Does Attitude Matter In Cancer?
Though Book Thursdays usually review classic children’s books or cancer survivor stories, this one is about a cancer survivor who wrote an essay about how to cope with the despair of a cancer diagnosis.
A scientist and statistician, Stephen Jay Gould was diagnosed with abdominal mesothelioma in 1982.
When Gould asked his oncologist for the scientific literature he could read about his diagnosis after surgery, the doctor said there was nothing worthwhile to read.
Gould, used to deep research, set out to find out for himself.
That was when he learned the median time for survival of his cancer was eight months.
What Is a Median?
A median is a statistical measure that means half will live longer than eight months and half will live less than eight months.
A common measure for many things, the median, as in household income or median home price in a city, is a statistic we read about frequently.
If the median home price in your city, for instance, is $100,000, then half the homes in the city cost more.
Half cost less.
If the median household income is $50,000, then half the people in the city make more. Half make less.
Where these numbers can be misleading is if you have very low or very high numbers in the mix.
Let’s say, for instance that in a population of 20 people, two are making $1 million a year and 5 are making $10,000 a year, with the rest making $50,000.
Half are making $50,000 or less. Half are making $50,000 or more. The median income is $50,000. But, there is a lot of variation in each half.
What Is an Average?
We are more used to the common calculation of average.
If you add all the incomes for the 20 people in the above example and divide them by 20, you find the average income is $135,000.
Gould fell back on his training as a statistician to interpret the median statistic as it applied to him, and his training as a biologist to understand that the wide room for variation could be hopeful for him.
He wanted to be one of the, figuratively, millionaires, and set about to see if this was a reasonable expectation.
What Do Statistics Mean in a Cancer Diagnosis?
The first thing Gould wanted to know was whether he was likely to fall into the less than eight months or more than eight months half of the median.
None of the risk factors applied to him, so he reasoned he fell in the more than eight months half.
- He was young.
- His disease had been caught early.
- He had excellent medical care available.
- He had much to live for as he was in the middle of a well-respected scientific career.
He believed that attitude mattered in extending your life after a cancer diagnosis, by helping to build up your immune system, and was naturally confident and even-tempered.
He determined that those in the half who died before the eight-month median point gave the left half of the median a small band.
While those who died in the more than eight-month half could live for several years and still be within that statistical band.
This is what is called a right-skewed distribution, with the right side of the median stretching out in a long tail.
He had every reason to think he would be in the long right tail.
He says this understanding of what the statistics really said probably saved his life.
He was not lost to despair.
Are There Factors That Can Change the Statistics?
In addition to not having the risk factors associated with a poor outcome, Gould followed an experimental new therapy.
Since statistics can only report on what has already happened, introducing a new factor, like a new therapy, can change the outcome that statistics will only catch up with after several years.
Gould died in 2002, twenty years after a diagnosis that seemed to spell out an eight-month outcome. He died of an unrelated type of cancer after a complete recovery from mesothelioma.
Two months before he died, he published his definitive life’s work on evolutionary biology.
Click here to read Stephen Jay Gould’s entire essay, “The Median Isn’t the Message.”
Click here for a YouTube video of the essay being read, with some illustrative graphs and photos.
To you and the understanding that may give you peace.
Carol Covin, Granny-Guru