Never Give Up: The Times reviews The Death of Cancer

Never Give Up--A review of The Death of Cancer in the Sunday New York Times Book Review:

A nice thoughtful review, although I don't agree re the issue of wanting more about palliative care. I think palliative care is great and should be started early to help patients live with a cancer diagnosis whether they are cured or not. But it should not be mistaken as an alternative to getting rid of the cancer.

Nor do I support prolonging life in hopeless cases.  It's also not the subject of the book.

That's not the issue in the review, however. The issue is the last sentence. The reviewer suffers from a common affliction called "median disease." He disparages the value of prolonging life using median survival of "only 3.5 months" (for the drug the patient couldn't get) which he says we forgot to mention.

What people with "median disease" miss is that prolongation of median survival ( a convenient statistical endpoint at which half the study patients have died ) often results, as it did in this case, in a tail on the survival curve where 25 percent of patients were responding and alive at greater than one year. In fact, at the study closure some patients were still alive at greater than 550 days. That was worth shooting for and might have gotten my friend Lee to the next active drug. "Median disease" can be a real problem for cancer patients.