13 ms·

How Long Have I Got Left?

276 points by conesus 13y ago

melling 13y ago
"And then my health began to improve, thanks to a pill that targets a specific genetic mutation tied to my cancer." Isn't tailoring drugs to specific mutations the next big revolution in medicine that we've been waiting for? Steve Jobs had his DNA sequenced to help fight his cancer. http://appleinsider.com/articles/11/10/21/steve_jobs_had_his_dna_sequenced_for_100k_to_fight_cancer http://appleinsider.com/articles/11/10/21/steve_jobs_had_his...
- deleted 13y ago
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- gregpilling 13y ago
  Yes, I am friends with Dr. Mark Nelson at University of Arizona and he is doing a startup in that area. http://pathology.arizona.edu/faculty/mark-nelson-phd http://pathology.arizona.edu/faculty/mark-nelson-phd
  - CreakyParrot 13y ago
    No offense, and it bothers me in almost any use, but the phrase "doing a startup" seems especially out of its depth in this context.
    - dack 13y ago
      What's your preferred verb?
      - aaronem 13y ago
        Why not just say "starting a business?" I've never seen what is so magically special about "startups" that they deserve to be regarded as inhabiting a separate, higher plane of their own, beyond and above ordinary entrepreneurship as the species has heretofore known it.
- deleted 13y ago
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- hrq 13y ago
  http://www.technologyreview.com/view/519686/steve-jobs-left-a-legacy-on-personalized-medicine/ http://www.technologyreview.com/view/519686/steve-jobs-left-... Another article describing a business that was started around this concept and seems to be having an important impact in medicine.
taylodl 13y ago
"I began to realize that coming face to face with my own mortality, in a sense, had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn’t know when. After the diagnosis, I knew that someday I would die, but I didn’t know when." Within this passage lies the meaning of life.
- nightski 13y ago
  The logical person inside of me wants to say that there is no meaning to life. But of course, that is not how I feel.
  - md224 13y ago
    Well, of course, that's the trick: to acknowledge a lack of objective meaning while seeking out your own subjective meaning, something that transcends the banal logic of the everyday. That's the tough part (or at least, it can be for many, myself included).
  - GhotiFish 13y ago
    well. I could make a decent argument that reproduction is a serviceable meaning to life if you like.
  - philwelch 13y ago
    Life is a sandbox game. You can choose your own goals, but from time to time it suggests goals to you. You get rewards for completing them, but you don't have to, it's just a way of making things easier if you have trouble deciding what to do.
  - the_cat_kittles 13y ago
    meaning is created, and its worth creating
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  - 13y ago
scorpioxy 13y ago
Nicely written. Why is it that we only look for what is important to us when we realize that we don't have long to live? Don't people realize that this is true starting the day you're born?
- invalidOrTaken 13y ago
  Because there's a lot of "unimportant" stuff necessary to sustain the important stuff.
  - bjelkeman-again 13y ago
    I think there is a lot true in that. It took me a good few years to get to the point of being able to focus on what is important for me. But, it do not think that the journey was wasted. Indeed it feels like everything/most what I have done up until now has put me in the position to do what is important, much more effectively and with some actual impact. I learn slowly, so it took a while, but the journey is what was important in the end not the goal. So now I look at every step along the way and make sure it is both useful to my surrounding world, fun and gives me experience to do something bigger, better, funner for the next step. It probably sounds like a cliche, but it is nevertheless true for me.
    - ZenoArrow 13y ago
      Thank you.
sdegutis 13y ago
For a long time I've been pretty worried about my mortality. But ever since I became a Christian a couple years ago, I've been much more at peace about it. Not all the way (yet?), but much more than before. I highly recommend looking into Christianity to anyone else feeling that same fear.
- obituary_latte 13y ago
  Please don't downvote just because you disagree. Have a discussion if you're comfortable with your beliefs. It would do more good for all involved.
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  - 300bps 13y ago
    Sorry, I was raised Christian and realized at 12 years old that it was complete bunk. How did I realize that? I read the bible. Literally every day. I read it cover to cover at least 15 times. It contains pearls of wisdom floating in a sea of nonsense. No rational person can read that book cover to cover and remain a Christian. Which is why Christians have bible study groups where they focus on John 3:16 and other pretty verses while ignoring the wackjob parts that make up most of the bible. But it is pointless for me to even point this out to you so I'll stop here.
ifktaotc 13y ago
A few years ago I got testicular cancer. The information about the disease came in pieces: first all I knew was that there was a lump; then came the ultrasound, the CT scan, then biopsy of the testicle, then a second surgery to sample lymph nodes to which the cancer might have spread. At every step I would obsessively query my doctors for conditional probabilities: given what we'd just found out, what were the chances of dying? Of relapse? Of chemo? Of sterility? I was always incredibly frustrated at how vague their responses would be - they'd say, e.g. "we don't like to give probabilities because you just never know what will happen!". And I would think, "That's exactly the point of a probability! Please just tell me a number!" One doctor eventually showed me a paper on outcomes for the lymph node surgery I had, with a relapse rate curve going out five years so. I found this incredibly helpful for managing my emotions because it let me track my progress in a very precise way: every monthly checkup that would go by uneventfully, I knew exactly what my chance of relapse had dropped to. The goal was to get to zero. More importantly, having actual numbers gave me something on which I could focus my optimism. It's so much worse to hear "you might become sterile" than "there's a 5% chance of becoming sterile". With the 5% number in mind, I'd do things like imagine myself in a room full of 20 people and think "wow, it would be incredibly unlikely to be randomly chosen from this group". Having spent a lot of time in a cancer hospital now -- around people who were much worse off than I was -- I believe that almost everyone has incredible reserves of optimism. I think it's better when the hopeful possibility is concretely defined - it makes it easier to imagine a path forward while you're stuck waiting for more information. Mine is obviously a completely different situation from the terminal cancer described by the author, where the question isn't, "when will I be free of this cancer", but rather "when will I die from it". Testicular cancer is very treatable, and I never faced a significant chance of death. I'm sure I would have been in a much different psychological state if I had. Also, PSA: testicular cancer is REALLY common for young males (if you're male you have a 1 in 500 chance of getting it between 20 and 34). Given HN user demographics, there are almost certainly some of you reading this who've gotten it already, or who will. You can save yourself a ton of trouble if you do a self-examination every once in a while. That's actually how I found out, and is a big reason that I avoided chemotherapy.
- yeukhon 13y ago
  Thank you. I supposed you just create this new account to share the story. But thank you, now I know I should do body check. I am only 22 and I already feel unsafe.
dollar 13y ago
For Christ's sake, is there no safe haven in this world for the unapologetic atheist? I thought that Hacker News might be the one safe zone where Jesus brainwashing is not regurgitated to the masses, but I guess not. News flash for everyone, death is inevitable, and people do not rise from the grave, whether they harbor sympathy for humans or not. Life's meaning, if there is one, is at this stage incomprehensible to human beings. If there is life beyond the grave, it definitely isn't life, and it definitely isn't what you think it is. How many more years must humanity be shackled to superstition and death fear before we fucking get over it and move on to the important work of getting off of this planet? For fucks sake...
- dollar 13y ago
  That's right Jesus freaks, downvote me to HELL!
  - gjm11 13y ago
    Unapologetic atheist here. I downvoted your complaint about downvoting because such complaints add nothing to HN. (I do share your distaste at the way some Christians have seized on this as a preaching opportunity.)
    - pstack 13y ago
      Frankly, the entire religion aspect of the discussion doesn't belong here. As an atheist, I'm entirely fine with you finding comfort in whatever you like, even if it is completely irrational. It is your business. I also accomplish nothing by being "militant" toward people simply for believing in something. That is best reserved for situations where that belief or things drawn from it are imposed upon the rest of society. For example, in public education, science, politicians, taxation, decisions of national importance. Things where that belief impacting beyond the scope of an individual's life are forced upon everyone and on behalf of everyone. However, it is also quite ridiculous to use this opportunity about an important topic to start telling people they should somehow convince themselves to believe in something metaphysical, because "it'll bring you peace". You aren't the Hare Krishna and this isn't the local airport. Let's leave the discussion at something like "I'm religious and find some solace and peace in my religion that helps me cope with potential mortality". Telling people they should "believe in jesus" and linking to ridiculous books or interviews about why they should believe in jesus in incredibly self-serving, inappropriate, and counter-productive.
cliveowen 13y ago
I get so scared and sad when I read these articles. I always wonder "could it be prevented?", sure, you know you shouldn't smoke, you shouldn't be overweight and you should do at least 15 minutes of exercise every day, but does it really help? I bet a doctor would know better than anyone else how to live a healthy life, so this obviously begs the question: could cancer really be prevented?
- kayoone 13y ago
  Hardly. Even if you are perfectly healthy you can still develop some form of cancer. You see, theres people smoking for 40 years living on to be 80+ and other non-smokers who develop lung cancer at 35. Or be run over by a car, or have a heart attack or whatever. Of course you could be super cautious with everything, do checkups of everything every year, but in most cases thats a gigantic waste of metal energy, money and time when you are young and you might also develop hypochondriac mental issues. Could it be prevented ? Sure, like almost any kind of premature death could have been prevented, but that doesn't help much.
- has2k1 13y ago
  According to the professionals of the field, there is little hope for ever preventing cancer. For a protein life that has sufficient complexity, cells have to divide/replicate to maintain the life of the protein machine, e.g a human body. Stuff can go wrong with the division/replication, it can be inaccurate in so many ways but what matters most is that the replicates can also replicate. Some cells die before they attempt a single replication. This could be due to a disease attack, vulnerable imperfect replicate, plus plus. As long as those that get to replicate can make up the numbers for those that die early. Cells that are resilient and can replicate fast and frequent enough before they die tend to pass on forms of this attribute to their imperfect clones. With time, many types of cells in the whole protein body get to attempt replications faster and faster. Pure natural selection at work -- a concrete example, smoking kills lung cells, so for the lung cells to maintain their numbers they have to replicate early enough in their life time and frequently. Most environmental pressures seem to force the biology of the cells in this direction, which increases the likelihood of replication eager cells aka cancerous cells. That is why at this moment in time, prevention seems bleak.
officer_gotcha 13y ago
Most people who'll die from cancer won't have access to a doctor anyway, so whatever.
gytdev 13y ago
one of the most clear, lucid and scientifically literate stories about existentialism I have heard in a long time. I bow my head to Paul Kalanithi, the author: http://www.stanford.edu/group/dlab/images/paulk.jpg http://www.stanford.edu/group/dlab/images/paulk.jpg
thomasz 13y ago
> We never cite detailed statistics, and usually advise against Googling survival numbers, assuming the average patient doesn’t possess a nuanced understanding of statistics When I was at the receiving end of that talk, this attitude made me incredibly angry. They know exactly that we will look up those numbers, they are just too afraid to have a honest discussion with us. People make very bad decisions because those numbers are discussed at forums, without the involvement of people who can interpret the statistical and medical significance of scientific studies.
- smnrchrds 13y ago
  Exactly. It's kind of like not telling your kids about sex: They will try to find information on their own and most probably they will be misinformed.
- vanderZwan 13y ago
  And would you suggest doctors would take two to three extra hours with every patient to work them through a basic statistics class which still isn't sufficient to explain the concept?
  - thomasz 13y ago
    Two to three extra hours is vastly exaggerated, and not that much time for someone who needs to know the chances of dying a horrible death. I might add that this is an objection based on economic argumentation, which, while not invalid, is not the one given by doctors. They argue like the author of the article did: That they know better than you how you will react to this kind of information, and that they can manage your morale by taking certain freedoms with the truth. I think that this is an unworthy and authoritarian approach which only leads to distrust: How can that guy say that I will certainly survive when Wikipedia, Lymphoma.org and the fucking New England Journal of Medicine agree that there is a one in five chance of me biting the dust in the next few years?
    - vanderZwan 13y ago
      > I might add that this is an objection based on economic argumentation, which, while not invalid, is not the one given by doctors If you think doctors don't have time for you for economic reasons, and not the fact that there are other patients out there, you really have no idea what doctors do all day. > They argue like the author of the article did: That they know better than you how you will react to this kind of information, and that they can manage your morale by taking certain freedoms with the truth. They have far more experience with people receiving this information than the person receiving it.
aaronsnoswell 13y ago
I don't understand how everyone here was able to read this article - I browse to that link and get a message telling me it is locked behind a paywall, requiring my subscription before I can read it. Do all HN readers also subscribe to the NY Times?
- nicolethenerd 13y ago
  You should get 10 free articles a month before the paywall appears. I'm guessing most HN readers haven't used up their quota yet.
  - mkempe 13y ago
    How to read the article: Search for the article's title in Google (hint: select the title in the non-working NYT URL, dashes are fine), and the link from Google's (probably) top result to NYT will let you in, freely.
- icegreentea 13y ago
  Try visiting in incognito mode. The paywall is cookie based.
powertower 13y ago
It's really difficult to read these types of stories and comments because it shows us that happy endings are not guaranteed for anyone by the universe. We're just all flesh that's about to fail - sometime, eventually. And that sometime comes sooner for some of us than latter.
brosco45 13y ago
Alternative medicine is the only solution.
marincounty 13y ago
I was told that Japanese Doctors don't discuss mortality rates with their patients. I was told they don't even mention the word Cancer. If a patient has stomach cancer, the patient is given the best currently available treatment, and is told they have a bad case of heart burn--and told they will get better! The reasoning is they want to get every once of magic The Placebo Effect has to offer. I don't know if it's better to quote stats to a patient, or lie(hopeing the Placebo Effect will take over?). Personally, I don't use the Internet for any health related concerns--It has always just made me feel worse, and is loaded with hysteria, and just horrid advice. And yes, I know U.S. Doctors can't lie to their patients. I'm just relaying what I was told twenty years ago. When I get sick--I'm not sure if I would want to the statistics of survival. I would live every day as my last. I would take any drugs the Pallitive care Physician offered though. My father benefitted greatly from the opiates the doctors prescribed before he died. I hope the doctor makes a full recovery, and commend him on his honesty and openness. Sometimes I forget doctors will someday be patients. Oh yea, to the Marin General counter person who asked me if I wanted to sign a Advanced Procedure Directive, before even saying hello--if you happen to read this--one day you will be on the other side of the counter. Good night! I hope you all stay well and are happy!
cko 13y ago
I'm very curious: are there people who fear samsara? I sure do. http://en.wikipedia.org/wiki/Saṃsāra http://en.wikipedia.org/wiki/Saṃsāra
MarkMc 13y ago
This part annoys me: > Where was the study of nonsmoking 36-year-old neurosurgeons? Maybe my youth and health mattered? Or maybe my disease was found so late, had spread so far, and I was already so far gone that I was worse off than those 65-year-old smokers. You don't need a 'study', you just need a comprehensive database that includes patients' age, smoking status, body-mass index, health status, and other prognostic factors. Then run a query to find what percentage of similar patients are still alive after 5 years. Just about every person who is diagnosed with cancer asks, "What are my chances?". (And the best treatment usually depends on an accurate answer). Wouldn't the benefit of compiling and maintaing a central database of all US cancer patients be worth the cost?

276 points by conesus 13y ago

"And then my health began to improve, thanks to a pill that targets a specific genetic mutation tied to my cancer." Isn't tailoring drugs to specific mutations the next big revolution in medicine that we've been waiting for? Steve Jobs had his DNA sequenced to help fight his cancer. http://appleinsider.com/articles/11/10/21/steve_jobs_had_his_dna_sequenced_for_100k_to_fight_cancer http://appleinsider.com/articles/11/10/21/steve_jobs_had_his...

deleted 13y ago
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gregpilling 13y ago
Yes, I am friends with Dr. Mark Nelson at University of Arizona and he is doing a startup in that area. http://pathology.arizona.edu/faculty/mark-nelson-phd http://pathology.arizona.edu/faculty/mark-nelson-phd
- CreakyParrot 13y ago
  No offense, and it bothers me in almost any use, but the phrase "doing a startup" seems especially out of its depth in this context.
  - dack 13y ago
    What's your preferred verb?
    - aaronem 13y ago
      Why not just say "starting a business?" I've never seen what is so magically special about "startups" that they deserve to be regarded as inhabiting a separate, higher plane of their own, beyond and above ordinary entrepreneurship as the species has heretofore known it.
deleted 13y ago
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hrq 13y ago
http://www.technologyreview.com/view/519686/steve-jobs-left-a-legacy-on-personalized-medicine/ http://www.technologyreview.com/view/519686/steve-jobs-left-... Another article describing a business that was started around this concept and seems to be having an important impact in medicine.

taylodl 13y ago

"I began to realize that coming face to face with my own mortality, in a sense, had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn’t know when. After the diagnosis, I knew that someday I would die, but I didn’t know when." Within this passage lies the meaning of life.

nightski 13y ago
The logical person inside of me wants to say that there is no meaning to life. But of course, that is not how I feel.
- md224 13y ago
  Well, of course, that's the trick: to acknowledge a lack of objective meaning while seeking out your own subjective meaning, something that transcends the banal logic of the everyday. That's the tough part (or at least, it can be for many, myself included).
- GhotiFish 13y ago
  well. I could make a decent argument that reproduction is a serviceable meaning to life if you like.
- philwelch 13y ago
  Life is a sandbox game. You can choose your own goals, but from time to time it suggests goals to you. You get rewards for completing them, but you don't have to, it's just a way of making things easier if you have trouble deciding what to do.
- the_cat_kittles 13y ago
  meaning is created, and its worth creating
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- 13y ago

scorpioxy 13y ago

Nicely written. Why is it that we only look for what is important to us when we realize that we don't have long to live? Don't people realize that this is true starting the day you're born?

invalidOrTaken 13y ago
Because there's a lot of "unimportant" stuff necessary to sustain the important stuff.
- bjelkeman-again 13y ago
  I think there is a lot true in that. It took me a good few years to get to the point of being able to focus on what is important for me. But, it do not think that the journey was wasted. Indeed it feels like everything/most what I have done up until now has put me in the position to do what is important, much more effectively and with some actual impact. I learn slowly, so it took a while, but the journey is what was important in the end not the goal. So now I look at every step along the way and make sure it is both useful to my surrounding world, fun and gives me experience to do something bigger, better, funner for the next step. It probably sounds like a cliche, but it is nevertheless true for me.
  - ZenoArrow 13y ago
    Thank you.

sdegutis 13y ago

For a long time I've been pretty worried about my mortality. But ever since I became a Christian a couple years ago, I've been much more at peace about it. Not all the way (yet?), but much more than before. I highly recommend looking into Christianity to anyone else feeling that same fear.

obituary_latte 13y ago
Please don't downvote just because you disagree. Have a discussion if you're comfortable with your beliefs. It would do more good for all involved.
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- 300bps 13y ago
  Sorry, I was raised Christian and realized at 12 years old that it was complete bunk. How did I realize that? I read the bible. Literally every day. I read it cover to cover at least 15 times. It contains pearls of wisdom floating in a sea of nonsense. No rational person can read that book cover to cover and remain a Christian. Which is why Christians have bible study groups where they focus on John 3:16 and other pretty verses while ignoring the wackjob parts that make up most of the bible. But it is pointless for me to even point this out to you so I'll stop here.

ifktaotc 13y ago

A few years ago I got testicular cancer. The information about the disease came in pieces: first all I knew was that there was a lump; then came the ultrasound, the CT scan, then biopsy of the testicle, then a second surgery to sample lymph nodes to which the cancer might have spread. At every step I would obsessively query my doctors for conditional probabilities: given what we'd just found out, what were the chances of dying? Of relapse? Of chemo? Of sterility? I was always incredibly frustrated at how vague their responses would be - they'd say, e.g. "we don't like to give probabilities because you just never know what will happen!". And I would think, "That's exactly the point of a probability! Please just tell me a number!" One doctor eventually showed me a paper on outcomes for the lymph node surgery I had, with a relapse rate curve going out five years so. I found this incredibly helpful for managing my emotions because it let me track my progress in a very precise way: every monthly checkup that would go by uneventfully, I knew exactly what my chance of relapse had dropped to. The goal was to get to zero. More importantly, having actual numbers gave me something on which I could focus my optimism. It's so much worse to hear "you might become sterile" than "there's a 5% chance of becoming sterile". With the 5% number in mind, I'd do things like imagine myself in a room full of 20 people and think "wow, it would be incredibly unlikely to be randomly chosen from this group". Having spent a lot of time in a cancer hospital now -- around people who were much worse off than I was -- I believe that almost everyone has incredible reserves of optimism. I think it's better when the hopeful possibility is concretely defined - it makes it easier to imagine a path forward while you're stuck waiting for more information. Mine is obviously a completely different situation from the terminal cancer described by the author, where the question isn't, "when will I be free of this cancer", but rather "when will I die from it". Testicular cancer is very treatable, and I never faced a significant chance of death. I'm sure I would have been in a much different psychological state if I had. Also, PSA: testicular cancer is REALLY common for young males (if you're male you have a 1 in 500 chance of getting it between 20 and 34). Given HN user demographics, there are almost certainly some of you reading this who've gotten it already, or who will. You can save yourself a ton of trouble if you do a self-examination every once in a while. That's actually how I found out, and is a big reason that I avoided chemotherapy.

yeukhon 13y ago
Thank you. I supposed you just create this new account to share the story. But thank you, now I know I should do body check. I am only 22 and I already feel unsafe.

dollar 13y ago

For Christ's sake, is there no safe haven in this world for the unapologetic atheist? I thought that Hacker News might be the one safe zone where Jesus brainwashing is not regurgitated to the masses, but I guess not. News flash for everyone, death is inevitable, and people do not rise from the grave, whether they harbor sympathy for humans or not. Life's meaning, if there is one, is at this stage incomprehensible to human beings. If there is life beyond the grave, it definitely isn't life, and it definitely isn't what you think it is. How many more years must humanity be shackled to superstition and death fear before we fucking get over it and move on to the important work of getting off of this planet? For fucks sake...

dollar 13y ago
That's right Jesus freaks, downvote me to HELL!
- gjm11 13y ago
  Unapologetic atheist here. I downvoted your complaint about downvoting because such complaints add nothing to HN. (I do share your distaste at the way some Christians have seized on this as a preaching opportunity.)
  - pstack 13y ago
    Frankly, the entire religion aspect of the discussion doesn't belong here. As an atheist, I'm entirely fine with you finding comfort in whatever you like, even if it is completely irrational. It is your business. I also accomplish nothing by being "militant" toward people simply for believing in something. That is best reserved for situations where that belief or things drawn from it are imposed upon the rest of society. For example, in public education, science, politicians, taxation, decisions of national importance. Things where that belief impacting beyond the scope of an individual's life are forced upon everyone and on behalf of everyone. However, it is also quite ridiculous to use this opportunity about an important topic to start telling people they should somehow convince themselves to believe in something metaphysical, because "it'll bring you peace". You aren't the Hare Krishna and this isn't the local airport. Let's leave the discussion at something like "I'm religious and find some solace and peace in my religion that helps me cope with potential mortality". Telling people they should "believe in jesus" and linking to ridiculous books or interviews about why they should believe in jesus in incredibly self-serving, inappropriate, and counter-productive.

cliveowen 13y ago

I get so scared and sad when I read these articles. I always wonder "could it be prevented?", sure, you know you shouldn't smoke, you shouldn't be overweight and you should do at least 15 minutes of exercise every day, but does it really help? I bet a doctor would know better than anyone else how to live a healthy life, so this obviously begs the question: could cancer really be prevented?

kayoone 13y ago
Hardly. Even if you are perfectly healthy you can still develop some form of cancer. You see, theres people smoking for 40 years living on to be 80+ and other non-smokers who develop lung cancer at 35. Or be run over by a car, or have a heart attack or whatever. Of course you could be super cautious with everything, do checkups of everything every year, but in most cases thats a gigantic waste of metal energy, money and time when you are young and you might also develop hypochondriac mental issues. Could it be prevented ? Sure, like almost any kind of premature death could have been prevented, but that doesn't help much.
has2k1 13y ago
According to the professionals of the field, there is little hope for ever preventing cancer. For a protein life that has sufficient complexity, cells have to divide/replicate to maintain the life of the protein machine, e.g a human body. Stuff can go wrong with the division/replication, it can be inaccurate in so many ways but what matters most is that the replicates can also replicate. Some cells die before they attempt a single replication. This could be due to a disease attack, vulnerable imperfect replicate, plus plus. As long as those that get to replicate can make up the numbers for those that die early. Cells that are resilient and can replicate fast and frequent enough before they die tend to pass on forms of this attribute to their imperfect clones. With time, many types of cells in the whole protein body get to attempt replications faster and faster. Pure natural selection at work -- a concrete example, smoking kills lung cells, so for the lung cells to maintain their numbers they have to replicate early enough in their life time and frequently. Most environmental pressures seem to force the biology of the cells in this direction, which increases the likelihood of replication eager cells aka cancerous cells. That is why at this moment in time, prevention seems bleak.

officer_gotcha 13y ago

Most people who'll die from cancer won't have access to a doctor anyway, so whatever.

gytdev 13y ago

one of the most clear, lucid and scientifically literate stories about existentialism I have heard in a long time. I bow my head to Paul Kalanithi, the author: http://www.stanford.edu/group/dlab/images/paulk.jpg http://www.stanford.edu/group/dlab/images/paulk.jpg

thomasz 13y ago

> We never cite detailed statistics, and usually advise against Googling survival numbers, assuming the average patient doesn’t possess a nuanced understanding of statistics When I was at the receiving end of that talk, this attitude made me incredibly angry. They know exactly that we will look up those numbers, they are just too afraid to have a honest discussion with us. People make very bad decisions because those numbers are discussed at forums, without the involvement of people who can interpret the statistical and medical significance of scientific studies.

smnrchrds 13y ago
Exactly. It's kind of like not telling your kids about sex: They will try to find information on their own and most probably they will be misinformed.
vanderZwan 13y ago
And would you suggest doctors would take two to three extra hours with every patient to work them through a basic statistics class which still isn't sufficient to explain the concept?
- thomasz 13y ago
  Two to three extra hours is vastly exaggerated, and not that much time for someone who needs to know the chances of dying a horrible death. I might add that this is an objection based on economic argumentation, which, while not invalid, is not the one given by doctors. They argue like the author of the article did: That they know better than you how you will react to this kind of information, and that they can manage your morale by taking certain freedoms with the truth. I think that this is an unworthy and authoritarian approach which only leads to distrust: How can that guy say that I will certainly survive when Wikipedia, Lymphoma.org and the fucking New England Journal of Medicine agree that there is a one in five chance of me biting the dust in the next few years?
  - vanderZwan 13y ago
    > I might add that this is an objection based on economic argumentation, which, while not invalid, is not the one given by doctors If you think doctors don't have time for you for economic reasons, and not the fact that there are other patients out there, you really have no idea what doctors do all day. > They argue like the author of the article did: That they know better than you how you will react to this kind of information, and that they can manage your morale by taking certain freedoms with the truth. They have far more experience with people receiving this information than the person receiving it.

aaronsnoswell 13y ago

I don't understand how everyone here was able to read this article - I browse to that link and get a message telling me it is locked behind a paywall, requiring my subscription before I can read it. Do all HN readers also subscribe to the NY Times?

nicolethenerd 13y ago
You should get 10 free articles a month before the paywall appears. I'm guessing most HN readers haven't used up their quota yet.
- mkempe 13y ago
  How to read the article: Search for the article's title in Google (hint: select the title in the non-working NYT URL, dashes are fine), and the link from Google's (probably) top result to NYT will let you in, freely.
icegreentea 13y ago
Try visiting in incognito mode. The paywall is cookie based.

powertower 13y ago

It's really difficult to read these types of stories and comments because it shows us that happy endings are not guaranteed for anyone by the universe. We're just all flesh that's about to fail - sometime, eventually. And that sometime comes sooner for some of us than latter.

brosco45 13y ago

Alternative medicine is the only solution.

marincounty 13y ago

I was told that Japanese Doctors don't discuss mortality rates with their patients. I was told they don't even mention the word Cancer. If a patient has stomach cancer, the patient is given the best currently available treatment, and is told they have a bad case of heart burn--and told they will get better! The reasoning is they want to get every once of magic The Placebo Effect has to offer. I don't know if it's better to quote stats to a patient, or lie(hopeing the Placebo Effect will take over?). Personally, I don't use the Internet for any health related concerns--It has always just made me feel worse, and is loaded with hysteria, and just horrid advice. And yes, I know U.S. Doctors can't lie to their patients. I'm just relaying what I was told twenty years ago. When I get sick--I'm not sure if I would want to the statistics of survival. I would live every day as my last. I would take any drugs the Pallitive care Physician offered though. My father benefitted greatly from the opiates the doctors prescribed before he died. I hope the doctor makes a full recovery, and commend him on his honesty and openness. Sometimes I forget doctors will someday be patients. Oh yea, to the Marin General counter person who asked me if I wanted to sign a Advanced Procedure Directive, before even saying hello--if you happen to read this--one day you will be on the other side of the counter. Good night! I hope you all stay well and are happy!

cko 13y ago

I'm very curious: are there people who fear samsara? I sure do. http://en.wikipedia.org/wiki/Saṃsāra http://en.wikipedia.org/wiki/Saṃsāra

MarkMc 13y ago

This part annoys me: > Where was the study of nonsmoking 36-year-old neurosurgeons? Maybe my youth and health mattered? Or maybe my disease was found so late, had spread so far, and I was already so far gone that I was worse off than those 65-year-old smokers. You don't need a 'study', you just need a comprehensive database that includes patients' age, smoking status, body-mass index, health status, and other prognostic factors. Then run a query to find what percentage of similar patients are still alive after 5 years. Just about every person who is diagnosed with cancer asks, "What are my chances?". (And the best treatment usually depends on an accurate answer). Wouldn't the benefit of compiling and maintaing a central database of all US cancer patients be worth the cost?