When Not to Treat Cancer: Making Rational Choices Based on Statistical Approach

Introduction:

Cancer diagnoses often lead to challenging decisions about treatment. Taking a rational and statistical approach can help individuals make better-informed choices, even if it means deciding not to treat cancer at all. This article explores the significance of risk assessment and statistical considerations when deciding on cancer treatments.

The Uncertainty of Diagnosis:

Mathematician Hannah Fry's personal experience with cervical cancer highlights the uncertainties associated with cancer diagnoses. Her oncologist informed her that the cancer might have spread to the lymph nodes, significantly affecting her chances of survival. This uncertainty presents a dilemma for patients and doctors alike when determining the appropriate course of action.

The Challenge of Risk Assessment:

Fry emphasizes the importance of calculating risks involved in cancer treatments. While cancer treatments can be life-saving, they often come with significant consequences and potential life-altering repercussions. The decision to undergo treatment should weigh the potential benefits against the potential harms.

The Prevalence of Undiagnosed Cancer:

Research conducted by Danish pathologists in the 1970s sheds light on the surprising prevalence of undiagnosed cancer in deceased individuals. Autopsies revealed abnormal tissues, both cancerous and precancerous, in approximately 25 percent of the women who had never been diagnosed with cancer. Similar studies have been conducted for various types of cancers, indicating that a significant portion of the population may unknowingly carry cancer cells in their bodies.

The Body's Natural Defense Mechanisms:

Despite the alarming prevalence of undiagnosed cancer, Fry points out that our bodies often have effective mechanisms to detect and eliminate cancer cells. In many cases, the body's immune system successfully finds and eliminates cancerous cells before they pose a significant threat. Additionally, some cancers may be slow-growing, allowing individuals to succumb to other causes before the cancer becomes life-threatening.

Examining Treatment Effectiveness:

Several studies have shed light on the effectiveness of cancer treatments and the potential risks they entail. For instance, a study involving 1,600 men diagnosed with prostate cancer found no difference in overall survival rates among those who received surgery, radiotherapy, or no medical intervention but were monitored regularly. Treatment interventions, such as radiotherapy, can lead to complications like erectile dysfunction, incontinence, and bowel problems, without significantly improving survival rates.

The Impact of National Screening Programs:

The article highlights a study from South Korea that examined the impact of a national screening program for thyroid cancer on mortality rates. Despite an increase in diagnoses and treatments, the mortality rate remained unchanged. This finding raises questions about the necessity and effectiveness of mass screening programs for certain types of cancer.

The Personal Experience:

Fry shares a poignant encounter with a woman who had undergone breast cancer surgery. Her oncologist presented her with the choice of continuing chemotherapy or stopping treatment, as the cancerous tissue had been removed, but the possibility of recurrence remained. The statistical analysis revealed that treatment would only marginally increase her chances of survival. Despite the small improvement, the woman opted for chemotherapy out of fear. This anecdote underscores the emotional and psychological factors that often influence treatment decisions.

Making Informed Decisions:

Fry acknowledges the difficulty of making rational decisions in the face of a frightening cancer diagnosis. However, she reflects on her own experience and questions whether the harsh medical treatment she endured was truly worth the marginal improvement in her survival rate. She believes that individuals should have the opportunity to factor in personal values and preferences when making treatment decisions, rather than relying solely on statistical data.

Conclusion:

Taking a rational and statistical approach to cancer treatment decisions can help individuals make informed choices. While the presence of undiagnosed cancer cells is a concerning statistic, our bodies often have the ability to detect and eliminate them. Research studies have highlighted the limited effectiveness of certain cancer treatments, and the potential risks associated with them. Ultimately, it is essential for patients and doctors to engage in open and honest discussions about the potential benefits and drawbacks of treatment, allowing individuals to make decisions that align with their values and priorities.

References:

(Wired - [https://www.wired.com/story/hannah-fry-cancer-treatment-math/)