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Cancer, Patient, and Statistics (Part 2)

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How long a prostate cancer survivor lives depends on a multitude of factors. It does not necessarily reflect the success of the treatment. To that extent the survival rates, whether for five or ten years are meaningless for an individual. When and how a person will die is beyond anyone to know. To say that he died unnecessarily or prematurely is a projection of one’s own prejudices as a result of his analysis. In my opinion, and I might be an absolute minority, there is no such thing as unnecessary or untimely death. Death is death, period; the qualifiers do not make any difference.

They are also the products of a conditioned mind. People use other qualifiers as well. For example, we often hear of a horrible death especially in connection with cancer. Or we come across the milder statement: ‘It was not a nice death’. In actuality it is the life prior to death that is horrible because of the pain and suffering during that period of existence. The death ends that horrible existence. Children die or persons die in the prime of their lives; these are called untimely deaths. What is a timely death? Is it the death at a ripe old age irrespective of the nature of life in the preceding years? What do we know about death? As Confucius said: “We do not even know what life is. How can we then know anything about death?” To add qualifiers to death presupposes that knowledge.

People young and old die of starvation as we have witnessed so graphically during the past few years; others die in accidents. We call these deaths unnecessary or avoidable. Many die in natural disasters; we call these acts of God. People have died in famines and disasters in all ages all over the world. Circumstances shape the events that lead to these deaths and these circumstances are beyond man’s control. We can analyze the events and come up with ideas as to what could and should have been done to avoid them but man’s role in shaping historical events is incidental. Man does not make history although historians will always say otherwise. A confluence of circumstances makes things happen. This confluence, as of stars, is beyond anyone’s control and, even worse, it is not predictable. Men can take steps to avoid a recurrence of undesirable events, at least ones that are man-made, but these steps can not guarantee success simply because there is another group of men on the other side of the fence trying to do exactly the opposite. In the final analysis man is just a pawn in the hands of circumstances.

It is the same way with an individual’s life. One broods over his past and says ‘if only I had done this’. Or he thinks about someone’s death and says ‘ if only he had done this or that, he would be alive’. But ‘if only’ is in the realm of fantasy. The fact is that those things were not done or could not be done. If a person dies of lung cancer and he had been a smoker, his death is attributed to smoking. There are any number of people who were chain smokers but developed no lung problem. The body has so many unknown facets that make positive assertions meaningless. All we have is evidence in the form of correlations and again we are dealing with numbers and probabilities.

For a patient faced with a fateful decision all this discussion of numbers may give an impression of total uncertainty and chaos. But the purpose here is to show that no rule of thumb based on numbers or statistics can be followed blindly. Each individual is different, he can not take a decision entirely based on what happened to another man or group of men. He should look at the numbers and make his own informed judgment after a frank discussion with his physician. The doctor’s word is not gospel and there should be no hesitation on the part of the patient to put forth differing opinions or suggestions. It is his life at stake and the ultimate choice must be his own. In order to make that choice he should be fully aware of the limitations of each and every piece of information being used. His active participation in the treatment is essential; for this he must understand what is going on at every stage from a patient’s perspective. Only then he will have the satisfaction of having done everything to the best of his ability. The outcome is in the future and, hence, unknown and largely unpredictable. Worrying about it serves no purpose. At this point ‘que sera, sera’ is the best attitude; it is not fatalistic, it is the only realistic attitude one can have.

Dharmbir Rai Sharma is a retired professor with electrical engineering and physics background. He obtained his M.S. degree in physics in India and Ph.D. in electrical engineering at Cornell University. He has taught in universities here and also in Brazil, where he spent sometime. He maintains a website devoted mainly to philosophy and science.

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  • Posted On January 5, 2007
  • Published articles 283513

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