Here's a cartoon representation (below) of the science of extrapolation. Offering a therapeutic plan to 92 year olds with metastatic breast cancer because the data on 40 year olds suggest a bias towards this outcome benefit or that outcome benefit is like waiting a few months to get a bulk rate on your wedding cake. The extrapolation of data is inappropriate. We have no way of knowing whether the data for doing nothing would show a survival benefit or not. It's the equivalent of offering her chiropractic care. Both are believers in their therapy.
If there are any oncologists reading this, I am more than open to some CME on the matter. Do you have compelling evidence that offering therapeutic intervention to 92 years olds in this situation has a survival benefit over doing nothing?
