
447 Days Ago, I Found Out I Had Cancer - dylangs1030
http://ticci.org/445-days/
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sachingulaya
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...](https://www.astro.org/News-and-Media/News-
Releases/2012/Many-incurable-lung-cancer-patients-misunderstand-the-goals-and-
limitations-of-palliative-radiation-therapy.aspx)

"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."

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

~~~
sachingulaya
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.

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mehwoot
"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?

~~~
seanmcdirmid
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.

~~~
yen223
Not to mention if you did your job well, the patient thanks you by saying
"fuck you".

~~~
chris_wot
Seems unlikely he remained his oncologist.

------
GiraffeNecktie
"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.

------
jostmey
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.

------
nicholassmith
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%.

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Tekker
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.

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

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

~~~
obviouslygreen
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."

~~~
Gobitron
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.

~~~
qxcv
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.

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

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

------
martinced
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.

~~~
enneff
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.

~~~
adrianmsmith
"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.

