At times, when all odds are stacked against you, clinging on to hope may be the only thing to keep you alive. But at other times, accepting fate and letting go may unexpectedly turn out to be lifesaving.

When you’ve been diagnosed with cancer and your chance of survival is bleak, deciding whether to battle it out – trying whatever alternative therapy or clinical trial available – or opting out of curative treatment isn’t exactly the kind of choice anyone would like to make. Yet it’s a choice that many people get confronted with at some time in life – no guarantees given, except for the knowledge that either way it’s going to be a rough ride.

It’s a conundrum that’s at the heart of two articles that appeared in The New York Times today. The article on “exceptional responders” provides a very well wrought and comprehensive insight into the genetic tombola that decides why some cancer patients can beat the odds, as well as the rather more mundane reasons why these chances are so slim and why clinical trials for cancer usually don’t succeed.

The other article tells the story of a baby who miraculously returned from his deathbed after what seemed to be an unsuccessful treatment for a very rare and  aggressive type of leukemia. Doctors now think that the decision to cut down on his immune-suppressing drugs – prescribed to avoid a possibly life threatening stem cell transplant rejection – and his parents’ decision to end recommended chemotherapy actually saved his life.

It’s a story that reminds me of the case of Charlotte – daughter of Dutch writer Pia de Jong – who was also taken home by her parents to die, but recovered from a leukemia that seemed to have disappeared by itself.

Despite all “Moonshots to cancer”, doctors and researchers may never find out why some patients get cured and others not. Cancer is an incredibly tenacious, adaptive and resourceful disease with a drive to survive equal to that of its unfortunate host. Who gets to win is a matter of (bad) luck, funding, perseverance and the power of evolution.

(Photo above text: the placard hanging outside one of my favorite hangouts in Seoul, back in the 2000s, photographed by Oinonio)