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Thursday, June 6, 2002    permalink
What are the odds?

Several years ago my mother died of pancreatic cancer at age 72. According to the American Cancer Society, for all stages of pancreatic cancer combined, the one-year relative survival rate is 20%, and the five-year rate is 4%. Those with Stage III or IV cancer like hers rarely live more than 6 months after diagnosis. Late-stage diagnosis is common because pancreatic cancer doesn't generate many specific symptoms until it is fairly advanced.

There are no good treatments for late-stage pancreatic cancer. Nevertheless, my mother underwent radiation and chemotherapy. I don't believe that her doctor gave her or my father a clear picture of the statistical outlook ~ I also suspect that they did not demand one. As soon as I heard about her diagnosis I got online and did the research.

When I understood how grim the situation was, I was faced with a dilemma. How should I convey what I knew? Should I say anything at all? Should I suggest that my mother not fight, not put herself through the suffering of a futile and barbaric regimen of poisons? Did I have the right to undermine their hope in any way?

In the end, I decided that I would support and advocate for my mother based on whatever she said she wanted to do, and to respect whatever limits she placed on her own information-seeking. My mother was an intelligent and dignified woman, and I chose to let her proceed in her own way. Many of her choices were colored, I know, by what she thought my father could bear (it was that way throughout their marriage). I believe that she couldn't let him believe that she didn't want to fight in every way possible for her life ~ and by extension for his.

Numbers are numbers, statistics are statistical. All can be bent, interpreted, recast, and abused (lies, damned lies, and statistics, right?). When the news is bad, we want to be outliers, several deviations from the norm, on the positive side of the curve. Still, I wonder, how might my mother's last days have been different had she and my father truly been able to integrate the numbers into their decisions?

These thoughts were prompted by a much less gloomy article by Stephen Jay Gould, important reading for anyone who wants to incorporate a statistical view into life and death choices.

3:41:20 PM    please comment []



© Copyright 2002 Pascale Soleil.
Last updated: 11/10/02; 3:01:14 PM.
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