by Dra Maria Alice [email protected]
Dr Maria Alice is a consultant in General and Family Medicine and is director of Luzdoc International Medical Service in Praia da Luz, Lagos.
Risin’ up to the challenge
Went the distance
Did my time, took my chances
Just a man and his will to survive
Whenever a child is born an inevitable fight starts – a unique, personal fight for survival. A fight that goes on for a lifetime … this new human being’s lifetime.
A few days ago, someone who I consider an extraordinary human being, told me in conversation: “I know I was told that my chances of a 5 year survival probability are 5%.” How does someone live and enjoy living with this feeling of inevitable end? The same way we all live with our lifetime prognosis?
This thought went on brewing in my mind. And I thought … what is a prognosis?
A prognosis is an estimate of the likely course and outcome of a disease. The prognosis of a patient is often viewed as the chance that the disease will be treated successfully and that the patient will recover – this meaning he will not die and will stay in perfect health.
Stay alive and in perfect health… Is it not this that all human beings fight for, from the moment they are born?
For 19th century physicians, particularly those following the French school of medicine, the main aim of medicine was not to cure disease but rather to give a diagnosis and achieve a satisfying “prognosis” of the patient’s chances.
Only several decades later did the focus of efforts, in Western medicine, shift to curing disease.
Doctors cannot estimate with certainty what the outcome will be for an individual patient as many factors affect the prognosis of a person, including the type and stage of the disease. But each patient is different and when estimating a patient’s prognosis, doctors usually use statistics, based on data from large groups of people whose situations are most similar to that of the patient.
Survival statistics contribute to predicting a patient’s prognosis but the way a patient responds to treatment depends on many factors, like the patient’s age and overall general health and, of extreme importance, the patient’s “power”, physical and psychological to fight disease.
No two patients are entirely alike, and their treatment and response to it can vary greatly.
A 5 year survival rate of 5%
What does this mean? That everyone else is going to live happily ever after and this person is the one that will only live, with the best considered and reasonable chance of 5%, for a maximum length of 5 years?
Not really! It means statistics give an indication that if all the right care is adequately used, this person is now aware of her possible length of life, something that others around her do not know. An advantage? Possibly…
I myself consider it is good to know.
Everybody else thinks that many more years are ahead, until a disease plays a dirty trick and, by thinking like this, they do not profit from their own limited time. Yes, we all have a limited time.
We are all born with a lifetime prognosis. It is written in our genes. Nevertheless, genes in an individual genotype do not reign alone, they are influenced during life, by life itself, by the environment and the phenotype does matter.
The way you live, the way you care for your body and your mind, changes your lifetime prognosis.
Living life is a challenge, but it is good and worth fighting for – whatever happens.
Live, enjoy, use to the maximum your will to survive.
Best healthy wishes,
Dr. Maria Alice
Consultant in General and Family Medicine
General Manager/ Medical Director – Luzdoc International Medical Service
Medical Director – Grupo Hospital Particular do Algarve