Numbers Game

Last week at our renal cell support group, we heard from Dr. David Sharp, an oncologic surgeon specializing in renal cell carcinoma, and specifically robotic surgery for tumor removal. He looks like he is 12 but has been in the business at least that long ... At any rate he quoted the most recent statistical estimates for renal cell: 2008, expected case discoveries, 54,000. 2008, expected deaths, 13,000. Mind you, when I started on this journey in 2000 the annual expected case rate was 38,000 and the expected death rate was 12,000. So in a few short years the reported incidence has increased by roughly 30%, and reported deaths have increased by about 8.3%. What's interesting about RCC is that it's generally an "incidental finding", that is, one goes to one's physician for something else and RCC is identified through nonspecific tests. It often shows up in CT scans for back pain, for example.

Discovered tumors also tend to be smaller than eight years ago, and the rate of partial nephrectomies has gone up as a result. Partial nephrectomies certainly lead to a better post-operative experience for the patient. Do I think that RCC is increasing in the population on its own? I'm not certain - I suspect that given better diagnostic tools, we may just be finding it more often, and earlier. The relatively lower increase in death rate I think can almost certainly point to better treatment options. It's a cliche, of course, but I think "living proof" applies here.

This beautiful piece of abstract art arrived at our house yesterday. It's an untitled work; perhaps it should be called

CAUTION: Remove hat before placing head under mower.

Saint H's beloved beat-up straw hat was knocked from his head by a low tree branch while he was mowing the lane yesterday. We suspect duct tape will fix it right up.