@ksellers3

I do not have the experience to answer your questions about Tulsa Pro and NCCC, Walsh

As to "how go they decide which therapy is appropriate...?"

That answer is as I and others have said, starts with the science, the clinical data and the guidelines.

After that, a lot of variables in play, mostly data emerging from clinical trials that is working it's way into mainstream clinical practice but because of the NCCN process which is rigorous and requires a longer time, are not yet part of the guidelines.

How do they decide...the better question to ask may be how do you decide with the support of your medical team..?

The latter requires you to do the homework, know the terminology, definitions, and take advantage of patient centric resources that organizations such as PCRi, PCF and others work do tirelessly to make available.

The support of your medical team is their training, education and experience.

There is a shared decision making model that depending on you and your medical team's personalities may be best suited for decision making in a complex environment where there are many variables.

Of the four treatment decisions I've had to make, two have been based on the clinical data and the NCCN guidelines, they ultimately were "unsuccessful." The other two were based on the clinical data but we parted ways with the NCCN guidelines and leaned more to the data from clinical trials. Even then, we modified the final treatment decision.

Kevin