#342 Cancer Statistics & You

Information vs. Condemnation + Target: Long tail

Stephen Jay Gould was one of the leading scientists of the 20th century. A Harvard professor and popular evolutionary biologist, he was known as the second Darwin.

He was also diagnosed with a virulent form of abdominal cancer at 41 and wrote a great, four-page essay documenting his experience analyzing the statistics of his case. It’s a quick, powerful read: The Median Isn’t the Message.

Here’s how Gould puts it: “When I revived after surgery, I asked my first question of my doctor and chemotherapist: ‘What is the best technical literature about mesothelioma?’ She replied, with a touch of diplomacy (the only departure she has ever made from direct frankness), that the medical literature contained nothing really worth reading. Of course, trying to keep an intellectual away from literature works about as well as recommending chastity to Homo sapiens, the sexiest primate of all. As soon as I could walk, I made a beeline for Harvard’s Countway medical library and punched mesothelioma into the computer’s bibliographic search program. An hour later, surrounded by the latest literature on abdominal mesothelioma, I realized with a gulp why my doctor had offered that humane advice. The literature couldn’t have been more brutally clear: mesothelioma is incurable, with a median mortality of only eight months after discovery. I sat stunned for about fifteen minutes, then smiled and said to myself: so that’s why they didn’t give me anything to read. Then my mind started to work again, thank goodness.”

He continues by saying that when most people hear something like “a median mortality of eight months” they think, “I’m going to die in eight months.”

Gould, however, points out that his scientific training came in handy as he unpacked what that actually means. A median survival rate of eight months, he says, means that half the people lived less than eight months and half lived longer. He also reasoned (correctly) that the distribution was probably “right-skewed” meaning there was a long tail to the right. Then he reasoned (correctly) that he had a chance to be in that long tail to the right.

Then he got to work to make sure he wound up in the right end of that distribution (literally and figuratively). He succeeded. He wound up living 30 times longer than that median predicted — another 20 years, eventually dying of an unrelated disease.

As David Servan-Schreiber puts it: “[Gould] had lived thirty times longer than the oncologists had predicted. The lesson that this great biologist teaches us is simple: Statistics are information, not condemnation. The objective, when you have cancer and want to combat fatality, is to make sure you find yourself in the long tail of the curve.”

How do we make sure we find ourselves (or loved ones) in the long tail of the curve?

That’s what we’ve been covering in this +1 series and in Conquering Cancer 101. We need to Optimize our terrain, cut off the supply lines, and have a positive, empowered mindset.

Gould also talks about the fact that we have the opportunity to be part of a different “cohort.” The statistics we read about for cancer (and everything else) are always going to include people following the typical western diet and lifestyle.

Don’t want to follow the typical statistical patterns? Don’t follow the typical modern lifestyle.

Today’s +1. Remember: Statistics are information, not condemnation.

Let’s not be a statistic. Let’s be a case study.

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