What I Want You to Know About Survival Rates

Your mom and I never talked about cancer survival rates, and the doctors never mentioned them to us, either. A couple of websites I checked out encouraged the patient and his or her family to stay away from such statistics. So did a book I ordered in the weeks after your mom was diagnosed.

But I couldn’t help myself. I looked them up.

Surprisingly, I was encouraged by what I saw. I had no idea what to expect, which meant I expected the worst. Was breast cancer a death sentence? Was it 50-50? When I read that the five-year survival rate for her cancer was in the mid-80% range, that gave me reason to hope. If you send an 85% free throw shooter to the line, you feel pretty damned confident the next shot is going in. Plus, I figured that given your mom’s overall health and age, she was well-positioned to hit nothing but net.

When your mom had a successful surgery and received her first clear PET scan showing no evidence of cancer, I felt even more confident we were in the clear. It was evident to me that we were not in the dreaded 15% territory. I was aware that recurrence would remain a possibility, of course, but as your mom’s hair grew back and her own optimism grew, I felt cancer was a thing that was solidly in our past.

That October, I wrote a Facebook post about Breast Cancer Awareness Month. I talked about my gratitude for all the doctors and scientists who had developed and refined treatments to give cancer patients real hope of survival. At the end, I said I was mindful of “survival rates and the dumb luck of being on the right side of them.” I wasn’t gloating. Nor was I blind to the fact that something could go wrong. I just felt fortunate and optimistic. And grateful for the sacrifices others had made to improve the odds for your mom.

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Of course, in the end, your mom was not on the right side of the statistics. For whatever reason, her treatments did not eradicate all the cancer and, after a couple years of dormancy, the breast cancer returned with a quickness and cruelty that none of us could have expected even on our most pessimistic days.

Which is probably why those websites and books advised not to check the statistics to begin with. If you’re on the right side of the stats, worrying about them won’t do you any good. If you’re on the wrong side of them, you might be filled with a false optimism, just like I was.

I am humbled now. I think I did not fully appreciate at the time what a survival rate tells you and what it doesn’t tell you. The survival rate didn’t mean that your mom had an 85 percent of living five years or more. It meant that out of a group of 100 women diagnosed with cancer similar to your mom’s, one would expect only about 85 of them to be alive five years later.

When you see it that way – when you look at the number as real people and not something more akin to Vegas odds – well, the best you can say is that 85% is a hell of a lot better than any number lower than it.

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We’re seeing a lot of statistics in the world today as the global community battles Covid-19. For example, I frequently read about the survival rates for those who are infected. It is very high, significantly higher than the 85% of your mom’s cancer, which is a good thing. That high survival rate is often cited by people who are resistant to the changes that epidemiologists have recommended we make to our daily lives: masks, social distancing, and now, vaccines (the amazing efficacy of which is another statistic I keep on seeing). The Vegas odds are good that any given person will survive the disease if infected, and those odds are nearly 100% for vaccinated people.

When you focus on the people and not the odds, however, it’s more sobering. As of today, it’s reported that 626,726 Americans have died from Covid-19. Across the globe, that number is 4,175,396. Currently, there is a surge of cases resulting from a more infectious variant of the virus. And while vaccinated and unvaccinated people are both at risk of catching the disease, almost all the people dying from it in the U.S. now are unvaccinated. Some of those who are unvaccinated do not have a choice to receive the vaccine – you, for instance, currently are too young to qualify for the emergency use authorization – but many others have made a choice not to receive it, for one reason or another.

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I think a lot about those other 99 women who developed a similar cancer around the same time your mom did.

Sadly, chances are that some of them have died from it, like your mom. I wonder how their families are coping with that loss. I wonder what kind of impact they each left on the world and on the communities around them. I wonder why they, like your mom, fell on the wrong side of the statistics.

I think about the 85 or so that are still alive, closing in on the five-year mark. I figure a few of them were unable to receive any of the Covid-19 vaccines due to health complications from the cancer, or because of ongoing treatments that have not afforded them an opportunity to safely receive a vaccine. I wonder if any of their cancers have metastasized, like your mom’s but more slowly, giving them a small chance to extend their lives long enough to see the next breakthrough in cancer treatment. It was what we hoped for as the best-case scenario when your mom’s cancer came back: that somehow a combination of chemotherapy and radiation could keep the cancer at bay long enough for a new treatment to come along and remove the word “terminal” from our vocabulary. In that scenario, she would have been at high risk of serious complications if she contracted Covid-19.

She didn’t make it long enough for that scenario to play out, obviously. But maybe it’s happening for another of the 100 real women.

Maybe that woman is lying awake tonight, holding a child about your age, worrying whether her immunocompromised body would survive the Delta variant if she should happen to catch it, despite her best efforts not to. Maybe she is wondering why she has to worry about two diseases instead of only one. Maybe she is silently praying she can make it long enough to see the breakthrough, so she can watch the beautiful child sleeping next to her grow up.

I’m rooting for her, just as I’m rooting for the other 84. I couldn’t do anything to improve your mom’s survival rates but maybe, just maybe, I can make a small difference for some of them.

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So, if you’re ever wondering, that’s why I got vaccinated, and why I will also sign you up to get vaccinated when it is authorized for your age: for all of those real people still fighting to stay on the right side of the survival rates.