Ken vs. The Statistics
Ken, a newcomer at December’s prostate cancer group, just learned he had the disease. He had fears to talk about, lots of questions for the group, and treatment decisions to make.
After hearing Ken introduce himself, Ted, a regular participant in the group, described the shock he felt when he was in Ken’s shoes and got his own biopsy results. “It still makes my stomach churn just remembering that day,” he said. Another long-time member began reviewing the variety of treatments available to Ken. Several men recommended he get a second or even third opinion before making his final choice.
As the discussion progressed, questions from the group about Ken’s test results increased. What was his latest PSA? What about his Gleason score? Soon the talk was full of scientific terms and statistics. My head began to spin. We were wandering far away from Ken’s fears.
Then, with the magic that speaking your own truth can accomplish in a group, Ken said something that brought us all up short. From what you guys are telling me,” he said, “sounds like I should just look for an actuary to treat my cancer.” The room erupted with laughter. There it was, the reducto ad absurdum, of applying statistics to the individual.
Cancer statistics are like motorized garden tools. They need to be used very carefully around individual living things. Just last month the U.S. Preventive Services Task Force created a storm of protest when they recommended that regular mammogram screening for breast cancer not begin until women turn 50. According to the numbers, “the benefits are less and the harms are greater when screening starts in the 40’s,” said Dr. Diana Petitti, the panel’s vice-chair. Immediately I thought of my friend, Dana, whose cancer was diagnosed when she was 43. Without the earlier screening, would she still be here? Would this latest guideline help or harm a future Dana?
The statistics in the prostate cancer group certainly were not helping its newest member. Ken was not just a Gleason grade 6 (3 plus 3) in a 68 year old otherwise healthy male with a rising PSA of 7.2. In his playful way, Ken reminded us that he was there to talk about not just his body or his cancer, but about himself. During the rest of the meeting we learned a lot about him. We learned that he was afraid of treatment, of its potential side effects, particularly impotence and incontinence. We learned he was not looking forward to telling his sons he had cancer. We learned he was bothered at night by a strange new vulnerability he had never known before. We watched the relief spread over his face when he discovered that every man in the circle felt that same vulnerability.
We learned, too, that our group of prostate cancer survivors was perfectly capable of falling back upon statistics in the face of a newcomer's many fears. As the group ended and we made plans for the next meeting, I thought, “I really like this new guy. Statistically, we need him.”
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