When my wife was diagnosed with cancer for the first time, in 1990, she was told that she was in Stage 1, which meant that 90 percent of all patients survive five or more years.
My wife and I recall the words our oncologist shared with us as if it were yesterday. He made it clear that if 90 percent survive, it also means that ten percent do not.
We understood that, but let’s face it, that ninety percent figure was very encouraging. I mean, let’s face it…if there’s only a 10 percent chance of rain, who in their right mind would carry an umbrella with them?
We believed my wife’s life was never really in danger. Yes, our lives were detoured via chemotherapy and radiation, but the words “life threatening” never entered our vocabulary.
Fast forward to 2006. The same knee that we believed would never house cancer again did so in a very aggressive fashion. This cancer was apparently created by the radiation that bombarded her knee sixteen years prior.
Suddenly, our detour became an airplane that lost its engines and was plummeting toward earth. Our new oncologist stated my wife was in Stage 3, with a survival rate of 28 percent. In fact, we were informed the odds were against us that my wife would survive the next holiday season, which was only five months away! In other words, the odds of passengers surviving a jetliner crash, or the possibility of curing my wife of cancer this time around were hardly optimistic, if not downright depressing.
Should we have prepared ourselves for death? Is there any sense in fighting? Are doctor-patient discussions such as these valuable or could they create a defeatist attitude?
My wife and I agreed that our doctors could not predict the future and we were going to prove them wrong. Instead of quitting and accepting our fate, we became fighters. We refused to allow death to enter our minds and never spoke about it, even when her treatments and surgeries almost caused her to pass away on three separate occasions.
Yes, we were in denial: completely and totally in denial!
So what does a cancer survival rate really mean?
According to the Mayo Clinic, “Cancer survival rates or survival statistics tell you the percentage of people who survive a certain type of cancer for a specific amount of time. Cancer statistics often use an overall five-year survival rate. For instance, the overall five-year survival rate for bladder cancer is 80 percent. That means that of all people diagnosed with bladder cancer, 20 out of every 100 died within five years of a bladder cancer diagnosis.
Cancer survival rates are based on research that comes from information gathered on hundreds or thousands of people with a specific cancer. An overall survival rate includes people of all ages and health conditions who have been diagnosed with your cancer, including those diagnosed very early and diagnosed very late.”
Of course, other factors do need to be considered, such as one’s overall health at the time of diagnosis, age, etc. All have an impact.
But the question remains, “Is it beneficial to know what your survival rate is, and would knowing it stimulate your “fight or flight” response?
Secondarily, is it counter-productive and potentially harmful for doctors to share these predictions with patients as part of the initial medical debriefing session? Are they doing the patient more harm than good with news that the outcome is likely frightening based on past statistics?
Does a positive outlook make a difference? Surprisingly, the answer is “no.”
The American Cancer Society shares on it’s website, …”researchers looked at the emotional well-being of more than 1,000 patients with head and neck cancer to find out whether it affected survival. Over time, those who scored high on emotional well-being showed no differences in cancer growth or length of life when compared to those with lower scores. Based on what we know now about how cancer starts and grows, there is no reason to believe that emotions can cause cancer or help it grow.” 1
So, it appears that it remains a personal choice.
In thinking back, is there the slightest possibility my wife and I would have said to her oncologist we do not want to know the odds of her surviving?
As the caregiver, I honestly don’t know the answer, though I think my morbid curiosity would have been the victor.
My wife, on the other hand, as the patient, stated it this way, “I would have wanted to know that the cancer was a serious concern and I was in for a very tough fight, however, in thinking back on it, I would have been better off not knowing my odds of survival.”
Is there a happy medium?
It appears that a happy medium might exist. Perhaps doctors should discuss the symptoms and treatment methods and reserve sharing the statistics until requested by the patient. Each patient is an individual. They know best what is important in learning about their upcoming medical journey, along with what information may be counter-productive to their state of mind as they grasp their new set of circumstances.
In other words, let the patient be the decision-maker, not the doctor.
And isn’t that how it should be for all patients throughout their medical journey? The patients, not the doctors, should determine their fate. Each patient should let it be known immediately that they are in charge and will determine what they feel they need to know (and avoid) to help get them to the finish line, whatever it may be.