Fallacy of the Five-Year Survival in Lung Cancer

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Abstract
Patients with lung cancer can be treated by either surgical extirpation or radiation. The former may offer increased five-year survival and prolonged life expectancies as compared to the latter, but subjects patients to the immediate risk of thoracotomy. We interviewed patients with "operable" lung cancer and found that they were quite averse to taking risks involving the possibility of immediate death. When these data about patients' attitudes were combined with data about survival after both radiation therapy and operation, it appeared that radiotherapy would be the preferred therapeutic plan for several of these patients. These results emphasize the importance of choosing therapies not only on the basis of objective measures of survival but also on the basis of patient attitudes. (N Engl J Med 299:1397–1401, 1978)

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