I have a lot more to say about what’s going on in our country, but I ran across an article that I feel compelled to share.
I’m a big fan of numbers geek Nate Silver. I learned about him like most everyone else did, in the run-up to the 2012 election. He had it right, almost down to a single percentage point state by state. As far as I can tell, he predicted the 2014 election too.
His website, Five Thirty Eight, examines statistics in myriad contexts and I was looking today for an article discussing how rare the Darren Wilson grand jury situation was. Again, more that later.
I stumbled across this article by Christie Aschwanden, “The Case Against Early Cancer Detection.”
She’s saying what I’ve been trying to say and she has the numbers to back it up. I won’t regurgitate the article here, but I highly recommend it. I will say that she has come up with the best metaphor to explain it.
Many people are married to what she calls “the relentless progression model” of cancer. Meaning, one cell goes bad, then two, etc. If that were the case, early detection really would stop cancer deaths. But, she explains, we’ve learned that cancer is not one disease and the biology dictates how it behaves more than the timing of detection.
Here’s where she gets brilliant. She describes four types of cancer:
- The Turtle – a cancer so slow-growing that it will never become an existential threat.
- The Rabbit – a cancer that is growing and spreading rapidly. This is the “relentless progression” type. Again, however, the biology of the tumor dictates whether current treatment methods are curative, and as I am so fond of saying, we only know we are cured if we die of something else.
- The Bird – a cancer that will become fatal before it is detected. Some have speculated, for example, that some breast cancers hides in the bone marrow, inactive and undetectable, then reactivate as metastatic breast cancer in the future. This “seeding” might even happen before the initial detection, no matter what at what stage the primary tumor is discovered.
- The Dodo – a cancer that will die off on its own without treatment.
We need to learn to identify these creatures.
We need to let go of the relentless progression model as panacea.
And, of course, we need to learn how to treat the rabbits and the birds to impact the death rates.