
Ask HN: I Have Cancer. What Should I Do? - dammit_lump
I just left my engineering job at a medium-large employer to join an 18-person startup. I am set to start the new gig late next week.<p>I found a marble-sized lump under my armpit a few days ago.  I quickly got it checked out, and the preliminary report just came back that it&#x27;s probably cancerous.<p>What the hell should I do?<p>I&#x27;m 25, and otherwise healthy, so was not expecting this.<p>I really care about this new team and was excited to work with them.  I feel horrible about joining a young business as an albatross instead of an asset.<p>I left my old job on good terms but have no idea how they could justify re-hiring an employee who left and may not be productive &#x2F; able to work.<p>If I start at my new job I&#x27;m afraid I will endanger the business and raise everybody&#x27;s premiums.  I think they have a fairly generic group plan.<p>If I don&#x27;t start my new job, how will I support myself?<p>My fiancé also works at a small startup so if I joined her insurance the same issues would apply.<p>I think I can still purchase my old insurance through Cobra, but I don&#x27;t know how long that will last.<p>Thanks.
======
tptacek
First, that sucks, and I'm sorry.

Second: if what you're facing is lymphoma (not unlikely given what you've
said), you've probably already been told this, but: lots of good outcomes,
especially for younger patients. I've known multiple people that faced it
(more than one of them older), and all of them beat it.

Third: what you really want to know: _do nothing differently_. Retain your new
job. You're fortunate in that you have a career in which you'll be able to
remain productive during treatment.

Having an illness doesn't make you an albatross. Your condition almost
definitely won't meaningfully impact your employer's HR costs (speaking from
some experience here), and those costs are not your problem. You are not
endangering your new employer. Don't listen to anyone who suggests your are.

Stay frosty, and do not casually make decisions that will impact your
insurance coverage.

~~~
sarciszewski
I don't know if you'll ever read this comment, Thomas, but that was probably
one of the most positive examples of condensed wisdom I've ever seen you
write.

------
88e282102ae2e5b
Imagine you didn't have cancer, but I told you that if you killed yourself,
I'd give everyone at your startup an extra $200/month for a couple years (or
however long you would've worked there). That's it. That's the entire deal.

Would you take it? I imagine not, but that's essentially what you're
proposing.

Everyone will want you to survive, and anyone who begrudges you for being
human because it cost them a trivial amount of money shouldn't really factor
into your health decisions.

~~~
allworknoplay
This is a phenomenal comment.

~~~
mistermann
What it ignores though is the interesting part, if the hiring manager knows of
his illness.

I'm quite right wing, but that's why imho medical costs should be socialized.
But of course, there are many problems that come along with that.

~~~
smoyer
I'm generally conservative too but this won't happen until we have tort reform
(which won't happen so long as politics is governed by lawyers).

I heard someone say that health care is completely provided in Australia for
about 2% of your gross pay because the leeches have been removed from the
process ... is this true?

P.S. Leeches = anyone that inserts themselves into the process without adding
meaningfully to the quality of care provided.

~~~
claudenm
Malpractice litigation increases health care spending by 2.4% [0]. Many states
have already passed tort reform that limits how and when a patient can sue and
recover. There are lots of factors that increase health costs in this country,
but litigation barely registers. Getting insurance companies out of the game
(the BIG Leeches, in your example, who take 20% of the dollars in the system)
would go a much longer way.

[0][http://content.healthaffairs.org/content/29/9/1569.abstract](http://content.healthaffairs.org/content/29/9/1569.abstract)

------
calcsam
(1) Buy COBRA. Do it now. You have 60 days from when you left your old job.
Fill out the COBRA form, either your old carrier or old employer should have
sent it to the last address you had on file. If you haven't received it or
lost it, call your old HR person & ask to discuss in person.

(2) When you start at your new job, they will submit forms for you to be
covered. Those forms will take 30-45 days to process, because carriers do all
this stuff by hand. It will be retroactive to the day you start. Most doctors
are cool with waiting, but it's a risk.

(3) Some small percentage of the time, this will get goofed up by the
outsourced data entry people carriers use, or the insurance broker your
startup uses, and you won't get covered. You would find this out when you go
to the doctor's office.

(4) Because of (2) and (3), you should sign up for COBRA from your old
employer, so you can start using it now (it is retroactive to your end date at
your old job). As soon as you are confirmed to be enrolled on your new
company's plan, you can, if you want, drop the old COBRA.

(5) From the financial perspective of your employers, startups buy insurance
from carriers on the "small group" market. Rates are determined by your
employees' age, gender, smoking status, zipcode, etc, not past medical
history. In other words, you will NOT raise everyone else's premiums.

(6) I'm an engineer at Zenefits, so I hear about & deal with this stuff day-
in, day-out. If by chance your new employer uses us for health benefits (quite
likely in the startup space) please ping me (email in profile) and I will
personally make sure everything works out on your insurance enrollment. If
you're not sure, ping me and I can check.

All the best.

~~~
x0x0
(7) Thank Obama and vote for Democrats. They are the sole reason small group
health insurance isn't medically underwritten and you aren't a financial
disaster for your employer. Plus, in case anything happens with the new job,
you can always get obamacare, even mid year because of a change in job status,
with guaranteed issue, and it may well be much cheaper than cobra.

Best of luck with treatment.

ps -- my father went through this. Be pushy with your doctor if you need.
They're not exactly lazy, but your outcome is more important to you than it is
to them. They should be able to describe in detail the experience of
treatment, but they may not do so unless forced. ie what drugs, what
radiation, for how long, how will it make you feel, what are reasonable
activity levels, etc.

~~~
digitalzombie
> Plus, in case anything happens with the new job, you can always get
> obamacare, even mid year because of a change in job status,

This happened to me and I got into obamacare mid year. It was pretty awesome.

~~~
jklein11
Can you explain what you mean by "got into obamacare?"

------
JosephMama
I got diagnosed with a lymphoma (Hodgkin's) in my early thirties. Otherwise
healthy also. With your age and lumps in the armpit, it sounds like lymphoma.
Luckily, lymphoma treatment has a pretty good success rate. A few things I
would recommend.

Get a biopsy. Getting cut open sucks, but until they take a tissue sample,
they really can only guess. Get it as soon as possible.

If you decide to take 'normal' western treatments (chemo/radiation), before
you start, bank sperm or eggs, depending on your sex. I had a difficult time
beating mine, and the chemos I eventually took left me sterile.

If you are an American, get in contact with the American Cancer Society. I
can't say enough good things about this organization. They should be able to
help with financial options for you, as well as alternative therapies and
medical trials. If you qualify for some of the trials, the cost may be
reduced.

If you decide to go with chemo, it affects different people differently. I
personally had 5 different types, with effects ranging from nauseous for a
couple of days to unable to move. You may be able to work through it, you may
not. But your co-employees will generally have nothing but empathy for you.

Don't delay treatments. The success rate only goes down with time.

~~~
mistermann
> If you decide to take 'normal' western treatments (chemo/radiation), before
> you start, bank sperm or eggs, depending on your sex. I had a difficult time
> beating mine, and the chemos I eventually took left me sterile.

I'd file this under good advice OP, regardless of where your head is at right
now.

------
51Cards
I am just recovering from cancer myself so a few thoughts from having just
gone through something similar.

1\. Get all your information first. Just because it's been deemed cancerous
doesn't clarify what's ahead. It could range from intensive treatment, down to
rather localized surgery. Talk to your specialists about the specifics and
you'll know what you're in for.

2\. Cover yourself foremost. I understand the altruistic desire to not affect
those around you but you do need to take care of yourself. Ultimately that has
to be your top priority. That said don't assume you would just be a burden on
a team. Once you get all your details you may find you could still contribute
during treatment.

3\. Don't panic, that will only stress you and make things worse. We still
call cancer "The big C" but in reality the outlook varies widely and many are
completely treatable. Once you have all your information lined up you'll feel
better.

My email address is in my profile if there is any way I can help further or if
you just want to talk. All my best.

Edit: In retrospect these should be 3, 1, 2 in order of priority.

~~~
allworknoplay
These sound right to me. I had cancer my senior year of college; not the same
at all but also in a position of trying to hold all my classes together, not
let potential employers find out, etc. Four months of treatment and I was
done; I sincerely hope you're as lucky.

Whether you are or not, though, it's true don't panic and cover your ass are
critical. Fortunately we live in an era of obamacare, though, as well as regs
about covering prexisting conditions. A hitch in what the top commenter said
is that you may not in fact be able to keep your job through treatment. I had
three week rotations, where the first five days of each rotation (sat - weds)
were sitting in the hospital all day hooked up to an IV, and it's _not_ a
reasonable work environment.

Obviously gather all the information, but I'd say get ready to get the cobra
if you can't hold it down at work with whatever scheduling arrangements the
hospital can make, and if that runs out on you you'll still be able to pay for
something that will cover you.

~~~
x0x0
Almost all cancer diagnoses protect you under the ADA and you are entitled to
reasonable accommodations. What is reasonable or feasible can vary widely, but
reasonable employers should attempt to work around such diagnoses. If you were
to be fired or retaliated against, consult an employment lawyer.

------
brownbat
Note that the responses here are universally in favor of you getting covered
and getting treatment.

I have a second recommendation that comes with some unjustified stigma: seek
counseling.

Any healthy person can/will feel depression or even guilt about this
diagnosis. You might be able to manage those emotions, but they might also
sneak up on you when you're not expecting it. And these strong (and natural)
responses can help you focus your priorities, but they're not a great asset to
help you navigate all of these major decisions that impact you and your loved
ones.

Imagine you're about to take a massive exam, but just went through some major
emotional trauma (a divorce, the loss of a parent). You are given the option
of having a TA check your math as you take the exam, pointing out where you
should go over your reasoning or proofs one more time. You're smart, studied,
and maybe you'll be fine. Even so, why would you ever say no to that option?

So, look for reliable objective support, not to replace, just to supplement
your decisionmaking. (Like you're sort of doing here, and HN can be great, but
a professional will be there next week too...)

------
ot
The fact that this thread exists makes me want to move back to Europe.

It's really hard, for someone who grew up with state-provided healthcare, to
understand how dealing with an illness involves decisions about employment.

To the OP: the system is deeply unfair, and you shouldn't feel bad for
obtaining what in the rest of the civilized world is an unalienable right.

~~~
ams6110
Whose health care system has contributed most to research and development of
increasingly successful diagnostic tests and treatments for cancer?

~~~
cromulent
I don't know. Who? It's really hard to tell.

I think pharmaceutical companies _produce_ a lot of them, but I wouldn't
consider them a "health care system" as they are typically public companies,
nor would I consider their IP to be a "contribution".

The large pharma companies are often in the US and Switzerland, but much of
their revenues are not cancer related so it is hard to work out which one is
doing the most.

------
essayist
Six and a half years ago, my wife was diagnosed with cancer. I'm fairly level-
headed, and there was initially all the project management of tests and
doctors' visits and insurance company stuff and test results to deal with,
which kept the feelings of "poor her", "poor us" at bay. And then I remembered
that her son (first marriage) had successfully dealt with HIV, other friends
with cancers of various sorts, and so forth.

Now cancer is serious, and you're still going through the diagnosis and test
roller coaster (and it sucks), but there are lots of different ways that this
can come out, and I'd agree the signs, so far, are ok to good.

You're not an albatross. This is what insurance is for, precisely. And you're
not just a co-worker, you're a friend, a human being, and you'll give your
friends and colleagues a chance to express their care and concern, to help.

Live a day at a time, take the diagnosis seriously, use all the skills you
have to understand what you're dealing with, and hang in there.

And it still sucks, and I'm so sorry.

PS. After a nasty but standard protocol of chemo (including a drug called -- I
kid you not - 4FU, because 2FU just wouldn't do) and radiation, she came out
on the other side, and we've been swing dancing, and skiing, and loving, and
all that jazz, so nowadays people get lucky a lot.

------
josefdlange
This is one of those times where you are literally allowed, even encouraged,
to think of only yourself.

You have cancer. You can't avoid that. It sucks. It's one of the worst hands
to be dealt. Get treatment. Get the best damn treatment. If you don't already
do so, start taking care of your body 100%. If you do, bump it to 110%.

Cancer is not easy. It is a vicious plague that wants nothing less than to
overtake your body for its own growth. It's ugly.

But you can beat it.

Take the time and effort you need to fight this, and use what you have left
doing what you love to do, which if you're anything like me, it's the work
that you'll be starting very soon.

It'll be exhausting. When you get into chemo, and maybe into marrow
transplants and stem cell procedures, you won't often have much energy--both
physically and mentally--to contribute, so do it now.

Sorry if this is blunt, but I don't want to give off the impression that
everything is going to be fine and everything is going to be normal. Shit is
going to hit the fan.

But you can do this.

You're fucking _dammit_lump_ ; you can do this.

------
malanj
I've been on the opposite side of the fence; I was a founder of a (~20 person
at the time) startup when one of the engineers told me they had cancer.

We did everything we could to help him. He didn't want to just sit at home and
feel sick, so with a few modifications to his normal schedule/workload he
could be productive.

It didn't really have any negative impact on the company, and years later even
I definitely don't regret that he joined and don't feel that he "burdened" us
with his problem.

I would think that most startups would feel this way. So 1) don't quit 2) get
them to help you and 3) stay positive :-)

------
dammit_lump
Update: thanks for all the encouragement. Looks like this was caught early so
I am fairly optimistic about the outlook, just wish it didn't need to affect
others around me as I face it.

I should note that I haven't actually signed up for insurance at my new
employer yet, as that's typically done after the first day. And my old
employers' coverage ends on the 31st. I'm going to check out Cobra to tide me
over. Does anyone have an opinion on the prospect of sticking with Cobra and
perhaps asking my new employer to help out with the premium versus being on
their health insurance? If I did need to eventually transfer to their
insurance I think new Healthcare Laws would mean I couldn't be denied coverage
due to pre-existing condition. I'll do some digging.

And btw fiancé has been helping from the beginning and we are dealing with
this together -- she's a keeper.

~~~
tptacek
No, do not do the COBRA thing. Opt in to your employer's group coverage. COBRA
expires. You are not responsible for optimizing your employer's health
insurance premiums and will probably have far less of an impact on them than
you're worrying about.

~~~
xenadu02
Don't listen to this. Don't let yourself have any gap in coverage and if the
new plan isn't as generous with the coverage then it may pay to cover the
COBRA premiums and use your old insurance as the primary.

There will be a gap between quitting and getting the paperwork and mailing in
your premium. They will reactivate your old insurance retroactive but that's
something to be aware of.

~~~
tptacek
Don't have a coverage gap and don't use COBRA instead of your employer's group
coverage.

------
foolrush
Live.

Breathe.

Your chances of living happily for a long life are very high. In doing so, you
are a valuable person with immensely insightful lived experience.

What decision makes the most sense for someone living to 89?

Make that one.

------
ams6110
Be sure you don't let your insurance lapse. Go on COBRA if you have to until
your new policy is in force. If you let coverage lapse more than about 30 days
you are more likely be hit with a pre-existing condition exclusion.

You say fiance; if you are not actually married her plan may not cover you?
Unless they cover "domestic partners" not actually married (some will, some
won't).

Anyway, manage the insurance situation. This sort of thing (unexpected, and
potentially costly) is EXACTLY what insurance is for. Much more so than birth
control or annual checkups which are entirely predictable expenses. Don't feel
guilty about using it for what it's meant for.

Take the job, it will keep your mind busy on something besides your health.
You're not contagious; you are not endangering anyone by going to work.

~~~
x0054
First, I wish all the best of luck to the OP. It's such a scary thing to go
through, but it's something you will get through, like many others said, the
outcomes nowadays are so much better than even 10 years ago.

As for the insurance, could someone explain this to me. I thought that with
ACA (Obama Care) the pre existing condition was not enforceable anymore an you
could get a private insurance based on your age, income, etc, not medical
history. Am I wrong about that? If that's not the case, than what's the point
of all this ACA nonsense to begin with. I thought that forcing me and other
people to buy insurance was exactly so someone like the OP wouldn't be left
out in the cold when they really need the help. Am I missing something.

Also, if pre existing conditions do not matter any more, how can the insurance
company raise the premiums for the company the OP would be working for. It
doesn't make much sense to me. In any case, take care of your self first and
foremost.

~~~
ams6110
Eh yeah I forgot about that change. I would still think you would want to
avoid coverage gaps, unless the law definitely mandates retroactive coverage.
As to how the insurance companies are allowed to calculate premiums, I guess
under the new law I have no idea. I don't see how they couldn't be allowed to
consider claims experience at some level, but maybe they can't do it per
employer anymore. But at the end of the day they still have to make a profit
otherwise why bother?

~~~
zrail
> I would still think you would want to avoid coverage gaps, unless the law
> definitely mandates retroactive coverage.

You do, but not for the reason you think. If you have a coverage gap of more
than three months you'll see a fine added to your income tax at the end of the
year, which for most people on HN would be 1% of household income above the
filing threshold[1]

[1]: [http://www.irs.gov/Affordable-Care-Act/Individuals-and-
Famil...](http://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-
Individual-Shared-Responsibility-Provision-Calculating-the-Payment)

------
11thEarlOfMar
The chairman of the company I consult with has been managing a major
engineering project and last week headed off for a cruise and train vacation
in Alaska, all in between radiation treatments for colon cancer. He's 59 and
determined to beat it and not let it slow him down.

Take the job and follow the treatment regime.

You will beat it, too.

------
dandrews
Don't do anything rash. Be prudent sure, e.g. move assets around before a big
surgery. But don't retire early, don't upset your daily existence any more
than you have to.

Collect as much clinical data as you can. My oncologists encourage me to troll
the internet, and give me URLs to check out. Be data-driven. Don't sweat the
unpleasant possibilities so much, and deal with what _is_.

You may have more than one oncologist: I've got a surgeon, a radiation
oncologist, and a GI oncologist. Keep them all informed of what the other is
doing; you shouldn't count on them to touch base with each other regularly.

I went totally open-book with my friends and family and employer. Anything
they want to know, I deliver in clinical detail. Some folks don't want to know
and that's okay. I've gotten tremendous support from everybody.

Keep a positive attitude. That's key. Better for you and better for your loved
ones. Tell jokes. Co-worker: "How are you doing?" Me: "I'm glad to be at work!
You can't wipe this smile off my face. How weird is that?"

------
jgome
Well, other people have said it all... but I think I should emphasize their
words.

What were/are your symptoms?

I had Hodgkin's lymphoma some years ago, and I can tell you this: Don't panic.
Not all cancers are the same, and the earlier the discovery and treatment, the
better. I suggest to read as much as possible about your specific illness.
There are lots of resources online, and many support/help forums. Also,
seriously, don't blame yourself because it is _not_ your fault, you don't
control it. And finally: you should care about yourself first, forget money or
other people's little problems.

Keeping yourself active is the best thing you could do. You have to care a
bit, though, and try not to get sick. You probably won't be able to work for a
few days after chemo (this depends on the treatment, though), and it may
affect you in many different ways.

I don't know much about insurance and related things in the US.

Just ignore "alternative" medicine, it's just a waste of time and money.

Make sure to eat well, but also make sure that the food won't affect you.

My best wishes to you. Hope this helps.

------
bjam
I was diagnosed with cancer at 25, and underwent multiple rounds of
chemotherapy and was out of work for some months. I was working at a small
software company ~25 people. Outside of the advice that has already been
given, I was very glad everyone around me so understanding and willing to
help. When I say willing to help, I mean people can really rally together. I
took paid my vacation and short term disability, and my employer continued to
cover my insurance and hold a position open for me without ever asking when I
was coming back. They never gave up on me, and I wouldn't expect any less of
your employer. Once you have a diagnosis, the doctors and nurses can really
help point you in some good directions if you need any financial or insurance
assistance. Also, don't be afraid to ask questions. Write down questions and
answers, write down prescriptions, doctors orders, ect. Don't be afraid to
lean on those that care about you and ask if you need help (not financially,
but with tasks, errands, or just to hang out).

------
mnazim
It's difficult to imagine the shock and stress your must be carrying on you
shoulders at the moment.

\- Keep doing whatever you are doing, normally. Nothing changes in the
routine.

\- Change only things that will affect your mental and physical health
positively. Seek professional counseling and familial moral support.

\- Will to live. I cannot stress how important this one is. One of my
acquaintances, given 15 - 30 days by doctors in his early 40s, survived 25
years, married off his children, retired from government job at 58, and lived
peaceful later years. I personally think his will to live was the primary
factor.

\- Solitude has healing properties, but don't isolate yourself generally. Try
to stay in the company of people who make you happy and calm and stay away
from people who constantly keep talking about your predicament in a way that
will bring your mood down.

\- Start treatment, as soon as possible.

My prayers with you!

------
yzzy
First off, wait for final results. I know more than one person (including my
wife) that had a scare like this and it turned out to be benign. It really
doesn't have to be cancer.

Second, if you do get bad news, don't change anything. Be honest with your
employer, and go on with your life. At your age, chances are you'll be able to
continue working through the treatment and long after that. It's unlikely that
your company's premiums will go up, but that shouldn't concern you.

Third, if you do get bad news, ask the doctor for a professional to talk to.
At your age, you need some guidance and perspective from someone you trust.

------
stractract
Do not worry about your job or feel guilty for being ill. Recovering will help
your company. Find an Oncologist that has treated this specific type of cancer
100s of times if not 1000s. THIS is key to getting a good outcome. Like
engineers doctors are not interchangeable. Their level of experience makes a
hugh difference. See [https://medium.com/backchannel/should-surgeons-keep-
score-8b...](https://medium.com/backchannel/should-surgeons-keep-
score-8b3f890a7d4c) This is true for things other than surgery. Good luck

------
aetherson
You should absolutely, completely, without hesitation do what it takes to get
insurance.

I don't know if a company's insurance premiums actually rise if an employee
gets sick. Even if they do, that's not your problem.

------
rmanalan
First, use your first instinct: SURVIVAL. Do what you must to get the best
insurance you can -- if that's cobra, do that (it's more expensive than a
regular ppo/hmo plan as a regular employee, but also usually better). Also,
doesn't Obamacare now allow you to be under your parent's plan up to 26yo? If
you're getting married soon, then get on your spouses plan if it can cover
your treatments -- don't be concerned with raising premiums for the startup...
this is what insurance is for.

Figure this out pronto. This is your top priority! Have someone help you!!

My wife was diagnosed with metastatic breast cancer back in 2006. I worked for
Oracle at the time via the acquisition of PeopleSoft. I never wanted to stay
at Oracle, but I ended up staying for 6+ years just so I can stay on Oracle's
United Healthcare PPO which was the best. It covered almost everything
including getting multiple opinions to crazy expensive clinical trials. I
finally left Oracle in 2011 and moved over to Atlassian only once I knew for
sure that switching insurance plans would not affect my wife's care, but even
then, I still bought Cobra for the first month into my new job just in case.

I know it sounds unheard of for many people here on HN to stay at a job you
don't like just so you can keep you and your loved ones healthy and alive, but
when it comes down to it, surviving is top priority.

------
Muted
Well I can't help you on what's financially the best choice (I'm not in the
US). But I might be able to give some suggestions on how to live based on my
experience.

First off, don't care about other people. There is no reason to think about
what effect it might have on your employer, or who gets screwed when you make
certain decisions. If you end up dieing because your treatment sucks, you
won't need to feel sorry. You really need to be selfish, the stakes are too
high not to be.

That aside, what you said sounds very similar to what I had. When I was 15 I
also discovered lump under my armpit, ended up being Hodgkin lymphoma. If that
is what you end up having, you should be extremely thankful. First of all
because if you need to get a cancer, that is the one you want (at least that's
what they told me). But also, in this endeavor, you are probably the lucky
one. At least in my case, the worst part was seeing what it did to my mother
and brother. I knew exactly how good/bad I felt but they could only guess at
it.

As to what to do, well this varies significantly from person to person. Some
people I met in the hospital wanted to learn everything about the disease, why
it occurred, what they could have done to prevent it, how they could of
discovered it sooner, ... Other people socialized a lot in the hospital and
talked to each other about chemo side affects, ... For me this all seemed like
a waste of time since in 8 months or so I would be a "normal" person again. I
tried to keep my life as close to normal as I could. I got to the hospital and
left as fast as I could, continued to go to as many classes as possible, kept
doing the same hobbies, meeting friends, ... So I would suggest, just do
whatever makes you happy =).

Anyway, hope this is somewhat useful. Good luck!

------
joeyspn
I've also been to the doctor earlier this week for the same reason, a lump
appeared in my axilla but fortunately the diagnosis was an odd tear in the top
of the latissimus dorsi muscle. A family member (nurse) indicated me that it
could be dangerous (a swollen lymph) so I needed to be checked ASAP.

I'm extremely sorry to hear that you haven't had the same luck dammit_lump.
But I'm sure you're going to get out of this situation stronger and with a
renewed illusion for life. I'm sorry I can't help you with your questions cos
I'm european and I don't know much about your healthcare system there.

Things like this makes me wonder why we (engineers) are not building or taking
more jobs at eHealth startups to help defeat these diseases.

During this week StackOverflow has been showing me this ad [0]. A company
trying to disrupt cancer research unifying under the same platform all the
cancer research centers worldwide and (apparently) plugin in bigdata analysis.
I've been lurking their site and the founder is a MD who also studied CompSci
on the side (online) while doing cancer research! I have enormous respect for
this people.

I'd encourage anyone who knows Java/BigData seeking a remote position to check
them out [1]. I'm sure in the coming years Cancer will be controlled the same
way AIDS has been turned into a chronic disease and is starting to be
completely wiped out from patients. But first we need to help doctors to build
tools and better understand the disease.

I wish you the best dammit_lump! stay strong

[0] [http://i.imgur.com/F1IxsCf.png](http://i.imgur.com/F1IxsCf.png)

[1] [http://www.medbravo.org/](http://www.medbravo.org/)

------
yareally
My brother has survived having B Cell Non-Hodgkin's Lymphoma twice throughout
his mid teens and early 20s. The kind he had was pretty rare/aggressive as
well. He's going on 30 this year and has been clean since. The diagnosis
probably hit you and your family like a ton of bricks, but your chances of
getting through it are likely good and I know treatments have improved quite a
bit in the past 10 years.

If you do happen to have one of the aggressive forms, start treatment ASAP
after having proper consultation. I know my brother started the day after he
was diagnosed, but his was aggressive and already advanced. If yours is not,
it may not need to be so rushed, but I'm not a doctor, so don't take anything
I say as proper medical advice please.

If there's anything I can answer about the experience my family went through
with my brother, just drop me an email (can be found at my github account
linked in my hn profile).

------
bane
Sorry you've gotten cancer. Cancer sucks.

Get it treated aggressively using science and medicine. A great many cancers
can have good outcomes. Worry about yourself first and foremost.

But start the job. You may be surprised at how little time good treatment will
take. If your employer is set up correctly, you'll have good insurance, good
vacation policy you can use and long-term disability in case you need to be
away for an extended period while you take care of yourself -- don't worry
about their premiums or any of that other stuff tptacek has it right, it won't
be a huge problem for them.

Also, being sick sucks, having some place to go where you are needed and
having things to take your mind off of being sick can help. But remember, and
this is hard to do with startups, put yourself and your health first, then the
company second. Nobody can reasonably blame you for that.

Now go kick cancer in the ass!

------
drchiu
Really sorry to hear that this is happening to you.

First of all, it's good you found it now rather than, say, months from now.

Second and most importantly, focus on taking care of your health first. I once
knew someone who had something similar to what you're experiencing. It was
lymphoma and he was just about to begin what was a very competitive program.

He was fortunate enough to be able to defer it.

Your health comes first, no matter what. So look hard at all your options (eg.
parents, friends, etc) before killing yourself to deliver on someone else's
bottom line.

Life's way too short.

In terms of insurance coverage, the only thing that matters is make sure you
have coverage. Don't go cancelling or changing coverage at this point --
especially to the benefit of the employer. Now that you have a known/likely
diagnosis, no insurance will want to touch you.

------
ldd
If I were in your position I would:

1) Calm down.

2) Gather information. More specifically, if you know a doctor, contact said
doctor. If you can't, find a way to meet with a physician as soon as possible
and get a second opinion. Get someone to explain to you what this diagnosis
means. Explore fully your plan, Cobra, etc.

3) Tell fiancee, family, etc (not in an alarming way). Or not. That is, decide
whether you want those closest to you to know. This is very personal and we
can't choose for you.

4) Save money

Above all don't panic. The most important step is getting informed on what is
happening and what your alternatives are and what options you have.

Perhaps right now you don't see this, but like others have said, you can beat
this. Now is the time to act swiftly and gather information. Don't waste time.
See a doctor ASAP.

------
caseysoftware
I'm sorry to hear that. As others have noted, find out all the details asap
before you start making decisions.

On the COBRA side of things, you have 60 days at minimum:
[http://www.dol.gov/ebsa/faqs/faq-consumer-
cobra.html](http://www.dol.gov/ebsa/faqs/faq-consumer-cobra.html) and it must
last at least 18 months and can go as long as 36 depending on how they have it
set up.

Also, I hope you have people around you to get support and talk with. I've
never dealt with cancer personally but I have to belief your mind is racing
and you're flooded with some mix of panic, fear, and more panic than I can
imagine. This is not the time to keep close friends and family in the dark.

------
BorisMelnik
Just came here to say very sorry to hear this news, that really sucks. I will
pray for you tonight. There have been a few cancer threads on here in the
past, hopefully some people who overcame it can chime in with some infinite
wisdom (srsly no pun intended)

------
moron4hire
>> I feel horrible about joining a young business as an albatross instead of
an asset.

Stop that. Did you get cancer on purpose? Then don't act like you foisted it
on them on purpose. Don't worry about the company, worry about yourself.

------
codingdave
I've been practically bedridden for 9 months with medical problems. I've also
been producing code that entire time.

Everyone is right that you should not freak out until you get all the info
from the doctors.

But lets assume you are going to be sick for a while. Once you get into that
phase, figure out 2 things:

1) When can you be focused and productive? Work at those times.

2) How can you take care of yourself, stay sane, have fun, and not let a
disease ruin your emotional stability. This is just as important,if not more
so, than the work.

One last thing - this is your life we are talking about. Startups are just
jobs. Keep your priorities straight as you make decisions.

------
PuffinBlue
Could you clarify that you have had this biopsied? It doesn't sound like you
have, particularly on the current timescale you intimated.

That is the only way to know for sure if it's cancerous (I've got first hand
experience).

I'm not saying don't worry about it, but 'probably cancerous' doesn't sound
like a biopsy report and that is needed first as that's the only way to tell.

Keep a cool head, take the precautions the others are recommending here
regarding your medical cover (God bless the USA) and get some confirmation of
what the lump is before you move on.

------
redpola
Don't be so noble. This is a good time to be selfish. Once you've recovered
you can pay back the world.

------
stractract
Do not worry about your job or feel guilty for being ill. Recovering will help
your company. Find an Oncologist that has treated this specific type of cancer
100s of times if not 1000s. THIS is key to getting a good outcome. Like
engineers doctors are not interchangeable. Their level of experience makes a
hughe difference. See [https://medium.com/backchannel/should-surgeons-keep-
score-8b...](https://medium.com/backchannel/should-surgeons-keep-
score-8b3f890a7d4c)

------
Sanddancer
Go on, live life, take the new job, get a biopsy, and if needed, kick cancer's
ass. A lot of the crappy things insurance companies would do in the past
regarding pre-existing conditions and cancer are now illegal. Your new co-
workers should understand that this came out of the blue, and that you'll be
doing what you can to work hard, and to beat cancer. You've caught it soon, so
there is a good chance that you'll be able to pull through without any
problems. Good luck.

------
hmmmmm1
If you were my sibling, I would probably entertain a discussion similar to the
following:

0) I am sorry

1) if you think about cancer like most people, then you are looking death in
the face ... Do so. Let it focus you on what is truly important.
[http://paulgraham.com/todo.html](http://paulgraham.com/todo.html)

2) define the problem to the greatest degree of specificity possible - this
likely means biopsy and pathological analysis and discussion of further workup
at an academic medical center or somewhere that genomic sequencing would be
possible, if indicated

3) as stated elsewhere - start indicated treatment as soon as you have an
answer for #2

4) if cancer is the answer, then two things (depending on the type) the
outcomes may be better than you think, however, find a second oncologist - the
running joke is that oncologists keep giving chemo after their patients are
dead - find another experienced voice (not neccessarily an expert in YOUR
cancer type) who seems comfortable with hospice as a possibility -- not all
are -- a life well lived and fighting tooth and nail to the bitter end are not
neccessarily the same thing.

5) get all of the insurance you can asap - don't worthy about the premiums

------
arca_vorago
Dont pull a Jobs and go all homeopathic, and follow your doctors advice....
But smoke, eat and otherwise imbibe a shitton of cannabanoids (eg marijuana).
Including drinking the juice of the plant (non-psycoqctive). There is.a large
lack of scientific studies on cannabanoids due to its schedule 1 status, but
the majority of the stuff that is used in government approved programs is
actually extracted and then sprayed onto plant matter (eg its not the real
deal, some of the 400+ cannabanoid compounds are missing), so be wary of
stufies using the missisipi university stuff. (Im a combat vet with ptsd so it
helps me in a different way)

Then i would make sure your legal stuff is taken care of, just in case, such
as power of attorney and your will. The last time I went to Iraq i included my
will and video messages yo my family and friends in a safe deposit box only
accesible to my executor.

Then I would start getting all philosophical and reading while doing chemo and
hope for the best, and live life a day at a time.

Much love to you through this tough time (talk about understatement eh?)

------
unicell
I had stage 2 Hodgkin's lymphoma when I was 25, did chemo for 4 months (ABVD)
and radiotherapy afterward. Healthy ever since (I'm 30 now).

One problem you might be having is dealing with an avalanche of advices, so
I'll keep mine short.

Mainstream treatments (chemo+radio) are very effective against lymphoma. From
my research the 5yr survival rate is over 80 if not in the 90s, and that's not
even the latest stats. I wouldn't replace chemo with other alternative
treatment, despite the damage chemo could potentially bring. I did take herbal
medicine during treatment, but that's just to alleviate the side effects of
chemo, not replacing it.

Everyone is different, but base on my personal experience and people who have
gone through similar situations, you should still be able to work and live
normally, except on the days you have chemo and possibly a day of two
afterward.

------
sirspazzolot
Others in this thread have first-hand experience with cancer and have offered
better advice than I could try to, and I don't have anything else substantial
to contribute. I just want to wish you good luck with your new job if you
proceed there, and many years of happiness with your soon-to-be wife!

------
KajMagnus
Best wishes with getting well and surviving.

Think about your parents and your fiancé. Those who are close to you, matters
more than [a relatively small amount of money to your future colleagues. Or a
large amount.]. How would your parents and fiancé feel if you quit your job
and risked your life (by getting less access to good health care?) in order to
in effect give money to a company?

You are more important than the company. And your future colleagues, will
agree with this, I think. Companies are built to make people happy. Not the
other way around.

(I think I a little bit can feel how you feel about joining the company and
then later on they will know that you have this illness. And I think that they
will think you did the right thing, when you joined. Assuming you don't over
work yourself, but take time to rest when you feel you need to.)

------
DaemonKrog
First: Go get a second opinion on that lump. It's possible that it's a benign
cyst caused by your pores not being able to do their job by being clogged with
anti-persperants. If it's a cyst and you switch to deodorant only, it could go
away on it's own. I've had this happen before, and it is exactly as you
describe. Regardless of what deodorant you use though.. go get a second
opinion.

Second: Don't be scared if it is cancerous. If it is, it seems you've found it
at such an early stage that a small surgery and some follow ups will ensure
you're fine. If you're worried about the insurance affecting the rest of the
startup, get insurance on your own (you don't actually have to purchase
insurance through work).

------
mpermar
I can't really help you with the legal issues as I'm not from the US, but, as
others have mentioned bear in mind these days many cancerous lumps can be
removed with non-that-intrusive local surgery. So, be positive! If that's the
case then the positive is that you've found about it while you're very young
and doesn't have expanded!

Moreover, if that's the case and there is a good outcome, then you've been
blessed with something that many others like me discover on their late
thirties, fourties or fifties. To appreciate life and enjoy every minute of
it.

Good luck.

------
rdl
The only change I'd make is to ensure you prioritize your overall health more
than you might otherwise, while working at your new job. If that means working
efficiently 40-45 hours/week vs. being less-efficient for 50-60 hours/week,
shouldn't be a big deal.

I don't think an 18 employee company is self insuring the risk, so it will be
a very small impact.

I _would_ probably not do a founding role at a startup while dealing with
cancer or other serious medical or family issue, but an 18 person employer
isn't a big deal.

------
klunger
The existing top comments (tptacek and calcsam) have already covered the
useful practical advice for your situation.

So, I just wanted to say that I really feel for you. Cancer sucks. A stranger
across the ocean is tearing up just reading about your situation and wish I
could help in some way. So, I am sure there are a lot of real friends and
family in your life who care about you and will help you get through this.
Don't be afraid to ask them for help when you need it. You aren't alone.

------
l8rlump
Hey. I'm sorry you've had your world turned upside down in this way. I'll add
my prayers to those already mentioned. There seems to be a lot of good advice
here about temporal matters. As someone who is going through a similar
journey, my advice is, please consider eternal things. If you're interested in
a Christian perspective, check out
[http://digitaltrousers.wordpress.com](http://digitaltrousers.wordpress.com)

------
FrankenPC
IF this turns out to be malignant and requires chemo, avoid stress if at all
possible. Also consider going on a high food value diet (tons of veggies) with
natural high fiber powders. Exercise.

I'm not saying any of this will help with cancer. Diet and exercise combined
with a low stress lifestyle will maximize your bodies ability to recover from
the chemo. Also this will help your brain keep optimized so depression won't
bring you down which will cause stress.

------
bluepill
Hi

That's rough and I'm sorry you have to face it.

1 - Try to think positive, I know it sounds hard but it actually helps a lot.

2 - Keep working as much as you can, it will help you not to think about the
negative stuff

3 - If your employer doesn't understand the problem then the job's not worth
it.

------
realrocker
Join back the medium-large engineering job if you could. Cancer treatments are
getting better everyday. But priority one is buying yourself as much head room
as possible both in terms of money and time.

------
smileprem
Try becoming a raw vegan. Inform your employer and join the company you want
to work.

chrisbeatcancer.com/how-a-high-fruit-diet-can-reverse-cancer-the-science-
behind-the-nori-protocol/

------
gadders
I think it's analagous to taking a new job and finding you were pregnant.
Would you resign in those circumstances?

//edit// And all the best for the future.

------
ndrane128
The affordable care act should protect you and your company from rate
increases due to preexisting conditions. This practice is now illegal.

------
scarmig
A question:

Should the OP tell his new employer right now? Or hold off until down the
line?

OP: As far as your lump, dammit indeed. Good luck and beat that thing!

~~~
fleitz
Your medical problems are not your employers business. Period the end.

------
serf
Sorry for your situation, I have very little advice for you.

What signs/symptoms prompted you to seek further help?

------
titusblair
You may want to look into HyperBaric Oxygen Therapy (HBOT), it is what I would
do if I had cancer.

------
viame
Don't stress. You said 'probably' but are not 100% sure, stress alone can
cause cancer.

Mediate.

------
catshirt
your future colleagues are literally the last thing you need to focus your
energy on. don't worry about them. worry about yourself.

------
dome82
I wish you to get well soon. Stay strong.

------
baumbart
Hi, I am gladful that I stumbled across this question. I am not going to tell
you a sorry.

The essence of my answer first: You _can_ heal yourself. The body follows the
mind. First there is reality in your head, and then in the physical world.

Second, read the book by Dr. Joe Dispenza, called "You are the placebo". If
you have a bit of patience, read the two earlier books mentioned there
("Evolve your brain" and "Breaking the habit of being yourself").

I have read a lot of books, covering spiritualist topics, healing, taoism,
traditional chinese medicine, ritualist magic and psychology as an overall
topic. The essence is, that what we call the rules of physics and medicine
today are short-sighted and often plain damaging. One example for this is the
belief that you can't change certain things.

Denying your own possibilities when they exist is a self-fulfilling prophecy,
you cannot disprove it if you don't _really_ believe in it. Doctors telling
you that you have a serious illness (or just in the risk of becoming ill) are
doing serious damage to you if you believe them, because your mind is making
it real.

Illnesses are an expression of something going wrong, which means you have to
fix it by changing how you live, what you do, and essentially, who you are. I
have had some minor illnesses such as cavities and hay fever, both of which I
fixed using meditation and visualization.

The books I mentioned show a practical way for us people today who essentially
believe science to be "true". It builds upon that belief, and I can really
recommend it if you don't have time wrapping your mind around ancient chinese
belief systems.

The reason I was not going to tell you a sorry is that I don't feel sorry for
you, I feel hope and I feel gratitude - there is a reality (which implies it
is _real_ and exists right now) in which you are 100% healthy, and giving your
experiences of _becoming healthy_ out to the rest of the world. It is
possible, and it is your choice. I am not wishing you luck, because luck is
not what you'll need. I wish you will be able to grow yourself from being a
victim, to having your live in your own hands. I wish you'll be able to take
action, and make decisions, and for the entire time, enjoy your process
wherever it leads you.

One last word, you will be free of injuries or problems if you _find_ yourself
being free of them, it is the moment when it makes "click" in your brain, and
that is the moment when reality changes. For me it was the moment when I
discovered that I had _no_ cavities, and that they _are_ healing, and that my
doctor was wrong. And in the same moment, my doctor _became_ wrong because
reality had changed. That is how it works.

------
andrewdubinsky
I just finished treatment for tonsil cancer in November. Don't be afraid.
You're not alone. There's more support for you than you realize and you're
stronger than you can imagine. Everyone you've met has been touched by cancer
somehow. Everyone.

I was afraid, but not alone. Family and friends showed up strong in every way.
You'll find that people are really caring and compassionate if you let them
be. Ask for help.

Your employer wants you to get better and they want to help you. I'm a
freelancer with hourly clients so it was especially hard on my finances. I
turned to credit cards, savings, and family to help out. Ultimately, I tried
to handle as much as I could, as long as I could. Depending on the type of
treatment, you can still work. My clients understood and stuck with me when I
had to take a break.

I did work up until the really bad parts of treatment. Throat cancer is a very
hard course of treatment as you have radiation daily plus weekly chemo. I was
very nauseous and tired, but mentally I was ok for a good while. There are
pain meds you can take that don't mess with your head very much. Take them if
they prescribe them.

Get the best coverage you can. Fight your insurance company if you have to.
Don't back down. The last thing they want is a cancer patient getting denied
care. I had to fight the insurance company for all the tests up to and
including the needle biopsy. After they found it was cancer, the insurance
company rolled over and paid for everything without argument. I hit my out of
pocket maximum within the first round of treatment.

The other patients you will meet can be a great resource. If you go through
chemo, it will most likely be a big room with lots of chairs so you can talk
to the other patients. Ask about tips and tricks. There's lots of good info on
how to combat the side effects.

Confirm any supplements/vitamins with your doctor as some chemicals can hinder
the chemo meds. Buy Ensure Plus. It's hard to feel like eating & that's a good
way to get calories. Make sure you get enough calories. You need energy to
fight.

Don't believe people that tell you X cures cancer. They don't fucking have
cancer. Go with what the medical community can validate with science. All
those treatments have all been debunked thoroughly and there is no conspiracy
against vitamin C. Doctors want you to get better. Survival rates have doubled
in the last 10 years.

Chemo is not worse than cancer. That's ancient history. Nowadays the anti-
nausea/pain/steroid meds are amazing. It's not like the old days where you
vomit constantly for a year. I'm not saying it's easy, but it's better than it
was even 5 years ago.

Take it serious. Don't give in to fear or negativity. Ask your Doctor to shoot
straight and not sugar coat the facts. Don't think about the future. Stay in
today. Don't lay in bed all day. If all you can do get is up just sit outside.
Let your friends/family see you sick. You don't need to be alone.

Choose life. I mean it. Make that choice every day.

It's hard to explain, but you'll face a choice at some point during this path.
Choose life.

------
redtuesday
I hope this is readable, my english is quite rusty since I don't have to write
much.

Get a biopsie (if that didn't happen already, not sure from reading) with
preferrably multiple samples. I don't know if you have that where you live,
but where I live one sample is examined in the hospital and one to three
samples are examined by external reference laboratories. The people in the
hospital are good, but the people in the reference laboratories (my oncologist
called them cancer nerds) are better since they often specialize on specific
cancer groups and do noting else but examine cancer samples.

This way you get the best result, and if it turns out to be really cancer you
can get the best treatment (definetly get a second opinion). If it turns out
to be Lymphoma (non hodgkin to be precise, but hodgkin would be more likely)
get your vitamin d levels checked if your doc doesn't check them on his own.

In case you get chemo newest studies show that vitamin d could be helpful [1].
Last year when I got my treatment the study was not finished but I asked my
oncologist about it anyway. We checked and found out that I had only 4.4 µg/l
of vitamin d3. It should be >30 µg/l, but if you live in northern areas it's
likely to be between 20-30 µg/l if you're healty. Two years before my cancer
was discovered I had my last vitamin d check and then it was >30 µg/l.

Also ask your oncologist about the rituximab level you will receive, newest
studies show that young men and woman need a higher dosis than whats standard
[2][3][4][5]

Speak to your doc about optimal 60. Some study results were presented at the
international ash congress. It uses a liposomal formulation of vincristin and
doubles the dosis. First results are realy promising and show even better
results than 1.5 times the normal dosis.

Should you be a young high risk patient (young matches definetly) like me ask
your doc about R-CHOEP 14. Studies show better results in young patients than
the standard which in most countrys is R-CHOP 14 or 21.[6][7][8]

Depending on the chemo and other variables it could be that you should avoid
some kinds of food. In that case remember the following sentence: "cook it,
boil it, peel it or forget it".

Go for a walk/be active every day if you can, a good cardiovascular system
distributes the drugs better and you preserve your muscles.

Avoid sick people and don't be near young kids if your chemo destroys
leucocytes which is typical for Lymphoma treatment. In the earlier cycles your
immunsystem should be able to handle it, but in later cycles sick people or
young kids (they are ill often and depending on the chemo you can get
sicknesses again that only kids get) are dangerous. My leucocytes dropped
below 0.5 every chemo cylcle even though I had to take G-CSF to push my
leucocytes. But discuss everything with your doctor.

Also, think about a port catheter. It has it's own risks but also benefits (it
spares your veins) and makes the cancer treatment easier.

It's very likely that you are steril after chemo so bank sperm/eggs depending
on your gender.

I'm the same age as you and was diagnosed with non-hodgkin lymphoma stage 4
(with multiple bulk tumors > 10cm and bone marrow involvement) last year after
relly bad backpain for a few months. Which I thought came from my chair at
work or my mattress since I was in good shape physically and my diet was
balanced. But when I got checked for a herniated disk with an MRT they found
the unwanted lodgers. After more checkups in the hospital they found them in
my pelvis, spinal column, rib, muscles, spleen and lung but luckily not my
brain or cerebrospinal fluid.

After getting 8 cycles of R-CHOEP 14 and 2 additional cycles with only
Rituximab directly after that I am in complete remission. The PET-CT after my
chemo showed that and now 3 months later my first aftercare CT shows that as
well.

I wish you luck, and if it really turns out to be cancer, don't panic. Stay
calm, think about your next steps (but I probably don't have to tell you that,
since you showed that by asking here on ycombinator instead of putting your
head in the sand like some people do) and do your research ,especially about
newest studies, if you know your cancer type. My oncologist was very
knowledgeable (lymphona is her speciality and she reasearches and publishes
about it herself since 20 or so years) about newest studies but liked it that
I informed myself and even found infos she did not read yet (no wonder, she
gives around 500 chemos each year, teaches at university etc.). With this she
could alter my chemo before my first treatment.

[1] Bittenbring J, Neumann F, Altmann B et al. Vitamin D deficiency impairs
rituximab-mediated cellular cytotoxicity and outcome of DLBCL patients treated
with, but not without rituximab . J Clin Oncol 2014

[2] Murawski N, Pfreundschuh M, Zeynalova S et al. Optimization of rituximab
for the treatment of DLBCL (I): dose-dense rituximab in the DENSE-R-CHOP-14
trial of the DSHNHL. Ann Oncol 2014

[3] Pfreundschuh M, Poeschel V, Zeynalova S et al. Optimization of rituximab
for the treatment of DLBCL (II): Extendet rituximab exposure time in the
SMARTE-R-CHOP-14 trial of the DSHNHL. J Clin Oncol 2014

[4] Pfreundschuh M, Poeschel V, Zeynalova S et al. Increased rituximab doses
eliminate increased risk of elderly male patients with aggressive CD20+ B-cell
lymphomas: Results from the SEXIE-R-CHOP-14 trial of the DSHNHL. J Clin Oncol
32[6], 2014

[5] Pfreundschuh M, Schubert J, Ziepert M et al. Six versus eight cycles of
bi-weekly CHOP-14 with or without rituximab in elderly patients with
aggressive CD20+ B-cell lymphomas: a randomised controlled trial (RICOVER-60).
Lancet Oncol 2008;9:105-16.

[6]
[http://www.ncbi.nlm.nih.gov/pubmed/21460380](http://www.ncbi.nlm.nih.gov/pubmed/21460380)
[7]
[http://www.ncbi.nlm.nih.gov/pubmed/23168367](http://www.ncbi.nlm.nih.gov/pubmed/23168367)
[8] [http://i.imgur.com/bq5ZZsr.png](http://i.imgur.com/bq5ZZsr.png)

------
Blueliner
Sorry to hear about your diagnosis. There is a lot of good advice from other
posters and I would like to offer you my suggestions having performed the role
of patient advocate for all the members of my immediate family who all were
diagnosed and treated with various forms of cancer (5 out of 6 family members,
everyone except me). I have built an extensive library of info, articles,
resources, etc. through the process of caring for my family members which I
would be happy to share with you and could offer more help if we could speak
so if you want to do that please provide me a way to contact you.

1) Get a definitive diagnosis & treatment recommendations from the best doctor
you can find (I know a number of internists, oncologists, oncology
radiologists, cancer surgeons, etc. that I could possibly recommend depending
on where you are located).

2) Get a second opinion to confirm the diagnosis is accurate and also a second
opinion on treatment recommendations.

3) Much of what to do next will depend on #1 & 2 above but there are a number
of things you can do immediately to greatly improve your chances of fully
beating your illness including:

-try and switch to a vegan diet and eat plant based foods. All cancers are fueled by animal foods and there is proven evidence vegans get fewer cancers and do better with cancer treatments than non-vegans. There are a number of foods that are especially good at preventing and fighting cancer including allium foods (e.g. garlic), cruciferous vegetables (e.g. broccoli, brussels sprouts, etc.), spices such as turmeric, ginger, etc., green tea, nuts & seeds, and others on the list of top cancer fighting foods.

-significantly reduce and/or eliminate as much sugar as you can from your diet, especially high fructose corn syrup and other highly processed forms of sugar. Sugar fuels cancer growth and to limit its growth and possible spread, cutting out sugar will really help.

-try and get as much cardiovascular exercise as you can ideally at least 30-40 minutes at least 5-6 times per week. Highly oxygenated blood which results from exercise inhibits cancer cell proliferation plus it will make you stronger and give you more energy especially before/after treatments.

-try and get as much sleep as you can. Proper rest is critical to help your body rejuvenate your normal cells and boost your immune system to fight the cancer. Maximizing your immune system is one of the most important things you can do to fight and beat the disease.

I don't have the space to include more but I can offer you advice &
suggestions if we can speak. One thing to know is that there are many new
promising approaches to treating cancer that are proving to be highly
successful including immunotherapy and others. You are young and if you caught
it early your chances of a successful treatment and full remission and a long
cancer free life are very good.

Best of luck to you.

------
michaelochurch
I'm sorry to hear this. Cancer is awful. Best wishes.

 _I feel horrible about joining a young business as an albatross instead of an
asset._

Don't. It's not your fault. You don't even know that you're going to have any
effect on their premiums and even if that happens, it's going to be a small
effect in comparison to everything else that startups have to deal with.

 _If I start at my new job I 'm afraid I will endanger the business and raise
everybody's premiums._

Don't worry about that. You shouldn't feel guilty about anything... unless
you're a health insurance lobbyist or executive or a legislator who fought
healthcare reform, which you're obviously not.

Just focus on getting well and giving the people around you, your job, and
most importantly, yourself, your best. Seriously, fuck everything else. This
is your life.

Besides, an 18-person company that can't survive one employee getting cancer
(and I suspect that it can) is a company that doesn't deserve to stay in
business.

So: take the job, get covered, and work when you can.

 _I left my old job on good terms but have no idea how they could justify re-
hiring an employee who left and may not be productive / able to work._

You'll be able to work, although not at 100%. It's not like life stops when
you undergo chemo or radiation. Yes, those therapies are brutal (my mother had
cancer, twice) and you'll probably need to take a few days off for each one,
but you can still be productive some of the time.

Let's say that you need 6 cycles of chemotherapy (over 18 weeks) and that each
involves three days during which you can't work. (There's a lot of variation.
Some people drive themselves to chemo. Some people need a week to recover.
Three days seems to be average, from what I've heard.) That's only 18 sick
days. It's nowhere close to a deal breaker.

Focus on getting well. Don't feel guilty because you didn't do anything wrong.

------
fleitz
Do everything you can to stay alive. Make sure you keep your coverage. Get
cobra coverage until your new plan takes affect.

Take your new job and work until your dr advises otherwise.

Being alive > personal finances > startup finances

Contemplate the differences between time and money, time has a fixed and
unknowable amount which is constantly ticking away, money is virtually
infinite and you can always get more of it, and you can live on very little of
it.

Paul Allen didn't kill MSFT and when your read his story MSFT sounds like the
morally bankrupt entity and not Paul Allen.

------
mknits
Apart from some great advice here, do watch "Cancer: The Forbidden Cures"
documentary.

------
skazka16
Eat B17.

------
pcunite
Find a UPCI church and ask the Pastor to pray for you. Yes, God can heal. It
happened to me (abdominal wall tear).

------
azea
Stop sugar. Cancer feeds on sugar. Stop sugar for win the fight man. Good
luck.

~~~
13years
There is research indicating this.
[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3871217/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3871217/)

However, it would be foolish to just stop sugar without seeing a doctor and
assume all is going to be well.

------
dandelion_lover
Even if this is a small hope, I would suggest to take a look at these papers:

Fruit, vegetables, and cancer prevention: A review of the epidemiological
evidence

[http://www.tandfonline.com/doi/abs/10.1080/01635589209514201](http://www.tandfonline.com/doi/abs/10.1080/01635589209514201)

Vegetables, Fruit, and Cancer Prevention

[http://www.andjrnl.org/article/S0002-8223%2896%2900273-8/abs...](http://www.andjrnl.org/article/S0002-8223%2896%2900273-8/abstract)

As far as I understood, this is already almost established that increased
consumption of fruits and vegetables helps somehow.

------
websurfshop
[http://www.healthrestorationranch.com](http://www.healthrestorationranch.com)

Mike has helped 100,s with same problem.

~~~
ikt
“Disease is natures’s effort to free the system from conditions that result
from a violation of the laws of health."

He should follow that up with: "I am basing this on absolutely nothing"

~~~
pluma
Alternative medicine.

"You know what alternative medicine is called when it's proven to work?
Medicine."

------
sree2
I am sorry to hear, This is my 2 cents from a person who has seen atleast 5 of
my family members fight cancer. First thing the only thing that kills cancer
cells is Oxygen its the live giver, take in loads of oxygen, food that gives
the maximum oxygen is Wheat grass juice ( you can get a shot at jamba juice)
take it daily you will see phenomenal difference, remember Neil Armstrong has
lung capacity twice that of normal people and he is completely cured of cancer
naturally . Try pranayam its the best way to take maximum oxygen and increase
your lung capacity and most important be positive !!!

~~~
ranman
wat?

------
pasbesoin
The People's Pharmacy is a public radio show produced in the U.S. Over the
years and with occasional listening, I've found it very informative and
useful.

The other day or week, I heard part of this episode while doing other things.
I haven't listened to the whole thing, yet. I do recall hearing about patients
who pursued e.g. nutritional reinforcement and who self-advocated, sometimes
having to go through several doctors to find the one they could work with.

I hate to be one of those "try this" people. But based on the overall quality
of the show, I'd feel remiss not to mention this episode.

Wishing you the best.

[http://www.peoplespharmacy.com/2015/05/21/955-surviving-
canc...](http://www.peoplespharmacy.com/2015/05/21/955-surviving-cancer-
against-all-odds/)

[http://www.peoplespharmacy.com/feed/podcast/](http://www.peoplespharmacy.com/feed/podcast/)

[http://traffic.libsyn.com/peoplespharmacy/PP-955SurvivingCan...](http://traffic.libsyn.com/peoplespharmacy/PP-955SurvivingCancer.mp3)

------
kika
Cancer is basically a problem of the immune system. We have a lot of cancer
cells in our bodies and our bodies manage to kill them quite efficiently.
Something went wrong in your body and a cell or two survived. I'm in no way a
doctor (I have experience with cancer, but as a, hm, 'user', or better,
observer) but IMHO the thrill of working in the startup and doing stuff that
you really like can substantially help your immune system to fight the hostile
lifeform in your body. "Positive" hormones stimulate the immune system. On the
other side, having not enough sleep, eating shit, having a lot of excess
weight (having a little is considered good) would actually harm your immune
system. That said, if I were you, I'd take the startup job, but would take
extra care of myself, not working 6x16+1x10 hours, eating right (not
necessarily fancy or organic, just basically good food), exercising enough and
having enough fresh air and rest. One doctor once said to me that I can cure
any illness by just sleeping 10+ hours a day. He was joking, but every good
joke is just partially a joke.

Yeah, and buy COBRA. Just in case. Most likely you will just waste a couple
grand on it, but this is your life on the line. Small companies use complete
idiots as insurance brokers (large ones do too, but they learned how to hide
this) these idiots may screw up you forms/submissions/cards/accounts/whatever
even multiple times in a row. You'd better be covered while you sort this out.

------
quangv
Hey Friend,

That sucks to hear. You are young yet, you can beat this. At risk of sounding
like a snake-oil salesman. You should look into a Green/Vegan diet. I'm
talking about wheat grass and kale. Mix it up, juice it, doesn't taste all
that bad.

I don't think you should worry about your co-workers premiums. It's all money,
honestly who can't go without an extra $50-300 a month or whatever. People
spend what they have usually, it'll all work it. It'll all work out.

It's called Insurance for a reason. Don't worry about the Insurance companies.
Focus on getting well, and staying stress-free as possible.

Good luck my friend.

------
calebm
My uncle had stage 3 colon cancer and beat it using a mixture of both
traditional and alternative medicine (such as a raw food diet and some other
treatment which wasn't available in the US). I strongly recommend looking
outside the mainstream. I recommend watching the Burzynski documentary and
checking out the Burzynski clinic.

~~~
tpiddy
Or you could stick with evidence and science based medicine. For another
perspective on Burzynski you can read SBM:
[https://www.sciencebasedmedicine.org/tag/stanislaw-
burzynski...](https://www.sciencebasedmedicine.org/tag/stanislaw-burzynski/)

~~~
13years
You should consider that the 'evidence' based medicine you speak of is largely
based on 53 studies, of which 47 could not be reproduced.
[http://www.reuters.com/article/2012/03/28/us-science-
cancer-...](http://www.reuters.com/article/2012/03/28/us-science-cancer-
idUSBRE82R12P20120328)

Which is probably why cancer survival when it can be surgically removed is
fairly good, but incredibly poor in general when it can't and must be treated
by medicine.

I don't know if Burzynski has something better, but I have seen the
documentary and researched the background. It is clearly not a case of the FDA
trying to stop bad medicine. He has been in trouble mostly due to protocol and
a clandestine attempt to take his patents. He has been in court many times,
and won every case, and never was he in court due to damage to clients, it was
always about some break of protocol, such as how medicine is delivered across
state lines etc.

Anyway, in general you aren't allowed to even try Burzynski's medicine until
all FDA approved medicines have already been tried. Only then can you apply to
be part of the FDA trial for his medicine.

