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June 27, 2012

I am not a statistic – I said so much in a new video resource guide for patients diagnosed with Colorectal Cancer developed by the Chris4Life Colon Cancer Foundation.  But with my relapse, which brought with it a progression to Stage IV cancer, I got curious; so a few days ago, I looked up colon cancer five-year survival rates.  I was at first shocked by what I found – I was not expecting to find anything nearly as low as eight percent (or even six percent, depending on the source).  What happened to colon cancer being one of the more curable cancers?  But after my initial freakout, I started to think reasonably – and thought of several reasons this particular statistic would not necessarily apply to me.

Statistics can be overwhelming – and even misleading – mainly because many of us do not know how to read and interpret them.  No one explains this better than Stephen Jay Gould in his essay The Median Isn’t the Message.  Gould, an evolutionary biologist, was diagnosed at age 40 with abdominal mesothelioma, an incurable form of cancer with a median survival rate of only eight months after diagnosis.  He lived, however, for twenty years longer, before passing away from an unrelated form of cancer.

After looking at the survival curve for abdominal mesothelioma, Gould realized several things.  First, a median survival of eight months meant that half of the people would live longer.  Young, otherwise healthy, and with access to good medical attention and a positive attitude, he had a good chance at being in that group. (Check.)  Second, the statistical distribution was right skewed, stretching out for several years.  Third, that statistics rely on a specific set of circumstances – typically, the conventional treatment at the time the study was done.

By the time I looked up survival rates, I had already read Gould’s article – and I used its reasoning to talk myself off the ledge.  First of all, the statistics I’ve cited above are based on data from 1991-2000.  The conventional treatment at that time did not include oxaliplatin, which was not approved by the FDA until 2004, but is now part of the standard chemotherapy regimen.  In addition, according to the American Cancer Society, 90 percent of colon cancer diagnoses – and 94 percent of deaths – occur in people over the age of 50.  Since a five-year survival rate (or at least the one I found) is imperfect – it does not take cause of death into account, simply counting how many patients are alive five years after diagnosis – the fact that most patients are at least twice my age is significant.  As David Servan-Schreiber, author of Anticancer, writes, “variation is the very essence of nature.”  Factors such as my age, and even my gender (both incidence and mortality rates are 35-40 percent higher in men than in women), place me in the variation as opposed to the mean or median (ideally, to my benefit).

Finally, I wanted to share an excerpt from the Gould article that I find especially encouraging:

“Attitude clearly matters in fighting cancer. We don’t know why (from my old-style materialistic perspective, I suspect that mental states feed back upon the immune system).  But match people with the same cancer for age, class, health, socioeconomic status, and, in general, those with positive attitudes, with a strong will and purpose for living, with commitment to struggle, with an active response to aiding their own treatment and not just a passive acceptance of anything doctors say, tend to live longer. A few months later I asked Sir Peter Medawar, my personal scientific guru and a Nobelist in immunology, what the best prescription for success against cancer might be. “A sanguine personality,” he replied.”

If nothing else, a positive attitude is something I have maintained since my initial diagnosis, and I do not plan to let go of it any time soon.  Learning of my recurrence and reading the statistics has been sobering, but constructively so; in some ways, I need to take this more seriously.  I must do everything I can – in terms of diet, exercise, stress reduction, and general health – to get better.  So I will – and my optimism will remain strong.

5 Comments leave one →
  1. June 27, 2012 11:37 pm

    I totally hear what you are saying. The Stage IV family is a slightly different family.

  2. June 28, 2012 6:47 am

    I was diagnosed with Stage IV metastatic colon cancer that also resulted in a colostomy in August 2011 and through a mix of faith, family support, chemo and positive attitude I have experienced no growth in the cancer since that time and continue to work and be very active. I appreciate this post – thank you! Bernie

  3. MLegrain permalink
    June 28, 2012 11:33 am

    Rachel! You write really well. Hope to see you soon! Call me if you want to hang out. Milli

  4. August 1, 2012 9:56 am

    So glad to have found your blog (Spotted it on ‘I’ve still got both my nuts’). I’ve heard about the Gould article and have to say it is empowering. It’s relieving to know statistics are not truly so black and white, despite first appearing to be. Good luck with your treatment and moving forward. I look forward to stopping by and saying hello.


  5. September 4, 2012 2:14 am

    Thanks for sharing the Gould article. I hadn’t heard about it. It’s so encouraging. A ‘must-read’ for everyone struggling with a cancer diagnosis.

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