Beating the Odds

I manage other people’s money for a living, so I know a thing or two about risk and statistical measures.  If I were a betting man, I would have bet against my living eight years after getting a diagnosis of late stage lung cancer. But, here I am, against all odds. 

I got my annual surveillance scan results this week and I am pleased to report that I am still NED (no evidence of disease). Dr. Thomas Fabian at Advanced Imaging has been one of my doctors from the beginning.  When I finished my scan this week, he was waiting at the door for me as I emerged from the exam room.  He guided me to his office to immediately review the results. I think he may have been as anxious to know the outcome as I was.  After all, he has eight years invested in my case.  
Together we looked at a comparison of this year’s scan to last year’s. Dr. Fabian reviews these detailed images like he is looking through a digital family photo album. For a layman with no medical training I cannot really see very much.  Dr. Fabian pointed out what he was looking at: “Here is the top of your heart….this is your lungs, here is where the tumor was, you can see the scarring from the radiation there…your liver is clean…nothing remarkable.” After a few minutes reviewing the all the images, Dr. Fabian told me that “Everything looks good.”  Those are words every cancer patient wants to hear.

As I was leaving I thanked Dr. Fabian and asked him how many patients he has known with my stage of disease still around eight years later. His answer was “Not many. You are definitely in the 5%.”  I also asked him if he has seen any uptick in lung cancer screenings.  Sadly the answer was also “no, not many.” If you are or were a smoker and you are 55 or older, don’t put it off.  Get screened!

I’ve been talking about the 16% five year survival rate for lung cancer in this column for many years.  But the reality is that 16% is an AVERAGE five year survival rate from date of diagnosis. That data could be parsed into survival rates based on stage of disease.  Stage I and II survivors would be the largest group, followed by Stage III and Stage IV, who naturally have lower survivorship rates.  If you took all lung cancer cases and put them in a graph with number of people diagnosed on the vertical axis and time to death from date of diagnosis on the horizontal axis, you would find that it forms a downwardly sloping curve.  By the time you got to 5 years on the time scale, 84% of the patients diagnosed would have died. The people who survive beyond the five year mark are the outliers.  As you move farther and farther to the right on the curve, the survivorship declines until 95% of the patients you started with are gone. I am one of the lucky ones in that is in the remaining 5%.

Most of the people diagnosed with lung cancer 8 years ago are now gone  As a survivor, I feel it is incumbent upon me to do what I can to honor them, remember them, and do something to increase survivorship.  If you would like to honor and remember someone you loved who died of lung cancer, make a memorial sign for them to be displayed at the SW Florida Run Walk November 7^th. Get your sign made today at www.lcrcinc.org .

Any discussion about the cancer statistics and death rates should include a caution: people are not statistics.  Every case is different and no one can tell you with certainty what the outcome of your case will be. Scientists love to use statistical measures to predict outcomes, but there are many factors that influence outcomes.  The more complex the problem, the more unreliable predictions will be. Cancer is about as complicated as anything in life.   The factors that influence the outcomes of cancer cases are as numerous as there are patients. Since no two people are alike, so no two cases are alike.  As I said at the beginning, based on statistics, I would have bet against me being alive today. The odds were against me. It turns out I would have lost that bet.  And as they say in golf, I’d rather be lucky than good!