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Comment by nezumi | Hacker News Reader

It's surprising how the disease crept up on him despite the annual checks. One of the benefits I imagine successful executives must have would be super-duper, executive-level healthcare. All the check-ups and screenings the rest of us miss out on because they're not quite cheap or statistically significant enough to be worth rolling out for the general population.

And yet the CEO of a biotech firm slips through the net.

Does executive-level healthcare exist or is it just in my imagination? Is there any significant advantage to be had if money is not an issue? Or perhaps he already had all these advantages (he already knew about the genetic marker) and that's how come he's in remission now?

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> It's surprising how the disease crept up on him despite the annual checks.

Depending on the cancer, they can act extremely fast. My father died from a pancreatic cancer, he got about three months after the discovery, and before that he spent under a month with severe back pains (doctors were telling him it was nothing but he forced them to get to the end of it and find out why he was in so much pain).

Considering Mr Martin's myeloma took out a whole vertebra before he hurt enough to go see the doc, I'd say the thing was particularly ferocious, and short of checking every 1-3 months he would only have caught it by luck.

> Does executive-level healthcare exist or is it just in my imagination?

it probably exists, but you have to factor in the long hours and activity which result in both physical stress and not much time to go see the doc', short of having your own on retainer.

> (doctors were telling him it was nothing but he forced them to get to the end of it and find out why he was in so much pain)

A family member is currently unwell, and their immediate family isn't doing a great job talking to the doctors. The doctor basically tells her something using medical terminology that she doesn't understand, and she doesn't follow up.

Previous experiences with doctors, and your story, have re-inforced my belief that if I ever get ill, as far as I'm concerned, that doctor is now my personal tutor and servant, and that I will get clear answers, explanations, and whatever tests might be necessary even if I have to streak up and down hospital hallways screaming and whipping nurses with my IVs.

IANAD, but my guess is that he was unlucky and the cancer was especially fast to act. Yearly checks might have been too granular, and the marker could have spiked shortly after his last test. Also, I'm guessing that it's rare to even know you have it until you start getting symptoms. How often do doctors run blood tests for random protein markers?

From wikipeida, it looks like the cancer is related to abnormal white cell buildup. If he's traveling a lot, he would be exposed to more sicknesses, and so might have more white cells then usual, so he has more to build up. But then again, IANAD, so this might be completely wrong.

From the story, it is evident that this gentleman has long been aware that he might develop myeloma. This implies that he had been diagnosed previously with a monoclonal gammopathy of unknown significance (MGUS). This may be clinically suspected based on routine bloodwork showing a gamma gap. Once you suspect it, there is a fixed protocol for further investigation. It also sounds like there were lapses in the routine checkups that would help with early detection if this did progress to myeloma. Very unfortunate; this CEO seems like a delightful person and I wish him the best.

It sounds more like he stopped getting checked years ago, and ignored warning signs due to life pressures.

I didn't get that feeling from the article at all. My brother actually has multiple myeloma as well; he's checked every 3 months to see if the blood levels have spiked and a skeletal survey is done every 6 months. It's almost a certainty that the cancer to start eating away at your bones and you not know it between the skeletal surveys.

"So every year Martin would get his blood checked, fearing the 1% to 2% chance that the marker had spiked.

It never did, and Martin slipped into a routine that included juggling long hours at the office, raising three teenage boys, racing cars, skiing, and cycling."

After reading the "slipped into a routine..." part I took it to mean that he stopped getting the annual tests, thinking that he'd done it long enough to satisfy himself that he wasn't going to get the disease. Sounds like I read it the same way sliverstorm did.

Is voting enough, or should we all say "me too"?

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