Fuck Cancer

[farmguy]

Here is a video on prostate cancer. He explains the laser process, pros and cons. Different types of MRI's. From the Prostate Laser center and Dr Sterling. Pass it along to anyone who just needs info.

https://youtu.be/KhFJHkImXGs?si=QAXP7Eu65SpdaZgG

[SorryBro]

50% of fear of cancer isn’t fear of mortality, it’s fear of financial ruin. That’s not right. If I was Uber rich I’d give all my money away to people being treated for cancer to alleviate that fear so they could focus on health/survival. I feel very strongly about that.

^This right here. I'd argue a bit more on the mortality side, but watching families in the pediatric cancer community face job loss (parents quit job to care for child), face residency fears (moving out of state for treatment), bankruptcy, etc. has been tough to experience. We were fortunate with insurance and what not, but many aren't.

Donate to research and uncompensated care if you feel so inclined...

[Bunion 2020]

^^^ Ouch, sorry to hear that. Cancer in children should be illegal.

[Trackhead]

Yes fear of mortality might reach 60% for me personally. Most of the fear of mortality is rooted in fear of how it would affect my son/wife. I’d jump off a bridge in a nano-second if it weren’t for them. Honestly I fantasized about suicide non stop during chemo. Literally wanted to blow my brains out, over dose on benzos, die in nuclear warfare. Seriously.

Now I’m remission I just fear it coming back. Odds are in my favor, but the odds are scary. I don’t want to ever tell my son I have cancer again.

In the last few weeks I’ve taken care of too many critically ill cancer patients in the ER, some not so old. It sucks. I don’t like it. Signing DNR orders, having the end of life discussions with families, all of it.

[mcski]

With so many false positives, is it even worth getting a psa test ?

[billyk]

With so many false positives, is it even worth getting a psa test ?

Well, yes, absolutely. As someone mentioned earlier, it’s not so much the absolute value, but the trajectory that counts the most. To see that, you need a history of regular PSA testing.

That’s what caught my prostate cancer, and probably why I’m still alive. My GP had been ordering PSA tests at my annual physicals for several years and noticed that the levels had started to spike up. He referred me to a urologist who did additional tests, which led eventually to a biopsy and rather startling news and surgery.

Prostate cancer for most people progresses slowly, like a tortoise. In my case, it was more like a rabbit. My Gleason score was about as bad as you can get. When they removed the prostate they found the cancer had reached the outside wall. However the surgeon removed an additional margin and the nearby lymph nodes which were cancer free.

Three years of follow-up PSA tests have all been undetectable, so it’s likely the cancer hasn’t spread further. Knock on wood.

Most people can get away with just monitoring the situation, but it didn’t turn out that way for me, and maybe not for you, either.

I would say, though, the biopsy was not a pleasant experience. And there are certain side effects from having your prostate removed which are not exactly desirable (but can be worked around to a certain extent). However, it does beat dying.

[Trackhead]

Good summary intended for patients regarding prostate screening:
https://www.uspreventiveservicestask...#39;t%20needed.

[riser4]

I'm really impressed that you and your lawyer made an issue of fixing the procedure and not just taking the money. Thank you for doing that.

This is a weak area in medicine. One study found a specimen source error rate of 2.3% which I think is high but even a tenth of that is too much. Labs have procedures for properly tracing the path a specimen takes. The weak spot is in the clinic or OR. I had tons of training in verifying patients but in 35 years in training and practice I never heard a word about specimen verification. Fortunately it never happened in any case of mine, but that was luck. (They lost a leg I amputated but it wasn't a cancer case, so no harm but definitely foul.)

Thank you for educating us about the problem.

I've related the story here before about sample cups and the fertility clinic for our IUI. The only thing that prevented the swap from being complete is the techs read the label that I had filled out on our jar. Some person in a white lab coat came running out into the lobby in a terrible panic to confirm my name. I compulsively fill out labels. Thankfully. Our generic brown paper bag got placed in the wrong basket. Thing #2 is definitely my kid.

[Trackhead]

^^^yeah mislabeling a CBC or a chem tube is one thing, but mislabeling a path specimen or a cup of sperm is next level terrifying

[billyk]

Good summary intended for patients regarding prostate screening:
https://www.uspreventiveservicestask...#39;t%20needed.

In contrast, here is some additional, more detailed info from the NIH:

https://www.ncbi.nlm.nih.gov/books/NBK556081/
Look at the section “Advantages of PSA Screening”.

[old goat]

Good summary intended for patients regarding prostate screening:
https://www.uspreventiveservicestask...#39;t%20needed.

"The U.S. Preventive Services Task Force (Task
Force) has issued a final recommendation on
Screening for Prostate Cancer. "
Final? I don't think so.

In contrast, here is some additional, more detailed info from the NIH:

https://www.ncbi.nlm.nih.gov/books/NBK556081/
Look at the section “Advantages of PSA Screening”.

Also look at the section on disadvantages.

[Trackhead]

Nothing in science or healthcare is final (good catch that’s an odd statement from them).

The NIH summary of all guidelines isn’t radically different and ultimately it’s a shared decision with patients.

There’s controversy across all aspects of healthcare … certainly nothing is black and white.

[old goat]

certainly nothing is black and white.

Xrays still are. (Sorry)

I was in health care long enough to see opinions on various things swing left to right, back left and back to the right. I read an article a long time ago about it. When something is accepted practice the journals will only print articles debunking the dogma. So the standard of care eventually changes, and eventually journals start printing studies supporting the orignal debunked dogma. So it goes back and forth. PSA was standard of care. Until it wasn't. Until it sorta is.
And if 5% chance of being wrong is accepted as statistically signifcant that means that 5% of the studies are wrong, which is a lot of studies. Of course most studies show statistical significance a lot better than that, but still--just by chance alone there's a lot of wrong ideas that get published. I saw a study that showed that if a woman had a breast biopsy mid cycle it was more likely to be positive for cancer. Then the same journal published a study showing if she had the biopsy during her menses it was more likely to be positive. And if you combined the results the timing of the biopsy made no difference.

[Trackhead]

Shades of grey!

[priapism]

I spent a week up in the eastside and then had a CBC 1 week later. Weird how I was found to be legit neutropenic (<0.5K/uL) and not just reduced ANC (0.75-1K/uL), for the first time after a year of maintenance. This didn't happen when I only had weekend trips to 6-8k ft.

Turns out high elevation via EPO may cause neutropenia during myelosuppressed chemotherapy?

This analysis of 5 randomized placebo controlled clinical trials carried out from 1988 to 2002 finds that EPO treatment of individuals undergoing myelosuppressive chemotherapy was associated with statistically significant increases in the incidence of severe neutropenia and suggests that competition between the erythroid and myeloid lineages may occur in the setting of suppressed hematopoietic reserves when the erythroid lineage is pharmacologically amplified.

https://ashpublications.org/blood/ar...ancer-Patients

tldr when on chemo be aware of your infection risk if you're at high elevations for longer periods

[Trackhead]

Were you on EPO?

Wouldn’t think physiologic EPO would after exposure to altitude would be enough to cause neutropenia, but I’m not a hematologist…..

[CantDog]

Thought this would be a good place to add this study. This study is small and local, but will be opening in the next few weeks(hopefully). Feel free to PM with questions. https://clinicaltrials.gov/study/NCT...%20pain&rank=2


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[abraham]

My dad's not coming home from the hospital.

Seven weeks ago his follow up scan showed a couple small tumors. They wanted to start treatment soon but said they were small.

Six weeks ago my dad took an offer to take a cancelled appointment slot to come in a day earlier so I could ski for my birthday. We walked 4 miles after that appointment, talking about it, and about his plans for our business now that he was able to focus better.

Five weeks ago I took him in for some final blood tests in preparation for the treatment he'd selected.

Four weeks ago he couldn't eat or drink more than a couple mouthfuls in a day. We took him to the hospital where he was admitted. The doctors found a tumor pressing against his digestive tract.

Three weeks ago things weren't improving so he started a steroid treatment. The goal was to shrink the tumor so he could get out of the hospital long enough to receive the planned treatment.

Two weeks ago that didn't work and he got a round of chemo, still working towards that goal.

Last week they suggested radiation to shrink the tumor, as the chemo didn't have much effect. He started it. But one of the scans showed cancer surrounding his heart, a rapid change from the scan a week before. I'm glad my mom was there with him when they explained things. I was the only one there 11 months ago at 1am when a doctor (PA? It's fuzzy) said he might have cancer before sending him home from urgent care.

Two nights ago my mom told him to make a track for her to follow, the way he had for so many years when they skied together and she was unsure what route to take.

[alias_rice]

Abraham, I’m sorry to hear this. Terrible news and fuck cancer.

[Norseman]

Fuck, man. Sorry, Abraham.

[Trackhead]

Sorry Abraham. This cancer shit touches so many lives in the worst kind of way.

[JimmyCarter]

Two nights ago my mom told him to make a track for her to follow, the way he had for so many years when they skied together and she was unsure what route to take.

Heartbreakingly beautiful.
So sorry about your dad Abraham

[TBS]

^^^ This
Sitting here with tears running down my face

[::: :::]

Abe, so sorry to hear this

[Buster Highmen]

So sorry to hear this Abraham. Your dad was a great guy.