A new study from Yale shows that 75 percent of physicians in training surveyed do not understand the statistics used in medical literature. The study surveyed internal medicine residents at 11 programs across the country.

The residents scored an average of 41% correct on the test and the senior residents scored worse than the junior residents, possibly reflecting a loss of knowledge over time.

Practically all of the residents surveyed agreed that it is necessary to know something about statistics in order to be able to read medical literature and 77 percent expressed an interest in learning more about the field.

According to the corresponding author, Dr. Donna M. Windish, "If physicians cannot detect appropriate statistical analyses and accurately understand their results, the risk of incorrect interpretation may lead to erroneous applications of clinical research."

Cancer is named from the place it originates. This makes a difference on what type of treatments will be effective. Being diagnosed with cancer of the unknown primary (CUP) means that cancer has been found in the body but the place of origin is unknown.

If later, the place of origin is found then the type of cancer diagnosis changes from an unknown primary to the specific organ or body area that the disease first began.

Some cases of cancer of the unknown primary are unfortunately never found. Physicians will then decide on the best course of treatment based on two factors: The way the cells look under the microscope and which organs are currently involved.

Statistics and Prognosis:

The exact number of cases of this disease is not known. It may be about 2% to 5% of all cancers in the United States. It is found more often among men than among women. The average age of people with this cancer is about 60 years.

This is a very dangerous cancer. Only half of patients will live 9 to 12 months after their cancer is found. There are several reasons why this cancer is so serious. First, most of these are fast-spreading cancers. Second, because the exact type is not known, it is harder for doctors to know what treatment is best. Also, the cancer is often widespread, making it harder to cure.

In recent years, microscopic and other diagnostic techniques have improved dramatically. For this reason, doctors can now determine the primary site in about four out of five cases.

Some national statistics on cancer included in the New York Times feature this week :

According to the American Cancer Society and the National Institutes of Health, there will be over 1.4 million new cases of cancer diagnosed this year.

Approximately 559,000 people will die from cancer this year in the U.S., making cancer responsible for about 1 out of 4 deaths in America.

I found this next statistic interesting, as I have seen so many conflicting numbers on this topic, the number of cancers that can be attributed to lifestyle.

According to this article, about 30 percent of cancer deaths this year will be from cancers caused by tobacco use. Another 33 percent of cancer deaths will be from cancers related to obesity, physican inactivity and poor nutrition combined. I assume that leaves 37 percent of cancer deaths due to genetic or otherwise unknown causes.

As far as age, 77% of all cancers diagnosed this year will be in individuals 55 years or older.

It didn't register right away. But not long after I finished doing some research yesterday on breast cancer screening tools did I realize the statistics on breast cancer incidence have changed for 2007. Not only did they change -- they're moving in exactly the right direction.

Think about this:

The American Cancer Society reports that 178,480 new cases of invasive breast cancer will be diagnosed in American women in 2007. This number was 212,920 in 2006. Deaths by breast cancer -- there were 40,970 in 2006 -- will number 40,910 this year.

Just as it had become second nature for me to rattle off 200,000 as the general number of women diagnosed with breast cancer each year, I must learn a new number. I love it.

Elizabeth Edwards' breast cancer recurrence has the disease once again dominating newspapers, magazines, television programs, and conversations.

Just two days ago, I heard a run-down of facts about breast cancer. They were shared to raise awareness, and while I was already aware of most of them, it's still quite sobering to hear some of the statistics that surround a disease that lands in the laps of more than 200,000 American women every year.

Think about these -- three powerful truths that happen to stick in my mind at this very moment:

The highest risk of breast cancer belongs to those older than 60.

Nearly 85 percent of women diagnosed with breast cancer have no family history of the disease.

And tragically, every three minutes, a woman is diagnosed with breast cancer.

The American Cancer Society has happily announced that cancer deaths have declined for the second straight year. This is big news -- mostly because our population is growing and aging and it's entirely possible this could have led to an increase in cancer deaths. Not only is this not true, but the drop in deaths for this second year is eight times greater than the drop during the first year. Amazing.

It's hard to imagine in light of this great news that there are still less hopeful statistics out there on the cancer front. But there are so many dimensions to this disease -- prevention, detection, diagnosis, treatment, survival -- that the numbers can vary tremendously depending on perspective.

From the perspective of diagnosis, one in two men and one in three women in America today will develop cancer during their lifetimes. These staggering statistics, based on data collected during 2001 through 2003, are detailed in a pivotal paper appearing in The Oncologist -- a monthly peer-reviewed journal for doctors devoted to cancer patient care.

Dr. Matthew Hayat and colleagues, who worked on this paper for the National Cancer Institute, reveal other worrisome numbers and facts.

It seems the number of new cancer patients is expected to more than double from the current 1.36 million in 2000 to almost 3 million in 2050. Five-year survival for all cancer stages combined ranges from as low as 16 percent for lung cancer patients to 100 percent for prostate cancer patients. And black Americans are reported to have the highest cancer incidence and mortality rates for men and women for all cancers combined.

So while less people are dying from cancer, diagnosis of the disease seems to be on the rise. Not exactly a perfect scenario -- but if science and research can keep up, perhaps those diagnosed with cancer will need to prepare not for death, but for the management of a chronic condition.

Breast cancer statistics for 2003 are in, and researchers have announced that the number of breast cancer cases dropped by an impressive seven percent, with the greatest drop occurring in women between ages 50-69 diagnosed with estrogen receptor positive (ER-positive) breast cancer.

The University of Texas M. D. Anderson Cancer Center researchers attribute this good news to the fact that in the same time frame, millions of women stopped taking hormone replacement therapy (HRT) over concerns that HRT led to an increased risk for breast cancer.

If the statistics hold for upcoming years, HRT will have proven a greater causative effect leading to breast cancer than originally believed.

"Incidence of breast cancer had been increasing in the 20 or so years prior to July 2002, and this increase was over and above the known role of screening mammography," stated Donald Berry, Ph.D. "HRT had been proposed as a possible factor, although the magnitude of any HRT effect was not known. Now the possibility that the effect is much greater than originally thought all along is plausible, and that is a remarkable finding."

While the researchers best guesstimate is that HRT might be the contributing factor to the drop in ER-positive breast cancer cases for 2003, they cannot be 100 percent certain at this point. We will need to wait and see what the years 2004 and 2005 tell us about any continuing declines in breast cancer cases, and learn what other, if any, contributing factors are responsible for the decline.

Previous posts we have done regarding HRT and breast cancer:

• Hooray for HRT!?
• HRT and smoking dramatically increases breast cancer risk
• HRT increases breast cancer risks

The opinion was overwhelming. I was too young for breast cancer. I heard it time and time again before my diagnosis and while it was mildly comforting to know that women in their early 30s -- like me -- rarely develop breast cancer, a sensation deep in my gut told me I was headed for something that defied statistics.

Two years ago -- on November 18 and 19 -- the clues concerning the lump in my breast were stacking up. At the time, the odds were in my favor -- despite the sinking feeling that sat in the pit of my stomach.

November 2004

I went to my OB/GYN on November 18. My doctor felt the lump but was confident it was nothing to worry about. It moved around easily, there was no discharge from my nipple, I did not feel any pain -- all signs that it was benign. But it's routine to get a mammogram for any mass so I got one the next day.

I was the youngest person waiting to get my mammogram, another sign that this lump was nothing serious because it is not common for young women to have breast cancer. Mammograms are not even recommended for women under the age of 40. I am 34. The mammogram films looked okay and the technician told me the doctor would talk to me but that she was not worried about anything. This was true but she did an ultrasound anyway to look further at the lump.

She determined it was not a cyst, which is fairly common, and nothing serious. It could be a fibroma (a common growth that can be removed or left in place without harm) or it could be cancer. She said she wanted me to have the lump removed. She wanted it out and "in a jar," she said. I asked her if it could be cancer and she said it could be.

My mom's best friend died from pancreatic cancer just three months after her diagnosis with the disease. One of my co-workers lost her mother to the same disease just weeks after diagnosis. Another co-worker's husband lost his battle with pancreatic cancer after a 15-month all-out fight. And a family friend has somehow been surviving this deadly disease for years now. He's the exception, defying the odds rarely in favor of long-term survival.

About 33,730 people will be diagnosed with pancreatic cancer in 2006. Many of them -- 32,300 -- will die from the disease that is rarely caught early. Pancreatic cancer is the fifth leading cause of cancer death in the United States.

All cancers are not treated equally. Some attract a frenzy of attention -- breast cancer -- and some receive not much attention at all -- gallbladder cancer. Some are vigorously researched and studied. Others sit by idly, rarely the subject of investigation. Some are feverishly funded. Some never prosper by way of financial support. Yet they all share something very important in common. They are all cancer.

All cancers are marked by an uncontrollable division and spread of abnormal cells. And they are all capable of delivering shock and despair and even death to any one of us. And that makes each one -- brain cancer, cervical cancer, colon cancer, eye cancer, liver cancer, prostate cancer, stomach cancer, you name it -- worthy of equal attention.

And so I bring to you Cancer by the Numbers, a series of posts that will feature the basics about all sorts of cancer, beginning with the numbers -- the statistics -- to help define the prevalence of each cancer, followed by important facts about screening, diagnosis, treatment, survival, and more. I will cover the well-known cancers, the sort-of-known cancers, the barely-known cancers. And while I can only offer what I can track down on each form of cancer, I intend to dish out every piece of data I can dig up -- so we all can become a little more informed, a little more prepared should we have to personally do battle with any one of the 100 possible cancers out there.

The American Cancer Society reports that 1,399,790 new cancer cases will be diagnosed in 2006. This estimate does not include most carcinoma in situ (noninvasive cancer) cases and also does take into account the estimated one million cases of basal and squamous cell skin cancers that will be diagnosed this year. Of these predicted cases, about 564,830 will result in death -- that's more than 1,500 people each day. Cancer is the second most common cause of death in the United States, exceeded only by heart disease, and accounts for one of every four deaths.

These numbers are staggering. But without further explanation, they are broad and all-encompassing and don't say much about how all the individual diseases add up. That's what I plan to do -- break it all down, cancer by cancer, until the numbers make sense. And the cancers do too.

When a question or concern or worry related to breast cancer pops into my head, I typically find myself parked in front of my computer in search of instant answers, instant comfort, instant wisdom. There are several different websites I consult -- each one different from the others, each one complementing the others. They are my reference tools, my handbooks, my encyclopedias. They offer me a clear picture of a confusing, cloudy disease. And here they are -- seven super websites that have been become staples in my life.

Cathy's EC Cafe' was started in 1995 to support those diagnosed with esophageal cancer. When Cathy's dad was diagnosed with the disease in 1995, Cathy could not find much information on the internet. Since then, The Cafe has celebrated more than ten years of providing information on esophageal cancer.

The website won the 26th OncoLink Editor's Choice Award in 2006. OncoLink site states "This award is given by the editors of OncoLink to the provider of the highest quality cancer information on the internet. Selection is based on the particular emphasis we at OncoLink place on patients and families who empower themselves with information about their disease. Your site is exemplary of this philosophy, and serves as a model for others."

You can find at Cathy's Cafe many survivor stories to read or you can join the EC-Group for a more personal touch. The information provided can help a newly diagnosed patient get all the information they need about esophageal cancer in one place.

One survivor story that I took particular interest in was Barry Bokhaut's. He also has on the website a story that he wrote called My Blue Hat. I loved his story and I really related to it being a cancer survivor myself.

Each month, about 22,000 women log on to the National Cancer Institute (NCI) web site and answer seven questions to determine their risk of developing invasive breast cancer. The Gail Model, named for the NCI's chief biostatistician, Mitchell H. Gail, generates a five-year risk and a lifetime risk for each woman who answers each of these seven questions.

• Does the woman have a medical history of any breast cancer or of any ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS)? Note: This assessment tool cannot accurately predict risk for a woman who already has a medical history of breast cancer.
  
• What is the woman's age? Note: This tool only calculates risk for women ages 35 and older.
  
• What was the woman's age at the time of her first menstrual period?
  
• What was the woman's age at the time of her first live birth of a child?
  
• How many of the woman's first-degree relatives -- mother, sisters, daughters -- have had breast cancer?
  
• Has the woman ever had a breast biopsy? How many breast biopsies has the woman had? Has the woman had at least one breast biopsy with atypical hyperplasia?
• What is the woman's race/ethnicity?

A simple drop-down answer menu is provided for each question, and explanations for each question are available. Upon completion of the short survey, the Gail Model spits out a five-year breast cancer risk and a lifetime breast cancer risk with comparisons to the general population of women.

While this is only an assessment -- based on statistics that do not always take into account individual differences -- it is still a helpful tool. Because it's clear that women can minimize breast cancer risk with behavior changes and sometimes medication. And generating a personal rating on risk is a rating worth knowing. It's also worth knowing that this tool was designed for use by health professionals. If you are not a health professional, consider discussing your results with your doctor.

Breast cancer is widespread -- so widespread that most of us have direct personal contact with someone living with this disease. Information about breast cancer is also widespread -- so widespread that it's easy to get lost in the maze of details that define this illness that two million women in the United States are living with at this very moment. Breast cancer has its own set of definitions and facts and statistics -- and myths too. And here are seven myths that are not worth spreading.

Most lumps in the breast are cancer.
Actually, most lumps in the breast are not cancer. But every lump should still be examined and diagnosed.

Breast cancer does not occur in young women.
While most breast cancer cases occur in women over the age of 50, breast cancer can and does occur in women of all ages. I was diagnosed at age 34.

Women with large breasts have a greater risk of breast cancer.
Size does not affect risk. But it can be more difficult to examine large breasts and therefore detect a suspicious lump due to a larger amount of tissue.

A woman has little or no risk of breast cancer if she has has no family history of the disease.
Most women with breast cancer -- about 75 percent -- have no family history of breast cancer. Simply being female puts all women at risk. I have no family history of breast cancer -- but I still was diagnosed with this disease and have been treating it for almost two years.

If mammography shows nothing to worry about, then there is nothing to worry about.
Mammography can miss 10 to 15 percent of all breast cancers. So any suspicious mass should be investigated with further tests -- such as ultrasound and MRI. When my lump was examined during a mammogram, my doctor was not worried. But an ultrasound that followed revealed a solid mass -- and this was something to worry about. A biopsy came next. And then came my breast cancer diagnosis.

Once a woman is treated for breast cancer, she should avoid becoming pregnant.
Many breast cancer survivors go on to have successful pregnancies and healthy children. Women should consult their doctors, however, about current and previous treatments and should discuss any possible concerns about pregnancy after breast cancer.

Removal of the entire breast is safer than segmental mastectomy.
Survival is similar for women who have breast-conserving surgery -- like a lumpectomy -- and for those who have either a total or modified mastectomy.

It's not surprising that inaccurate information is floating around about breast cancer -- because there is so much information on the topic and much of it is not completely understood by those who study the disease every day. But we all can take an active part in our own education by researching each tidbit of news that comes our way. We can confirm it, deny it, and understand it better if we take matters into our own hands. And if we don't spread anything we just are not sure about. We owe it to ourselves -- and women everywhere -- to spread only the most accurate information about this disease we all need to better comprehend.

I love the terminology used by those behind the scenes at Hurricane Voices. This is where I first read the words breast cancer dancer and where individuals have gathered to advance the rebellion against breast cancer. The content on this site is powerful, edgy, and truly inspiring -- it incites public action. And it makes me want to jump up and do something -- now. To break down the barriers to progress in pursuit of the causes and cures for breast cancer -- which is the whole purpose of Hurricane Voices.

Hurricane Voices began because of one woman -- Lois Egasti, a wife and mother living with metastatic breast cancer. Lois, who passed away on April 15, 2003, knew she was not alone and felt the need to take a stand against the disease. So she put her urge into action and formed this not-for-profit organization. And in just four years, a great community of voices emerged -- voices that have helped raise support and participation in far-reaching programs and events.

Hurricane Voices offers on its website a family reading list, a regular newsletter, an empowering overview of breast cancer and its statistics, and a sampling of various myths surrounding breast cancer. Hurricane Voices provides direction for involvement in unique conferences -- such as When a Parent Has Cancer: Strengthening the School's Response which helps school systems support families affected by parental cancer and Breast Cancer: Truth & Consequences, a conference that challenges the status quo concerning breast cancer. Hurricane Voices initiates thought-provoking public awareness campaigns and strives to inform the public that the disease we call breast cancer is a very serious illness.

Every day, more people are being diagnosed. Every day, more people are dying. Yet we are not beating this disease -- in fact in the time it takes to brush our teeth or drink a cup of coffee, another person has died of breast cancer. And this is what Hurricane Voices wants us to know. This and the fact that well-meaning, misconstrued survival rates in the 90 percentiles only extend for five years. And five years is just not enough.

Powerful -- that's what Hurricane Voices is -- powerful. And each of us can contribute our own power to this organization by becoming a Hurricane Voice. So speak up -- by simply clicking here.