When I purposefully made the decision to leave a stable career as a lab scientist with a 401k and insurance to pursue my vocation as a professional shit poster, I gained something far more valuable: internet friends. One of them was Benny (or something like that for anonymity’s sake). I didn’t think I’d be friends with Benny for long. It wasn’t because we had major disagreements (which we did) or because online friendships are hard to maintain (which they are), no. It was because Benny was cancery as fuck.
Benny had a kind of cancer I’d never heard of. Mesenchymal chondrosarcoma is described as “an aggressive bone cancer with a poor prognosis.” It spread; an inoperable brain tumor popped up. His chances for surviving were pinned at somewhere between low and fuck you.
That was nine years ago.
Today’s Moment of Science…Surviving against the odds.
The human mind is about as properly wired for intuitively grasping statistics as it is for interpreting seagull. The lotto is really high this week so you should buy like, five tickets because that’ll cover enough combinations to have you on a yacht with Bezos by next week. Only a 2% chance of dying from that novel cough-pneumonia-brain amoeba thing going around? Pffft, that’s basically no one so it’ll never be you, amirite #freedomlovers? And according to some stats website, the presidential candidate you’re rooting for has a 66% chance of winning so if you don’t stop to think about it, that means they’re getting 66% of the votes. Um.
It’s not like there are any “good” types of cancers, but some are higher up on the danger mutant list than others. Going to battle with- technical term here- the motherfuckiest motherfuckers in oncology, the survival rates are terribly low. But whatever “low” is, it’s a number higher than zero.
With a cancer diagnosis comes a number, a percent telling a patient how steep their odds are for survival. But surviving… what, exactly? Treatment? To be cancer free? To sit on a porch with your sister wives?
A few different terms are used depending on the type of cancer. Absolute survival rate is a percentage of patients with a particular cancer who survive (a given interval, typically five years) past their diagnosis. Simple. For the five year relative survival rate, the percent of the general population of the same sex and age group that would survive the same time interval is taken into account. The finest radioactive isotopes science has to offer can lay waste to tumors across different age groups, but the actuarial tables look a smidge different decade to decade. Accounting for all causes of mortality gives a more clear picture of the true cancer survival rate.
An imperfect yardstick, there’s some disagreement over how useful of a measure this is from one type of cancer to another. On one hand, it’s an easily understood indicator of the potential disease course. On the other hand, it only tells you how likely someone is to be breathing five years from the day of their diagnosis. Really, when taking chemo with a radium-223 chaser, continuing to draw breath is a fine priority.
Some cancers are inoperable, slow-moving, and best described as chronic diseases. The aim of treatment in these cases isn’t remission; it’s stasis for as long as possible. Progression-free survival, rather than a percentage, is a prognosis for how long until the disease typically starts advancing. In types of cancer that can be kicked down to a murmur in the wind, disease-free survival is a measure of time from remission to either recurrence or any cause of mortality.
A confluence of factors affects survival rates. Age at diagnosis is part of the calculus, but it’s not a linear relationship for all cancers. Women have better survival rates than men for many kinds of cancer, though it’s not entirely clear why. The stage (how much tumor there is) and grade (how fucked the cells look) play in tandem with the location of the malignancy. Cells don’t have the courtesy to break the same way every time however, and the type of cancer makes a world of difference. For example, most thyroid cancers have a survival rate of about 99%. However, anaplastic thyroid cancer is a rare form of the disease with a median survival time of four months post-diagnosis, and maybe one or two people out of a hundred make it past five years.
Someone survives past five years though.
So, my friend Benny.
I was ready to write this asshole’s eulogy at least three times. Instead, today I asked him for permission to tell you nice folks about him for this piece (which he happily gave). His tests and scans all indicate no evidence of disease. Though I disagree, he did complain that treatment fucked up his joints, and “cut (his) sexy back from stupendous to merely amazing.” I will forever call him chemobreath.
This has been your Moment of Science, reminded of the gem of wisdom from philosopher Han Solo, “Never tell me the odds.”
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