The (Not So) Funny Thing About Lung Cancer Statistics

We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.

There is a funny story from the months immediately following my diagnosis nearly three years ago. It goes something like this. My wife* is chatting with a friend/relative on the phone, optimistically describing how I am about to begin chemotherapy for my Stage IV lung cancer. She is in a good mood, or as much of one as a person can be in while discussing such a topic. After all, her husband (me, in this story) is about to get treated using the best available medicine, and he is still relatively young, comparatively healthy, and he has fully embraced the path of his treatment after substantial scientific research. The friend/relative is quiet on the other end of the phone for a long time as my wife details how we see the next few months unfolding. In short, she paints a positive picture of her husband's prognosis. After a pause, the friend/relative says, "But you've seen the statistics, right? You know he's probably going to die in a few months. You should be ready for that."

Okay, maybe that story isn't so funny. At least not in the "laugh out loud" kind of way. But it does highlight one of the reasons why statistics, designed as a tool to help us understand data and how it applies to real situations, ironically can be more damaging than they are useful. (Irony is a form of humor, after all, so I still consider it a funny story.)

Statistics sometimes fail to tell the whole story.

The real punchline to this story is that my wife had not looked at the statistics, was not even remotely aware of what they might "reveal" about my prognosis, because I had explicitly asked her not to. Fortunately, I had prepped her for this sort of response, by telling her upfront that the stats failed entirely to consider my personal demographic. They were skewed at the outset to appear dire -- depending on what version of the stats one looked at, I had anywhere from a 2 to 4 percent chance of making it past 18 months, much less two or five years. (On the other hand, if I made it past five years, then I had pretty much a 98% chance of getting all the way to ten...) The reason they seemed so bad was simple: survival rate statistics are faulty by design. They cannot reflect the current, cutting-edge advances in medical treatment because it takes about ten years to aggregate five-year survival rate statistics. Additionally, the statistics are exceedingly broad, since they are based on the stage and general type of cancer, but do not account for individualized factors, nor advances in detection. (For that matter, they also do not account for car accidents, murder, alien abduction, or death by other diseases.)

You see, inside of those statistics, you have a large sample of people with other underlying health conditions, skewed to an older population (many who qualify as elderly), most of whom were probably diagnosed quite late in the progression of the disease. Even with the best of treatments, a significant number of those patients would probably die within a year or two, regardless of the medical approach or even their stage of cancer. Under no circumstance would I want to lump myself in with that demographic sample.

It takes time for medical advancements to be reflected in survival rate statistics.

And a lot can happen in ten years when it comes to the development of new treatments. The last decade alone has seen a huge increase in available drugs, from targeted therapies that work on specific gene mutations to an array of new immunotherapies that help the body's own defenses kill off the cancer within.

So when another friend/relative was on the phone with my wife a few months later, after I had spoken with that person numerous times and my wife had just finished a report on how well I was responding to my chemotherapy, it was easy to shrug off the comment, "But he's dying and you should be prepared for that..." Because statistics never lie. But they also never tell the truth.

* For purposes of this story, my wife is a composite character who may or may not have been related to me at any given point in the narrative. Even so, it is a more accurate representation of our collective reality than the survival rate statistics available online.