Cancer

Apr

25

2012

"Cancer by the Numbers" by John Allen Paulos | Project Syndicate

It is difficult to communicate medical risk to a large audience, especially when official recommendations conflict with emotional narratives. That is why, when the United States Preventive Services Task Force (USPSTF) in 2009 presented its guidelines for breast cancer screening, which recommended against routine screenings for asymptomatic women in their 40’s and biennial, rather than annual, mammograms for women over 50, the public responded with confused fury.

Illustration by Paul Lachine
CommentsThe key to understanding this response is to be found in the nebulous zone between mathematics and psychology. People’s discomfort with the findings stemmed largely from faulty intuition: if earlier and more frequent screening increases the likelihood of detecting a possibly fatal cancer, then more screening is always desirable. If more screening can detect breast cancer in asymptomatic women in their 40’s, wouldn’t it also detect cancer in women in their 30’s? And, if so, why not, reductio ad absurdum, begin monthly mammograms at age 15?

www.project-syndicate.org/...cancer-by-the-numbers

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Data Interpretation Statistics Cost Benefits Harm Cancer Screening Health

The USPSTF recently issued an even sharper warning about the prostate-specific antigen test for prostate cancer, after concluding that the test’s harms outweigh its benefits. Chest X-rays for lung cancer and Pap tests for cervical cancer have received similar, albeit less definitive, criticism.
CommentsView/Create comment on this paragraphThe next step in the reevaluation of cancer screening was taken last year, when researchers at the Dartmouth Institute for Health Policy announced that the costs of screening for breast cancer were often minimized, and that the benefits were much exaggerated. Indeed, even a mammogram (almost 40 million are given annually in the US) that detects a cancer does not necessarily save a life.
CommentsView/Create comment on this paragraphThe Dartmouth researchers found that, of the estimated 138,000 breast cancers detected annually in the US, the test did not help 120,000-134,000 of the afflicted women. The cancers either were growing so slowly that they did not pose a problem, or they would have been treated successfully if discovered clinically later (or they were so aggressive that little could be done).

Nov

25

2011

Balderdash: Inspired by Tony Tan telling students not to "fritter away [time] in pursuit of peripheral and frivolous activities"

gssq.blogspot.com/...tony-tan-telling-students.html

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Death Youth Age Baudrillard Cancer Dying

""窃以少年老成，中国称人之语也；年长而勿衰，英、美人相勖之辞也，此亦东西民族涉想不同、现象趋异之一端欤？青年之于社会，犹新鲜活泼细胞之在人身。新陈代谢，陈腐朽败者无时不在天然淘汰之途，与新鲜活泼者以空间之位置及时间之生命。人身遵新陈代谢之道则健康，陈腐朽败之细胞充塞人身则人身死；社会遵新陈代谢之道则隆盛，陈腐朽败之分子充塞社会则社会亡."

Roughly translated, Chinese people like to compliment young people for being mature, where as British and Americans like to encourage each to stay young while growing old. Young people are like the fresh and active cells of a body. If there is no metabolism and the old cells don't get replaced by the young ones, the body dies. Society works the same way.

Chen Duxiu said this in 1915. Nearly a century later, we are still trying to make young people boring old people."

Aug

9

2011

Model for in vivo progression of tumors based on co-evolving cell population and vasculature : Scientific Reports : Nature Publishing Group

With countless biological details emerging from cancer experiments, there is a growing need for minimal mathematical models which simultaneously advance our understanding of single tumors and metastasis, provide patient-personalized predictions, whilst avoiding excessive hard-to-measure input parameters which complicate simulation, analysis and interpretation. Here we present a model built around a co-evolving resource network and cell population, yielding good agreement with primary tumors in a murine mammary cell line EMT6-HER2 model in BALB/c mice and with clinical metastasis data. Seeding data about the tumor and its vasculature from in vivo images, our model predicts corridors of future tumor growth behavior and intervention response. A scaling relation enables the estimation of a tumor's most likely evolution and pinpoints specific target sites to control growth. Our findings suggest that the clinically separate phenomena of individual tumor growth and metastasis can be viewed as mathematical copies of each other differentiated only by network structure.

www.nature.com/...srep00031.html

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Data Model Mathematics Average Statistics Cancer Health Care Medicine

Mathematical Model Will Soon Allow Personalized and Accurate Cancert Treatment | The Utopianist - Think Bigger

One of the most difficult things about treating cancer is that each case is a very individual process; tumors recruit blood vessels in order to grow, yet also send out new vessels of their own. This harnessing of the body’s resources is what eventually allows a tumor to metastasize — be carried into other parts of the body where growth continues. On the other hand, sometimes tumors don’t grow at all. Predicting each patient’s unique response to cancer and its progression is a large part of the battle, as an accurate estimate is required to begin appropriate treatment. The field of Oncology is always seeing exciting developments, and this latest one is no different — its benefits touch future and existing cancer patients, alike. Knowing that hindsight is 20/20, it would be a lot easier if there was a “fast-forward button” with which doctors could view each unique case before it develops.
Physicist Sehyo Choe and colleagues at the University of Heidelberg, Germany have developed such a button in the form of a mathematical model. By inputting data about the tumor and its current location of blood vessels, the model allows doctors and researchers to see how the tumor will grow and move — if at all — giving them a very accurate helping hand when it comes to prompt and accurate treatment. Tested on mice, the model accurately predicted the progression of all cancer-stricken subjects, giving researchers that amazing “fast-forward” capability.

utopianist.com/...and-accurate-cancert-treatment

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Data Model Mathematics Average Statistics Cancer Health Care Medicine

Predicting each patient’s unique response to cancer and its progression is a large part of the battle, as an accurate estimate is required to begin appropriate treatment. The field of Oncology is always seeing exciting developments, and this latest one is no different — its benefits touch future and existing cancer patients, alike. Knowing that hindsight is 20/20, it would be a lot easier if there was a “fast-forward button” with which doctors could view each unique case before it develops.

Physicist Sehyo Choe and colleagues at the University of Heidelberg, Germany have developed such a button in the form of a mathematical model. By inputting data about the tumor and its current location of blood vessels, the model allows doctors and researchers to see how the tumor will grow and move — if at all — giving them a very accurate helping hand when it comes to prompt and accurate treatment. Tested on mice, the model accurately predicted the progression of all cancer-stricken subjects, giving researchers that amazing “fast-forward” capability.
Co-author Neil Johnson from the University of Miami says that “in the future, treatments will no longer have to be based on population averages. People will get individual treatment based on the predictions of our model.”

Jun

20

2011

Could a Vaccine for Cancer be Just a Few Years Away? | The Utopianist - Think Bigger

Some very exciting news from the realm of the lab rat: a vaccine has cured prostate cancer in mice, and the kind that was well-established. It may seem counter-intuitive, but with cancer, vaccines are given after infection and then teach the immune system to fight what is already there. Frustratingly, the immune system often turns a blind eye on tumors, but this kind of vaccination system will “wake it up”, making it fight.

utopianist.com/...ay-be-available-in-a-few-years

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Cancer Vaccine

Human vaccine used to cure prostate cancer in mice

ScienceDaily (June 19, 2011) — Mayo Clinic investigators and collaborators from the United Kingdom cured well-established prostate tumors in mice using a human vaccine with no apparent side effects. This novel cancer treatment approach encourages the immune system to rid itself of prostate tumors without assistance from toxic chemotherapies and radiation treatments. Such a treatment model could some day help people to live tumor free with fewer side effects than those experienced from current therapies.

www.sciencedaily.com/...110619133456.htm

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Vaccine Cancer

Jun

18

2011

OpEdNews - Page 3 of Article: "The Politics of Cancer"

it's easier to pollute than protect public health, that regulatory agencies turn a blind eye, that elected officials are corrupted to go along, that big money nearly always gets its way, that organizations like NCI and ACS abound with conflicts of interest, and that many scientific community members willingly compromise their integrity in return for generous research grants and other benefits.

As a result, cancer is a growth industry, environmental harm and human health the price for big industry profits. The power of vested interests keeps them burgeoning. Public awareness can change things, not decades more worthless research in lieu of simple solutions, eliminating harmful substances that kill.

www.opednews.com/...tephen-Lendman-110616-619.html

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Politics Cancer Health Bioethics Environment

everyone can vote with their pocketbook, boycotting harmful products, buying safer ones, and encouraging others to do the same thing. That's how important battles are won, by ordinary people at the grassroots - getting informed, doing the right thing, telling others, and proving where real power lies when it's used constructively.

OpEdNews - Page 2 of Article: "The Politics of Cancer"

www.opednews.com/...tephen-Lendman-110616-619.html

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Politics Cancer Health Bioethics Environment

the war on cancer is being lost, not won, because profits take precedence over public health, a testimony to corrupted priorities and criminal politicians who enforce them.
Cancer has proliferated because of the dramatic increase in carcinogenic environmental and workplace substances, Epstein saying in the preface to his 1978 book:

"Cancer is caused mainly by exposure to chemical or physical agents in the environment. The more of a carcinogen present in the human environment, hence the greater the exposure to it, the greater the chance of developing cancer from it. There is no known method for measuring or predicting a 'safe' level of exposure to any carcinogen below which cancer will result in any individual or population group."

OpEdNews - Article: "The Politics of Cancer"

"The Politics of Cancer" explained how exposure to environmental and occupational carcinogens causes cancer. Yet they're avoidable because safe substitutes exist. Nonetheless, the National Cancer Institute (NCI) and American Cancer Society (ACS) - groups Epstein calls "the cancer establishment" - ignore preventable causes, searching for non-existant magic bullet cures. In fact, they allocate minimal budget amounts to prevention while deceiving people to believe they stress it.

www.opednews.com/...tephen-Lendman-110616-619.html

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Politics Cancer Health Bioethics Environment

"(t)he cancer establishment is fixated on damage control - diagnosis, treatment and basic genetic research - and is indifferent, if not sometimes hostile, to cancer prevention - getting carcinogens out of the environment."

"The second factor is conflicts of interests, which are significant when it comes to the National Cancer Institute (NCI), but profound and overwhelming (for) the National Cancer Society (NCS)." In fact, they're incestuously tied to the "drug industry, the mammography industry, the pesticide industry, and other such industries" that profit from cancer proliferation. It's big business. The more victims, the greater the bottom line benefits.

Notably, one former NCI director left for a drug industry position. Another went to the American Cancer Society (ACS) before heading up the fiberglas industry, producing a recognized carcinogenic product that should be banned.
Epstein and other public health experts know the war on cancer is winnable by determining avoidable and involuntary carcinogenic exposures, then lobbying Congress to remove them legislatively or by regulations.

He also supports laws that criminalize or hold corporations and their officials accountable for knowingly introducing new carcinogens into the environment.

Instead, of course, they buy politicians like toothpaste, lobby effectively for pro-business legislation and deregulation, and control corporate friendly "watchdog" agencies serving them, not the public interest by revolving door their officials in to run them.

Jun

5

2011

Evaluating The Evidence for Cell Phones and WiFi « Critical Thinking « Skeptic North

n many discussions of the “dangers” of WiFi and cell phones, the precautionary principle is evoked. It is the idea that we have “an obligation, if the level of harm may be high, for action to prevent or minimise such harm even when the absence of scientific certainty makes it difficult to predict the likelihood of harm occurring, or the level of harm should it occur.” It is important to note that the precautionary principle or approach is required when we do not have a scientific consensus or if we have a lack of scientific certainty. It is used often in European regulation of potential health and environmental hazards. “Scientific certainty” is an important clause here, because it does not mean 100% certainty. Science can never give that absolute a result and if we required 100% certainty of no risk, we would not walk out our front doors or even get out of bed, lest we have a mishap.

www.skepticnorth.com/...dence-for-cell-phones-and-wifi

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Mobile Wi-Fi Radio Waves Cancer Uncertainty

he “weight of evidence” approach to evaluation of causality is often vilified by cell phone and WiFi scare mongers as being an inadequate way to judge the evidence – often because it disagrees with their own sentiments about the science. If you can’t disqualify the evidence, then you can go after the method of evaluation and disqualify that, right? Of course, the weight of evidence approach is often portrayed as a dumbshow of putting all the “positive” trials on one side of the scale and all of the “negative” trials on the other and taking the difference in mass as the evidence. This is how Dr. Phillips characterised it in his paper on electromagnetic fields and DNA damage, as well as his appearance on CBC Radio. Of course, the procedure is much more like a systematic review, where all of the papers, regardless of their outcomes, are weighed for their quality. (The higher quality studies will have good internal and external validity, proper blinding and randomisation, large enough sample size, proper controls and good statistical analysis; as well as being reproduced by independent investigators.) Then they are tallied and a rational conclusion is offered as to the most likely state of the evidence (of course, it is much more involved than I am stating, but suffice it to say, it does not involve a scale.) This is standard operating procedure and, in fact, is what we all do when we are evaluating evidence: we decide which studies are good and we pool the evidence before we make a decision.

Analysis: Hold the panic on cell phones and cancer | Phones | iOS Central | Macworld

Do cell phones cause cancer? Nobody really knows for sure, but scientists are determined to keep an eye on the ever-evolving evidence that continues to accumulate on the subject.

That’s the gist of a report recently released by the World Health Organization’s International Agency for Research on Cancer (IARC), the United Nations body responsible for oncological studies. In the report, IARC scientists have classified cell phone usage as a possible cause of cancer, meaning that, while the data currently available is still inconclusive, the subject deserves further research before a call can be made one way or another.

www.macworld.com/...phone_cancer_who_analysis.html

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Mobile Wi-Fi Radio Waves Cancer Uncertainty Causation Model

Today’s cell phones are, essentially, extremely sophisticated radios and, as such, emit electromagnetic waves. Much like the vast majority of radiation that surrounds us—from visible light to AM and FM radio waves—electromagnetic waves do not possess enough energy to interact directly with the tissues in our bodies in a way that can cause direct damage.

“The radiation that cell phones emit is nowhere near the kind of radiation that x-ray machines, for example, emit,” says Perras. “X-rays […] have much, much shorter wavelengths. Consequently, [they] carry much more energy and thus have much more penetrating power, which is required to be able to image the interior of the human body.”
X-rays and other “hard” waves are called ionizing radiation because they can interact with the human body in a way that leads to the creation of chemical compounds called free radicals that can, in turn, be responsible for mutations and the incidence of cancer.
5 more annotation(s)...
- The focus of much of the currently-ongoing scientific research, then, is on whether the radiation emitted by cell phones is focused enough to be absorbed into the body and cause heating, which could, in the long run, damage human tissue and eventually lead to cancer.
- The issue is particularly important because most users still hold their phones close to the head; since the brain is particularly sensitive to external stimuli, even a small amount of heat could lead to medical trouble in the long term.
- What makes it challenging to determine if a link between cell phones and cancer actually exists are the many variables involved. “The incidence of brain tumors is quite small, making it more difficult to study in large numbers,” says Dr. Eric Olyejar, a Radiation Oncologist from Ironwood Cancer and Research Centers, based in Chandler, Ariz. That means “quantifying the lifetime dose each patient received is extremely difficult.”
- To make things more difficult, cancer often develops as a result of many different factors. “Family history, exposure to chemicals or radiation, growth defects, the amount of radiation that is actually coming from the phone, amount of time used, proximity to the brain, skull thickness, and wave frequency are only a few of the many variables,” Olyejar says.
- cell phones have become so ubiquitous that it’s hard to compare the health of users and non-users.

Apr

9

2011

11.01.97 - Misconceptions about the causes of cancer lead to skewed priorities and wasted money, UC Berkeley researchers say

BERKELEY -- Despite a lack of convincing evidence that pollution is an important cause of human cancer, this misconception drives government policy today and results in billions of dollars spent to clean up minuscule amounts of synthetic chemicals, say two UC Berkeley researchers.

This is only one of many misconceptions, they say, that serve to divert money from the most important causes of cancer: smoking, poor diet, our own hormones and chronic infections.

berkeley.edu/...11_01_97a.html

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Pollution Cancer Policy Science Risk

One of the big misconceptions is that artificial chemicals such as pesticides have a lot to do with human cancer, but that's just not true," says Bruce N. Ames, professor of biochemistry and molecular biology at the University of California at Berkeley and co-author of a new review of what is known about environmental pollution and cancer. "Nevertheless, it's conventional wisdom and society spends billions on this each year."

"We consume more carcinogens in one cup of coffee than we get from the pesticide residues on all the fruits and vegetables we eat in a year," he adds.
there may be many excellent reasons for cleaning up pollution of our air, water and soil, the researchers say, prevention of cancer is not one of them.
11 more annotation(s)...
- "The problem is that lifestyle changes are tough," says Gold, director of the Carcinogenic Potency Project at UC Berkeley's National Institute for Environmental Health Sciences Center and a senior scientist in the cell and molecular biology division at Lawrence Berkeley National Laboratory.
  
  "But by targeting pesticide residues as a major problem, we risk making fruits and vegetables more expensive and indirectly increasing cancer risks, especially among the poor."
- Whereas 99.9 percent of all the chemicals we ingest are natural, 78 percent of the chemicals tested are synthetic. So when more than half of all synthetic chemicals are found to cause cancer in rodents, it's not surprising that people link cancer with synthetic chemicals.
  
  But of the natural chemicals in our diet that have been tested in animals, half also cause cancer, Gold says.
- "We need to recognize that there are far more carcinogens in the natural world than in the synthetic world, and go after the important things, such as lifestyle change."
- Misconception: Cancer rates are soaring. In fact, the researchers say, if lung cancer due to smoking is excluded, overall cancer deaths in the U.S. have declined 16 percent since 1950.
- Misconception: Reducing pesticide residues is an effective way to prevent diet-related cancer. Because fruits and vegetables are of major importance in reducing cancer, the unintended effect of requiring expensive efforts to reduce the amount of pesticides remaining on fruits and vegetables will be to increase their cost. This will lead to an increase in cancer among low income people who no longer will be able to afford to eat them.
- Misconception: Human exposures to carcinogens and other potential hazards are primarily due to synthetic chemicals. Americans actually eat about 10,000 times more natural pesticides from fruits and vegetables than synthetic pesticide residues on food. Natural pesticides are chemicals that plants produce to defend themselves against fungi, insects, and other predators. And half of all natural pesticides tested in rodents turn out to be rodent carcinogens. In addition, we consume many other carcinogens in foods because of the chemicals produced in cooking. In a single cup of roasted coffee, for example, the natural chemicals known to be rodent carcinogens are about equal in weight to an entire year's work of synthetic pesticide residues.
- Misconception: Cancer risks to humans can be assessed by standard high-dose animal cancer tests. In cancer tests, animals are given very high, nearly toxic doses. The effect on humans at lower doses is extrapolated from these results, as if the relationship were a straight line from high dose to low dose. However, the fact that half of all chemicals tested, whether natural or synthetic, turn out to cause cancer in rodents implies that this is an artifact of using high doses. High doses of any chemical can chronically kill cells and wound tissue, a risk factor for cancer .
  
  "Our conclusion is that the scientific evidence shows that there are high-dose effects," Ames says. "But even though government regulatory agencies recognize this, they still decide which synthetic chemicals to regulate based on linear extrapolation of high dose cancer tests in animals."
- Misconception: Synthetic chemicals pose greater carcinogenic hazards than natural chemicals. Naturally occurring carcinogens represent an enormous background compared to the low-dose exposures to residues of synthetic chemicals such as pesticides, the researchers conclude. These results call for a reevaluation of whether animal cancer tests are really useful guides for protecting the public against minor hypothetical risks.
- Misconception: The toxicology of synthetic chemicals is different from that of natural chemicals. No evidence exists for this, but the assumption could lead to unfortunate tradeoffs between natural and synthetic pesticides. Recently, for example, when a new variety of highly insect-resistant celery was introduced on a farm, the workers handling the celery developed rashes when they were exposed to sunlight. The pest-resistant celery turned out to contain almost eight times more natural pesticide in the form of psoralens -- chemicals known to cause cancer and genetic mutations -- than common celery.
- Misconception: Pesticides and other synthetic chemicals are disrupting human hormones. Claims that synthetic chemicals with hormonal activity contribute to cancer and reduced sperm count ignore the fact that natural chemicals have hormone-like activity millions of times greater than do traces of synthetic chemicals. Rather, lifestyle -- lack of exercise, obesity, alcohol use and reproductive history -- are known to lead to marked changes in hormone levels in the body.
- Misconception: Regulating low, hypothetical risks advances public health. Society -- primarily the private sector -- will spend an estimated $140 billion to comply with environmental regulations this year, according to projections by the Environmental Protection Agency. Much of this is aimed at reducing low-level human exposure to chemicals solely because they are rodent carcinogens, despite the fact that this rationale is flawed. Our improved ability to detect even minuscule concentrations of chemicals makes regulation even more expensive.

Feb

17

2011

Cancer resembles life 1 billion years ago, say astrobiologists - microbiology, genomics, genetics, evolution, cell biology, cancer, astrobiology - Australian Life Scientist

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www.lifescientist.com.au/..._years_ago_say_astrobiologists

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Cancer Evolution Life

astrobiologists, working with oncologists in the US, have suggested that cancer resembles ancient forms of life that flourished between 600 million and 1 billion years ago.
Read more about what this discovery means for cancer research.
12 more annotation(s)...
- The genes that controlled the behaviour of these early multicellular organisms still reside within our own cells, managed by more recent genes that keep them in check.
  It's when these newer controlling genes fail that the older mechanisms take over, and the cell reverts to its earlier behaviours and grows out of control.
- The new theory, published in the journal Physical Biology, has been put forward by two leading figures in the world of cosmology and astrobiology: Paul Davies, director of the Beyond Center for Fundamental Concepts in Science, Arizona State University; and Charles Lineweaver, from the Australian National University.
- In the paper, they suggest that a close look at cancer shows similarities with early forms of multicellular life.
- According to Lineweaver, this suggests that cancer is an atavism, or an evolutionary throwback.
- “Unlike bacteria and viruses, cancer has not developed the capacity to evolve into new forms. In fact, cancer is better understood as the reversion of cells to the way they behaved a little over one billion years ago, when humans were nothing more than loose-knit colonies of only partially differentiated cells.
  “We think that the tumours that develop in cancer patients today take the same form as these simple cellular structures did more than a billion years ago,” he said.
- the genes that controlled this early multi-cellular form of life are like a computer operating system's 'safe mode', and when there are failures or mutations in the more recent genes that manage the way cells specialise and interact to form the complex life of today, then the earlier level of programming takes over.
- One piece of evidence to support this theory is that cancers appear in virtually all metazoans, with the notable exception of the bizarre naked mole rat.
  "This quasi-ubiquity suggests that the mechanisms of cancer are deep-rooted in evolutionary history, a conjecture that receives support from both paleontology and genetics," they write.
- Their notion is in contrast to a prevailing theory that cancer cells are 'rogue' cells that evolve rapidly within the body, overcoming the normal slew of cellular defences.
- However, Davies and Lineweaver point out that cancer cells are highly cooperative with each other, if competing with the host's cells. This suggests a pre-existing complexity that is reminiscent of early multicellular life.
- cancers' manifold survival mechanisms are predictable, and unlikely to emerge spontaneously through evolution within each individual in such a consistent way.
- The good news is that this means combating cancer is not necessarily as complex as if the cancers were rogue cells evolving new and novel defence mechanisms within the body.
  Instead, because cancers fall back on the same evolved mechanisms that were used by early life, we can expect them to remain predictable, thus if they're susceptible to treatment, it's unlikely they'll evolve new ways to get around it.
- If the atavism hypothesis is correct, there are new reasons for optimism," they write.

Aug

8

2010

CancerGuide: The Median Isn't the Message

The Median Isn't the Message by Stephen Jay Gould

cancerguide.org/median_not_msg.html

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Statistics Science Cancer

Statistics recognizes different measures of an "average," or central tendency. The mean is our usual concept of an overall average - add up the items and divide them by the number of sharers
The median, a different measure of central tendency, is the half-way point.
8 more annotation(s)...
- A politician in power might say with pride, "The mean income of our citizens is $15,000 per year." The leader of the opposition might retort, "But half our citizens make less than $10,000 per year." Both are right, but neither cites a statistic with impassive objectivity. The first invokes a mean, the second a median. (Means are higher than medians in such cases because one millionaire may outweigh hundreds of poor people in setting a mean; but he can balance only one mendicant in calculating a median).
- The larger issue that creates a common distrust or contempt for statistics is more troubling. Many people make an unfortunate and invalid separation between heart and mind, or feeling and intellect. In some contemporary traditions, abetted by attitudes stereotypically centered on Southern California, feelings are exalted as more "real" and the only proper basis for action - if it feels good, do it - while intellect gets short shrift as a hang-up of outmoded elitism. Statistics, in this absurd dichotomy, often become the symbol of the enemy. As Hilaire Belloc wrote, "Statistics are the triumph of the quantitative method, and the quantitative method is the victory of sterility and death."
- This is a personal story of statistics, properly interpreted, as profoundly nurturant and life-giving. It declares holy war on the downgrading of intellect by telling a small story about the utility of dry, academic knowledge about science. Heart and head are focal points of one body, one personality.
- We still carry the historical baggage of a Platonic heritage that seeks sharp essences and definite boundaries. (Thus we hope to find an unambiguous "beginning of life" or "definition of death," although nature often comes to us as irreducible continua.) This Platonic heritage, with its emphasis in clear distinctions and separated immutable entities, leads us to view statistical measures of central tendency wrongly, indeed opposite to the appropriate interpretation in our actual world of variation, shadings, and continua. In short, we view means and medians as the hard "realities," and the variation that permits their calculation as a set of transient and imperfect measurements of this hidden essence. If the median is the reality and variation around the median just a device for its calculation, the "I will probably be dead in eight months" may pass as a reasonable interpretation.
- But all evolutionary biologists know that variation itself is nature's only irreducible essence. Variation is the hard reality, not a set of imperfect measures for a central tendency. Means and medians are the abstractions. Therefore, I looked at the mesothelioma statistics quite differently - and not only because I am an optimist who tends to see the doughnut instead of the hole, but primarily because I know that variation itself is the reality. I had to place myself amidst the variation.
  
  When I learned about the eight-month median, my first intellectual reaction was: fine, half the people will live longer; now what are my chances of being in that half. I read for a furious and nervous hour and concluded, with relief: damned good. I possessed every one of the characteristics conferring a probability of longer life: I was young; my disease had been recognized in a relatively early stage; I would receive the nation's best medical treatment; I had the world to live for; I knew how to read the data properly and not despair.
- Another technical point then added even more solace. I immediately recognized that the distribution of variation about the eight-month median would almost surely be what statisticians call "right skewed." (In a symmetrical distribution, the profile of variation to the left of the central tendency is a mirror image of variation to the right. In skewed distributions, variation to one side of the central tendency is more stretched out - left skewed if extended to the left, right skewed if stretched out to the right.) The distribution of variation had to be right skewed, I reasoned. After all, the left of the distribution contains an irrevocable lower boundary of zero (since mesothelioma can only be identified at death or before). Thus, there isn't much room for the distribution's lower (or left) half - it must be scrunched up between zero and eight months. But the upper (or right) half can extend out for years and years, even if nobody ultimately survives. The distribution must be right skewed, and I needed to know how long the extended tail ran - for I had already concluded that my favorable profile made me a good candidate for that part of the curve.
- The distribution was indeed, strongly right skewed, with a long tail (however small) that extended for several years above the eight month median. I saw no reason why I shouldn't be in that small tail, and I breathed a very long sigh of relief. My technical knowledge had helped. I had read the graph correctly. I had asked the right question and found the answers. I had obtained, in all probability, the most precious of all possible gifts in the circumstances - substantial time.
- One final point about statistical distributions. They apply only to a prescribed set of circumstances - in this case to survival with mesothelioma under conventional modes of treatment. If circumstances change, the distribution may alter. I was placed on an experimental protocol of treatment and, if fortune holds, will be in the first cohort of a new distribution with high median and a right tail extending to death by natural causes at advanced old age.

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