Monday, October 17, 2011

Going to a used car salesman who tells you not to buy a car.

Fair warning, this is going to be one of those posts full of technical info...In the best of all possible ways!
I saw the radiologist this morning, and after a very comprehensive intake and exam he said that in his professional opinion I am not a candidate for radiation.

Well, yahho! But why??
Remember my three choices? The first being do nothing, with a 25% chance of reoccurrance?
Well, as it turns out, not so much.
That statistic (which, unfortunately, is being bandied about in oncology and surgical offices across the country) is based on ONE study.
Oh, wait it gets better.
It was one study done retroactively.
As he explained, most clinical studies are set up so they decide what they are looking for regarding the efficacy of some treatment, and what population they need to study to get the clearest results.
So they would then solicit doctors to find, let's say, 1,000 women in that category. 500 would receive the treatment they are investigating and 500 would receive a placebo (just keep this in mind if you are ever given the opportunity to participate in a clinical trial).
The 1,000 patients are then closely followed during the treatment and for 10 years afterwards.
A decade.
And based on all of that data they can see if a treatment protocol has actual benefit or not.
But this study was done retroactively: they decided what results they were interested in, took a number of cases from the files, separated them out into different groups and drew their conclusions.
Pretty odd way to do research, eh?

(Breaking into my late night infomercial voice)
But, wait! It gets better!!

The study, which he actually went and made a copy of, for me, was done with 574 women with DCIS and mastectomies.
Of those only 80 were found to have very close margins, like I have.
Of those 80, only 45 had comedonecrosis. (the form of DCIS I presented with)
Of those 45 only 16 were in the same statistical group as I am: under 60 and post menopausal. (The endocrine input is vital to all types of breast cancer, even DCIS depending on the type.) we are down to a study consisting of 16 women??

Yes, and of those 16 women, who did not receive radiation, 4 had a reoccurance.

As he said, yes 4 out of 16 is 25%, but in his professional opinion as a physician who also takes part in research, he is not convinced that were those numbers expanded out to 100, that 25 women would have had a reoccurance.
Especially since in research .5% is considered statistically significant
(Which strikes me as odd. Half a percent is statistically significant?? Well, ok...)
But of those 16 the statistics were only .3.
His words? "This has no valid clinical significance. I see no medical reason to treat you with radiation."

Which also means that I am also not really a candidate for further surgical intervention either!
*doing the Snoopy dance!*

Now, to get this cellulitis healed, and continue to clean up my diet and life.
And just live.
No worries, mate!


mrs mediocrity said...

That is wonderful news for you!
Hope you are feeling much better!

d smith kaich jones said...

well damn! double damn! this is fabulous news!! i be doing that happy dance with you!


stella said...

I'm caught up and wow!