H. BRUCE RINKER: Does One Count?

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H. Bruce Rinker

Galileo (1564-16-42) declared “Mathematics the language of science.”

For us modern day scientists, that language is based on statements of statistical significance and probability. Scientific data rarely lead to absolute conclusions.

Among the sciences we have a special, but not exclusive, language to help us to study natural phenomena on the winnowing and threshing floor of Statistics. For example, lung cancer is almost 20 times greater in cigarette smokers compared to nonsmokers. There is a significant likelihood of a catastrophic meteorite impact on Earth in the next 200,000 years. What are the chances of survival for two or ten years with metastasized pancreatic or uterine cancer? These numbers are based on our observations and interpretations, a “best guess,” about the works of nature.

There are no absolutes in the sciences. After-all, tomorrow the apple may fall “up” however unlikely the possibility. Statistics is a language to help us slough off the irrelevant.

Nature is continuous. All data exhibit variability, The role of statistics is to quantify this variability and allow us scientists to make more accurate statements about the world around us.

As many of my readers know, in October 2016, I was diagnosed with an aggressive and terminal brain cancer called a glioblastoma, also known as GBM. It’s a killer disease.

At the time of my diagnosis the median survival rate was 15-16 months. That was 30 months ago! This history makes me a statistical outlier for such a dreaded malady.

We do have case reports of patients surviving for 10-20 years, but this population is relatively small, Survival rates are only part of the story about cancer that help us to understand the prognosis of a disease. As it turns out, the outlook for patients with GBM varies with their specific circumstances including age, overall health, grade of tumor, its location, family histories, individual lifestyles, and treatment therapies. Due to all this variability, medical professionals cannot predict what will happen to any one individual struggling with a brain tumor.

Survival rates do not tell the whole story.

In the parlance of Statistics, it’s all about “n,” the total population size. The greater value of “n” the stronger the conclusions that may be made: in other words, how many case reports do we have of patients surviving more than 1-3 years with GBM? “n=1” is not enough to make any conclusive statements about the disease. In other words, an exception is not a rule.

Early in the process of writing my book about my cancer journey, I had asked a GP friend to review the manuscript. His response was, “Bruce it’s too esoteric for most GBM patients. My endorsement might give others a false hope about their own survival. Your story is one-in-a-million.” As a scientist, I understood his concern immediately. But given that we still know so little about this cancer, my cancer journey could have a kernel of relevance for its hoped-for cure. Does one count? It could make all the difference in the world!

“Never doubt that a small group of thoughtful committed citizens can change the world,  indeed it is the only thing that ever has,” Margaret Mead (1901-1978).

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Bruce is a forest ecologist, science educator, and explorer. He may be reached at [email protected] He is the author of A Pearl in the Brain: The Cancer Journey of a Scientist in His Search for the Seat of the Soul. Further you may help him to advance the knowledge about about GBM by purchasing the book and by joining his gofundme.com/rinker-book-publishing-campaign . He and his team are working now on social marketing and a Spanish translation of the book. Please help others to understand this dreadful disease!