading through the literature.
If you are a clinician, start with the White Paper, which sets out the theoretical and empirical foundation for the framework. The papers build from there.
If you are a researcher, the full twenty-three-paper archive is available as a single download on the Papers page, along with supplementary materials.
The framework is a body of research proposals. It is not, and should not be read as, medical advice. Individual care belongs with an individual clinician.