447 Days Ago, I Found Out I Had Cancer | Hacker News Reader

447 Days Ago, I Found Out I Had Cancer

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62 pointsdylangs103042 comments

Radiation oncology researcher here--I'm glad treatment was effective! I'm very busy tonight(ASTRO's abstract deadline is tomorrow) so I'll get straight to it.

Generally speaking, your oncologist is not your enemy. Managing expectations with patients is very tough. Even if you tell a patient that radiation is palliative and is not meant to cure a significant fraction of them will believe it is curative. Cancer patients are unwilling to understand their prognosis and "drilling it in" so that patients can make accurate treatment decisions is important.

See: https://www.astro.org/News-and-Media/News-Releases/2012/Many...

"The study investigated patient beliefs about the effectiveness of palliative RT and analyzed survey data from 384 patients over the age of 21 who were diagnosed with stage IIIB (wet) or IV lung cancer from 2003 to 2005. Patients in the study received or were scheduled to receive RT and completed a survey approximately four months after diagnosis. Results from the survey indicated that most patients believed that palliative RT could help them: 78 percent of patients believed that RT was “very” or “somewhat likely” to help them live longer, and 67 percent believed that RT was “very” or “somewhat likely” to help them with problems or symptoms resulting from their cancer. Of concern, however, 64 percent did not understand that RT was not at all likely to cure their disease."

Probably hard to judge the exact relationship between 'the oncologist' (was it just one of many? the first? they said he 'couldn't survive it', not 'treatment A is palliative only'...) and Federico, but I guess the point is that your doctor isn't your friend and they have an obligation to tell you what you need to hear.

All up, it must be pretty tough being an oncologist.

What are your thoughts on using Guanabana (specifically the acetogenins and other phytochemicals)? Do you know of any ongoing research? Results?

That's far outside my realm of research. I work mostly on competing risk survival models and bone-marrow sparing IMRT. My layman's opinion though is to be extremely skeptical of anything that purports to cure cancer. If it lacks efficacy then it's dangerous to pick over a more conventional therapy. If it does work that means its cytotoxic and needs to be evaluated for safety.

Either way you're in dangerous territory.

"To the oncologist who told me I couldn't survive: fuck you."

Goddamn I am so sick of people talking shit like this; "_They_ said I only had 3 months to live! I sure showed _them_".

What, you think they get fucking pleasure out of telling people they are going to die? They're just doing their job, and 95% of the time, they are right. You think they're rooting for cancer to beat you? Would you prefer your doctor didn't give you an honest opinion?

I think being an onocologist is the most depressing profession one could go into. I mean, you have this disease that is hugely fatal, many of your patients die, you have lots of noise on survivability, sometimes you win, often you lose. You can cause lots of anxiety with a misdiagnosis or a prediction that doesn't pan out.

I think this is true.

I have a lot of friends that have started down the route to become a consultant oncologist but changed after a few years of training.

I think having hope even if it's terrible odds is far better than knowing you will fail. IMO, working in a nursing home or a hospice is far worse as that really is all about waiting to die.

> I think having hope even if it's terrible odds is far better than knowing you will fail.

I don't think doctors get to make that call anymore.

Sometimes you win against cancer but you lose from something else. A co-worker of mine, Nick, in his 20s had Hodgkin's disease was doing well but then suddenly died of pneumonia.

The bathroom urinals will never be the same without hearing Nick say "So this is where the dicks hang out!"

Depends on the person. I'm sure many people deal with it and get personal enjoyment out of (what they perceive to be) saving lives.

Not to mention if you did your job well, the patient thanks you by saying "fuck you".

Seems unlikely he remained his oncologist.

There's a difference between "You're going to die" and "It is very unlikely you'll make it"

We have no idea what the doctor actually said vs. what the patient heard. One could imagine the doctor says "you are unlikely to make it" and the patient just hears "you are going to die."

Based on your reaction, I am guessing you have never faced a serious illness like this with tedious, painful treatments. The senseless statistically unlikely occurrence of cancer in a young person is almost guaranteed to produce overwhelming anger. It's natural to express this, especially in the face of doubts.

source: I am 30. I am days from finishing a year of radiation, surgery, and chemo for cancer.

Well, I had similar thoughts to mehwoot's opinions. Doctors generally need to set expectations low. Some might not have the best bedside manner in doing so, but I feel like it's better than overpromising and underdelivering.

source: I am 42, and I had cancer when I was 16 (very similar to Lance Armstrong's prognosis, minus the brain cancer) and again when I was 37.

I agree. I think that this sort of thing is going to produce a "me against the world" mentality, and so I understand why these reactions occur. But although I understand it, I don't think it is right to say "fuck you" to the doctor who treated you, unless there is real cause for it. Their job is already hard enough.

Thank you for relating your story, I can see why anger is common among those facing (possibly) terminal illnesses.

Not only are they most often right, but doctors know to under promise and over deliver. Which is better: "You'll never have use of that leg again" followed by a success story due to hard work and PT, or "Don't worry brah, that'll be healed in like two weeks" followed by a long slog of missed goals, unmet promises, and malpractice lawsuits? "You said I'd be walking in two weeks, and it's been two months!" Enjoy your new lawsuit!

I don't think they are right 95% of the time. Unless they just say "you are going to die because of cacncer" but if they said it to random person on the street they would be already right one time out of four.

How much can patient with treated cancer live varies greatly. Each cancer is at least few new species of life. Personal predictions are not possible, especially not before trying some treatments.

Even giving average survival is bullshit because you can't factor in all the things you know about given patient (or his cancer) into the average. Often there is very little to know about the particular cancer you have. Looking at cancer cells taken from the point of biopsy doesn't reveal much. Even sequencing DNA doesn't say much because 3 centimeter off the site of the biopsy, cancer cells can have different genome.

If you have cancer you don't know how long you are going to live. Same way as nobody does. And even if you beat cancer you'll still have more than 1 chance in 1000 of dying next year for whatever reasons like the rest of us.

Depending on the cancer type, oncologists let you off the hook after some years. As far as I know that more or less means that if you got cancer after that set period, this new cancer is considered unrelated to the first one. Don't know how much statistics are behind that, so.

And yes, I guess you have to be a very special peronality type to become an oncologist. Nothing to say of becoming a child oncologist.

Completly agree with the last sentence, only that most people consider cancer a special cause of early death that scares the hell out of them. At the same time nobody worries of comuting 30 miles one-way day to work, all around the year and don't give a shit if there's black ice half the time in winter.

Interessting how far human self deception goes.

I hope you never get cancer. You might feel just as angry. It might not be necessarily logical (but then, maybe it was), but those dying and who know it, I can imagine, feel not only fear by grief. Grief they are leaving behind their loved ones. Grief of no longer being on this earth.

I'd not be so quick to condemn.

People also should not take out their anger and grief on their doctor. While it's understandable and we should cut them slack because of their situation, doctors deserve some slack as well.

"To the oncologist who told me I couldn't survive: fuck you."

Although maybe he did you a favor by externalizing the thing you had to fight. Sometimes life is funny like that.

Quote: "I wouldn't be here without science, and without the work of people who believe in science."

I believe in the value of science.

It's interesting, often we see the whole "Give it to me straight doc, how long have I got?" and the doctor being over cautious. Whilst I'm sure many doctors can compartmentalise incredibly well, I imagine telling someone that chances of survival are very, very low has to be a gruelling experience. Is it better to know that the chances are bad, and be prepared for the worst, or to have an overly optimistic doctor who wants to avoid having The Conversation? I don't know, thankfully I've never been through it, but I'd prefer the doctor to be as realistic about my odds, and if I got through it then I'd know I fell into the 20%.

As someone with Stage IV cancer, I say "congratulations" but don't be so hard on your oncologist - I don't know your details, but every situation is different. Every cancer case responds differently. If you think your oncologist was wrong, then switch oncologists. However, maybe (s)he was right if they gave you a life-saving regimen. Enjoy the life you have, and be grateful for every day/week/month/year that you're still around.

Great story. Great writing. Thank for you sharing man. Best wishes!

Congrats. To anyone facing serious health issues: look into juicing fruit and vegetables with an emphasis on dark, leafy greens.

Also, keep an eye on the phases of the moon, and visit your local reflexologist regularly for maximum results.

Suggesting this for "anyone facing serious health issues" is exactly as helpful as recommending magnet or pyramid treatment. We have science for a reason, and it's not "here's a ridiculous generalization that I saw on a GNC commercial."

I don't understand this criticism. The comment wasn't about rejecting science. It's foolish to think that our current level of scientific knowledge is the ONLY thing worth paying any attention to.

The problem is that well intentioned suggestions like "eat dark leafy greens" tend to sew doubt in the minds of patients, and as a result you have lots of cancer sufferers on batshit insane diet regimes because "a friend-of-a-friend said this would help"[0]. When someone is staring down death and you say "hey, I bet this would help", they're going to listen very, very intently, regardless of what a rational person might make of your suggestion.

At its extreme, this mentality can be actively harmful. I know of one person who does "spiritual healing" over the phone, charging a handsome fee to pump your telephone line full of good vibes. It may sound stupid (the cynic might even assume malice on the part of the giver-of-vibes), but things aren't so black and white when the chips are down.

[0] This wouldn't be so bad if it weren't for the fact that crazy diets compromise your ability to enjoy life without delivering any discernible medical benefit. It's all well and good to adopt a fighting attitude and say "I'm going to beat it!", but that attitude may not result in an optimal payoff in the long run.

It's foolish to think that our current level of scientific knowledge is the ONLY thing worth paying any attention to.

To fight the cancer, there's not really much else. I'm a Christian and prayer is important to me. But honestly, science is the only real tool that we have to fight cancer.

Cancer patients should not be recommended juicing fruits. Cancer feeds on sugars and fructose can promote cancer growth for some types of cancer:

http://cancerres.aacrjournals.org/content/70/15/6368.abstrac...

Well done, congrats man! You're the hero.

Congrats. You are lucky. Don't resent your doctor for that prediction. Have a good life. Find peace.

I'm currently undergoing exams because I got bad blood results and I'm crossing fingers it's not cancer.

But I'd like to comment on something in TFA:

"I wouldn't be here without science, and without the work of people who believe in science."

As a whole, so far, science seems to be positive for us: longer life expectancy, less painful death, etc.

However it's not guaranteed to stay this way. Neuromarketing is also a side-effect of science. Creating food and drinks which create highly dependent people is also a result from science (directly done on rats in labs).

So for example one could reasonably say that the number of obese people in the U.S. in the state is directly linked to science: both in the way the product creating these obese people are conceived and marketed.

What if an obese people got a bypass allowing him to lose weight or a heart operation saving its life... When the very thing that created this condition in the first place was science.

Another example: the epidemiologic test to see if cellphones do cause braincancer or not are being tested right now, on nearly every single citizen. We'll only know for sure the long term health issues (if any) in ten or twenty years.

Many people could then have cancer due to science.

Sure science can help too, but what if the condition in the first place was due to science?

Hiroshima. Fukushima. Tchernobyl.

Don't get me wrong: I'm not a luddite and I'm for science. As much of it as possible. Let's open the Pandora box and see what is inside.

BUT I fully know too that a lot of our illness (including obesity) are directly linked to science too.

Cellphones? There is little scientific data to back up your fear of cellphones. Cellphones emit electromagnetic radiation that pass through our bodies like light passes through a window. It is the exact same phenomena. Visible light is nothing but electromagnetic radiation that may pass through silica (glass) and our atmosphere.

This is a silly argument. Science is the pursuit of knowledge. All of the negatives you list could be counteracted by giving those involved more knowledge.

I'd bet that scientifically literate people are less susceptible to "neuromarketing". Or, at least, if the general populace were more well-educated they could create legislation to limit the efficacy of such techniques.

The nuclear disasters you mention could all have been averted through a better understanding of risk, materials, procedures, and psychology. These are all scientific fields.

"This is a silly argument. Science is the pursuit of knowledge." But the original article said more than that, it says "I wouldn't be here without science", implying science leads to positive outcomes. The comment you're replying to simply adds that science can lead to negative outcomes as well.

"The nuclear disasters you mention could all have been averted through a better understanding of..." Not "Hiroshima. Fukushima."

And if you mean psychology could be studied more to avert the need to use weapons, psychology is not the same type of science as cancer research. We can't conduct experiments e.g. "how will the leaders of NK react, if..." in the same way we can conduct experiments on cancers.

All of the negatives you list could be counteracted by giving those involved more knowledge.

This is a naive argument. Knowledge has no sense of good or bad. It just is. And it can be used for good or bad, depending on who holds it. Whether a corporation sacrificing health of the population in pursuit of profits, a military sacrificing slaughtering innocent members of the enemy in pursuit of victory, or many other things, we have many examples in our world's history where science has been used for bad, sometimes unknowingly and carelessly (or even recklessly), and sometimes knowingly and deliberately.

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