from the series The Art of Oncology: "Certain Death in Uncertain Time: Informing Hope by Quantifying a Best Case Scenario"

Note: Stephen Gould's writings were extraordinarily popular died in 2002)

"Research informs us that the majority of patients with metastatic cancer desire information about their likely survival duration. The literature also recommends that prognostic information be communicated to those who request it in a manner that is meaningful and realistic, but maintains hope.....The following edited extract from Edward Kennedy’s memoir (and others) conveys the importance of trying to answer these questions....."

"...But I wasn’t willing to accept the doctor’s prognosis for two reasons. The first was my own obstinate will to carry on in the face of adversity, one of the many habits of discipline that my father instilled in me…. The second was the way the message was delivered. Frankly, it made me furious. I am a realist, and I have heard bad news in my life. I don’t expect or need to be treated with kid gloves. But I do believe in hope...."

"....As Stephen Gould published 3 years after reading that his median survival with abdominal mesothelioma was 8 months, “the median isn’t the message.”7 He argued that median survival can be both misleading and discouraging and believed few people have sufficient understanding of statistics to evaluate what the term median
really means....."