The chemotherapy patients’ waiting room was quite a bit smaller, and its walls were lined with chairs, leaving a gap in the middle for a table that usually held a basket full of biscuits, and some more magazines. The atmosphere tended most weeks to be very convivial. We would all ask each other how we were getting on, receiving congratulations or sympathy dependent on our answers. In the corner was a kettle, and tea- and coffee-making facilities. For something that had the prospect of being so grim as receiving chemotherapy, it was really quite a happy place.

Two weeks ago, that all changed. In an effort to increase the size of the treatment area, our waiting room was converted into a haematology treatment room, all the chairs were moved from our waiting room into the main one, and in order to squeeze them all in, the chairs were rearranged into tightly spaced rows, all facing the receptionist, as though she were on a stage. In fact, that was exactly how she felt about it, and has since lowered her chair so that she doesn’t feel stared at by all the waiting patients. I do feel sorry for her.

But most of all, I feel sorry for all the patients. Being in rows, all facing the same way has removed all sense of conviviality. It’s really hard for people to talk to each other, and if you feel the need to get up and wander around, perhaps to ease an aching back, it’s now a lot more difficult. It seems such a shame to have thrown away all the benefits that the old arrangement had. I can see that there are clinical and financial benefits in having a larger treatment area, but all the same, it’s really tough on those of us who have lost out. And I include the haematology patients in that group too.

Although our National Health Service gives us medical care that is free at the point of use, and I am extremely impressed with the medical staff both their behaviour and their attitude, there can come the occasional time when resource limitations really bite. This is definitely one of those times.

I’ve just written to my MP telling them why I am concerned that the Digital Economy Bill could be rushed through without a full Parliamentary debate. Will you write to your MP too and tell them why the government shouldn’t rush through these draconian laws. It only takes two minutes. Or you can take a little longer and add a personal touch your letter to your MP, as I did.

Thank you.

It is a natural question for anyone to ask when he first discovers that he has cancer. As a scientist, my first inclintion was to look for some data to help me to understand whether anything I did could have contributed to my cancer’s development. It doesn’t take long to find out that there is a whole list of risk factors for oesophageal cancer. From a Wikipedia page I found a long list of factors that increase the risk of getting oesophageal cancer, of which the only relevant ones were my sex (I’m male, and men are much more likely than women to get this cancer) and the fact that I was overweight (until the cancer got going). One of the factors mentioned is age, but only old age, so in that sense my age reduced my risk of developing cancer.

This is not the end of the story, however. There are some factors associated with reduced risk of contracting oesophageal cancer. From the same page I found that the fact that I occasionally used ibuprofen worked in my favour, as did the fact that I like both brocolli and coffee, maybe even pizza! Unfortunately, I don’t have an ulcer, which is a shame, as Helicobacter pylori (the bacterium associated with ulcers) may have a protective effect.

All very well, I thought, but there are no numbers. How harmful was it that I was overweight (technically obese, as I was more than a quarter heavier than my ideal weight)? And did my diet otherwise help? Let’s try to find some numbers.

The Cancer Research UK site was helpful here. One page told me that obesity is associated with a risk factor of roughly 2. What does that mean? Simply put, it means that I was twice as likely as a non-obese person to develop cancer. Wikipedia has more details on risk factors if you’re interested.

How likely is a normal person to develop cancer? Once again the Cancer Research UK site provides the information. Of every 100,000 males aged between 45 and 49 years, 6.8 of them are expected to develop oesophageal cancer. In other words, I had a probability, in the absence of any risk factors, of 0.0068% of developing oesophageal cancer. If you leave out all the positive things I did, such as drinking coffee and eating a wide variety of vegetables and pizza, and only consider the fact that I ate too much and was therefore overweight, I had a probability of 0.0136% of developing cancer.

I think the conclusion is clear: I was quite simply unlucky. It would not make any sense at all to say that my obesity caused my cancer. Otherwise, how could I explain the remaining 99.9864% of probability? Similarly, it probably made no practical difference that I ate and drank all those “good” things, as the associated probabilities were equally tiny.

What does this tell me about risk factors? Let me try to illustrate with a question. How would you feel if you were told that being obese increased your chances of developing oesophageal cancer by 0.0068%? Or put another way, that you were increasing your chances to 0.0136%? Would you worry about it? No, neither would I. But if you were told that you were doubling your chances of developing the cancer? That would be far more likely to be worrisome, wouldn’t it? These differences are statistically significant. That means you can reliably measure the difference; it doesn’t mean that the difference is important. And there, I think, is the reason that people talk about risk factors. The measurable difference is something you can talk about and get worried about. I have noticed frequently that news programmes on the radio or television often mention increased risk factors, but they never say what the absolute risks are. Maybe that’s because those risks are not uniform across the population, which would make it difficult to summarize them in a single, easily understood number. (Consider that as a relatively young man, my risk of developing my cancer was a lot lower than that of a retired man, for example.) But I don’t think it would be too hard to show a graph of the relevant distributions. Scare stories attract an audience, don’t they? And they’re easier to write, just less informative.

There. I’ve said enough. Time for others to have a say.

Even if he won, it would likely cost Simon £50,ooo, but if he lost the costs could easily be ten times that. Simon felt that the matter was one of public interest, and after taking legal advice decided to fight the case. In May 2009 the judge made a ruling that hurt Simon’s case, saying that a key statement in the article was one of fact, and not of comment. This made the case a lot harder to defend. Simon chose to go to the Court of Appeal, his least worst option, where he would argue that the judge misconstrued his article. That raised the costs even higher.

Britain is renowned as having the most libel-friendly laws in the world. It is easy for organizations to threaten individuals with a libel suit that will be expensive to win and more expensive to lose. It makes it hard even to question an organization that might be responsible for bad science. That is not something I want Britain to be famous for. Nor am I alone. Simon is being supported by a charitable organization called Sense about Science, with a web site where you can also read  full details of his case.

You can help

The best thing we can do to help is to get the political parties to make a manifesto commitment to reform libel law. A petition has been started in an attempt to raise at least 100,000 signatures, and let politicians know that we demand reform. Remember:

All that is necessary for bad science to triumph is that good politicians do nothing.

Don’t give them any excuse to do nothing. Sign the petition.

Allow me to clarify. How many terrorists are there in Great Britain? One hundred? One thousand? I don’t know, but 1000 seems on the high side. How many of them would be stupid enough to use a camera suspiciously and openly? Now ask yourself how many busybodies, or even public spirited citizens who have been scared by the Government’s misguided demonization of Muslims, will think they have seen something suspicious that should be reported. Every day. It’ll be chaos. I give it a month for the problems to become evident, and six months before they abandon the campaign. It’ll only be that long to save someone’s face.

What a farce!