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Published: Sunday, 3/25/2007

The Numbers Game

Statistics are grim business.

Somewhere between 1 in 2 men and 1 in 3 women* will be diagnosed with cancer sometime in our lives. You have an almost 30 percent chance of dying from heart disease. And, as we've heard again and again since Elizabeth Edwards was diagnosed with Stage IV breast cancer last week, only 1 in 4 patients survive longer than five years after such a diagnosis.

But there are statistics, then there is life. If we all believed statistics were a reliable predictor of what would happen to us as individuals, no one would buy another lottery ticket, since the statistical odds against winning are so fantastically ridiculously stacked against us. But we buy them, even if only occasionally, even if just on a whim, because as bad as we know the odds are, we think we're special.

I would argue that is a wonderful thing about humans, this ability to close our eyes and hope for something different. (That it makes us easily manipulated by con artists, advertisers, and unscrupulous people of all stripes is the flip side of this.)

But while our fantastic optimism about lottery tickets has to be put in the category of wishful thinking, not getting your underwear all in a bunch about the statistical probability of a 1 in 4 cancer diagnosis is viewed as a rational thing to do. No one would advocate you run around worrying about this all day. You probably ought to think about your risks: Do you smoke? Do you have a family history of cancer? Are you a sun worshiper? Are you overweight? And make adjustments in your life by changing behavior and increasing screening, but beyond that, jeez, who cares? Go about your business people. There's nothing to see here.

Yet we expect people with an actual cancer diagnoses to behave somehow differently. I've seen this played out. Cissi Jackson was a Pemberville woman with metastatic breast cancer. Nothing nothing nothing convinced her she wouldn't beat this thing. And she was criticized for it. When I wrote about Cissi 2002, I encountered a lot of hand-wringing about her false hope. Now Cissi eventually succumbed to her disease, but her battle was valiant, and she was happy. I met her after she'd left one doctor who'd insisted she accept her fate, by which he meant that he knew what her fate was. She ignored his advice, got a new doctor who tried different drugs, and extended her life longer than she would have with the acceptance she'd been advised to embrace.

So, statistics aren't necessarily predictors of individual fate. They say something about patterns and trends, and not always nice things. But do you surrender to them?

Janet Schmeltz from Bowling Green would say no. An email from her the other day reminded me of the difference between statistical trends and personal circumstances. Here's what she wrote:

I read your article concerning Mrs. Edward's

recurring cancer, and my heart went out to her.

I, too, was diagnosed with Stage IV breast cancer two

years following my initial diagnosis. But it is

possible to beat the odds! I went through experimental

treatment at the best cancer center in the world: M.D.

Anderson in Houston, Texas. I had a bone marrow pull

and storage, extremely high doses of chemotherapy and

had to be placed in a laminar air-flow room (bubble)

for 50 days.

The breast cancer oncologists there consider me cured from Stage IV when in 1994 I developed a new primary tumor solely in my breast and restaged me as Stage I. I am still cancer free and have been an active teacher for 32 years.

So, fellow lottery players, let's recognize how much more reasonable Janet Schmeltz is about cancer odds than we are with our dollar tickets. No one knows how any individual case will come out. You have signs and indications, but that's it. If you went around obsessing about your 40 percent chance of dying of heart disease every day of your life, we'd be deeply concerned about your mental health. You may accept those are the odds, but you're still alive, and that's what matters.

* Cancer statistics come from this document

from the American Cancer Society, see page 14. These statistics exclude diagnosis with basal and squamous cell skin cancers.



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