Making cancer statistics understandable

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After the initial diagnosis of cancer, most patients turn to Google to learn about their disease and inevitably to the statistics of cancer: overall survival, progression-free survival, response rate, risk of side effects, benefits of treatments, etc... It's easy to latch on to a number and see your future etched in stone, but that's not typically the case. There is quite a bit behind those numbers and interpreting them for your individual cancer may help you make better medical decisions.A great place to start when interpreting cancer studies is the National Cancer Institute's Glossary of Statistical Terms. Another good resource is the Journal of the National Cancer Institute's Reporting on Cancer Research. It was written with reporters in mind, but patients will find it very useful when reviewing studies to make treatment decisions. One person who used his knowledge of statistics and asked his oncologist for help was the blogger of "Yet Another Prostate Cancer Blog," which is somewhat ironic because I haven't seen that many blogs devoted to prostate cancer. But this is a good one.Jim was diagnosed with metastatic prostate cancer and has been on treatment for a little over a year. He's a former electrical engineer, so he understands the numbers. Additionally, he asked his oncologist how to apply the statistics of metastatic prostate cancer to his individual cancer. Survival, side effects, progression, all of these depends on the treatment, the patient,the cancer and a multitude of other factors. Jim has written a pretty good explanation of how cancer statistics can work for you. Here's a recap below. It's also worth a look at how he shares his psychosocial response to cancer. Jim speaks very openly about side effects and dealing with depression and anxiety during treatment. What Statistics Can and Can't Tell Us"Let's get the biggest issue out of the way first. Cancer statistics can't tell us how long we'll live."Jim writes that the statistics may give us a hint, even a strong hint of how the cancer or patient may react to treatment, but there are no guarantees. After weighing his treatment options and the probability of side effects, he opted for radiation. After talking with several medical professionals who told him the most likely side effect would be mild fatigue, he happened to be in the small percentage who were affected with severe nausea. How to Re-interpret Cancer StatisticsJim was able to look at the statistics for metastatic prostate cancer and interpret how they may apply to his individual case. He compared his case with a large randomized clinical trial of men with metastatic prostate cancer and looked at the median survival.Median survival is the time in a particular study where half of the patients have died and half are still living. If a trial followed 100 patients for 10 years, and the point that half of the patients had died was three years, that's the median survival, even if some patients were still alive after 10 years.After looking at the median survival of metastatic prostate cancer, Jim noted his metastases were detected early, bone pain was minimal at diagnosis, he responded favorably to hormone therapy, his age (young) and overall health (good)--all of which can increase the probability that he will have a longer survival than the median. However, he also shares that his Gleason score was higher and his cancer may be more aggressive. Taking all of these factors into consideration and discussing them with his oncologist, he got a pretty good idea of where he stood, a process he says took several months.So, while he had come upon statistics that gave him a median survival probability of 30 months, they ended up with a conservative idea of at least 36 months and an optimistic 84 months, especially with the new treatments that have been approved lately--much better than the original 30 months Jim had originally come across."Always keep in mind that with any statistic, it probably needs to be reinterpreted to better fit the individual in question."

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For patients with cancer, the ongoing chemotherapy shortage may cause some anxiety as they wonder how they will receive their drugs. However, measuring drugs “down to the minutiae of the milligrams” helped patients receive the drugs they needed, said Alison Tray. Tray is an advanced oncology certified nurse practitioner and current vice president of ambulatory operations at Rutgers Cancer Institute in New Jersey.  If patients are concerned about getting their cancer drugs, Tray noted that having “an open conversation” between patients and providers is key.  “As a provider and a nurse myself, having that conversation, that reassurance and sharing the information is a two-way conversation,” she said. “So just knowing that we're taking care of you, we're going to make sure that you receive the care that you need is the key takeaway.” In June 2023, many patients were unable to receive certain chemotherapy drugs, such as carboplatin and cisplatin because of an ongoing shortage. By October 2023, experts saw an improvement, although the “ongoing crisis” remained.  READ MORE: Patients With Lung Cancer Face Unmet Needs During Drug Shortages “We’re really proud of the work that we could do and achieve that through a critical drug shortage,” Tray said. “None of our patients missed a dose of chemotherapy and we were able to provide that for them.” Tray sat down with CURE® during the 49th Annual Oncology Nursing Society Annual Congress to discuss the ongoing chemo shortage and how patients and care teams approached these challenges. Transcript: Particularly at Hartford HealthCare, when we established this infrastructure, our goal was to make sure that every patient would get the treatment that they need and require, utilizing the data that we have from ASCO guidelines to ensure that we're getting the optimal high-quality standard of care in a timely fashion that we didn't have to delay therapies. So, we were able to do that by going down to the minutiae of the milligrams on hand, particularly when we had a lot of critical drug shortages. So it was really creating that process to really ensure that every patient would get the treatment that they needed. For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.
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