Lies, Damn Lies, and Cancer Statistics

Sooner or later, every guest of this Hotel will have a close encounter of the worst kind with the terms “median survival” and/or “median mortality” with some number of months or years attached to the term. Consequently, evolutionary biologist Stephen Jay Gould’s essay, “The Median Isn’t The Message”, should be on everyone’s reading list; I’ve provided a link on the right side of this page under the patient resources heading.

I’m just a math-challenged recovering attorney but even I get Gould’s very important message, which my simple lawyer mind boils down to these three critical points. One, half the patients live longer than the median. Two, an individual patient with a fighter’s positive attitude, who is otherwise in good health, and who seeks out and receives the best available treatment, very likely has a better than 50% chance of surviving beyond the median. Three, the variation around the median is invariably “right skewed”--i.e., some number of patients among those who live longer than the median, perhaps a lot of those patients, live long beyond the median. And some of those folks on the right hand side of the curve stand at least a chance of surviving to a time when treatment advances become a game-changer.

In honor of Gould, here are some new lyrics to the Beatles’ “Let it Be”…



When they scan myself and find some trouble
Statisticians speak to me
Median survival, I will beat.
And in my hour of darkness
Docs are talking odds on treating me
Speaking odds of dying, I will beat.
I will beat, I will beat.
I will beat, I will beat.
Median survival, I will beat.

And when the doctors talk to patients
Stuck in cancer world with me,
There will be statistics, we will beat.
For though docs may be smarter there is
Still a chance that they can’t see
There will be statistics, we will beat.

We will beat, We will beat.
We will beat, We will beat.
Yeah, There will be statistics, We will beat.

We will beat, We will beat.
We will beat, We will beat
Median survival, we will beat.

We will beat, We will beat.
We will beat, We will beat
There will be statistics, We will beat.

We will beat, We will beat.
We will beat, We will beat
Median survival, we will beat.

And when my scans are cloudy,
There is still a curve right skewed for me.
Skewed into the future, let it be.
I drive up to the cancer clinic
Cancer doctors talk to me
Speaking odds of living, I will beat.

Let it be, let it be.
Let it be, let it be.
There will be tomorrow, let it be.

Let it be, let it be.
Let it be, let it be.
There will be tomorrow, let it be. hoooo' hoooo'