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Things to know if you get cancer in 2026

https://jjmaxwell4.com/writing/things-to-know-when-you-get-cancer/
278•jjmaxwell4•1h ago

Comments

runjake•38m ago
This is fantastic. Thanks for posting it, JJ. There's a very strong chance you'll save n>0 lives by posting this.

Minor addition: When you talk to someone who has undergone the surgery, try to find someone that's a similar age and in similar shape to you, otherwise you may get wildly varying answers.

You'll respond, experience and heal from a surgery quite differently at 40 vs 50.

jijji•36m ago
have you tried PNC-27 peptide? Another option is focused ultrasound (HIFU) that I would look into before going the traditional route, which might kill you quicker than the cancer itself.
conception•30m ago
https://journals.lww.com/ajg/fulltext/00000434-201710001-018...

Note untested medicine is untested.

trvz•35m ago
Frankly, I have the impression that doctors at large put as little care towards their patients’ health as us programmers do towards our software.
timcobb•25m ago
Building ivory castles and whatnot? ;)
HelloMcFly•4m ago
Sure, there are bad apples in medicine just like there are in tech. But knowing many doctors personally, reading this fills me with equal parts frustration at your cynicism and sadness for what they endure.

What's the difference for a physician today vs. 30 years ago? Among other things, today's physicians struggle because they're being crushed: continuously squeezed by the financialization of their hospital/practice, carrying larger debt, more time spent fighting the insurance machine just to get basic treatments approved. On top of all of that, they are less respected in general and often face outright hostility from patients... all while being paid relatively less than their predecessors.

The comparison rankles, obviously.

akshaydeshraj•35m ago
Extremely sorry you had to go through this.

My only submission will be to consider India, which is fast becoming a hub for medical tourism. You can get any test you want and meet specialists in hours, not even days.

toephu2•7m ago
Also China...China is generally better for advanced medical technology and complex hospital-based treatments.
iyonn•34m ago
Thanks! I'm saving it for hopefully never. I hope your treatment is/was successful!
sieste•32m ago
The late Jake Seliger and his widow Bess blogged at length about their experience navigating the medical system after his squamous cell cancer diagnosis. That was in 2023-25 though.

jakeseliger.com

bessstillman.substack.com

Cider9986•15m ago
This is his last article I think. https://news.ycombinator.com/item?id=41157974
baoooooooooooo•32m ago
Meaningful.

Our friend group went through the support-mode version of this this year and much of the advice rings true.

To add, a giant shared document that the group of friends had access to in order to take notes. Findings, theories, doctor statements will be shared when the patient isn't in a great place to be taking notes.

And for anyone reading this that might have someone facing cancer in their lives, go make a nuisance of yourself being present - feel empowered to spend a bit more time than you might initially think is necessary/helpful with them. Facing this stuff alone is when it is at its hardest.

emerongi•6m ago
> go make a nuisance of yourself being present

I was hospitalised (not cancer) and completely zoinked out of my mind due to sleep deprivation, constant blood loss and being in pain 24/7. People did visit, but I guess they just thought... I have things under control? I wish they had talked to the doctors and asked more questions. Ultimately I came out of it fine, but I probably would have gotten a better result with someone advocating for me.

Please go and be a nuisance. As someone with a clear head you will likely be able to understand the topic better, from a more neutral standpoint, and potentially push for the best possible treatment.

ValueTheory•32m ago
> AIs may downplay the seriousness of things. I was chatting with various models and most pushed me in the direction of “you don’t have cancer” for a while. Just something to note.

This is certainly another data point for "never trust AI chatbots".

dekhn•30m ago
Statistically, it makes sense- most people asking AI if they have cancer don't have cancer, so a model that is lacking detailed information should basically be returning based on the basal rate of cancer in the population with a threshold applied.
jacobgkau•27m ago
Should it? Or should it say it can't be sure and to ask a doctor?

Doctors might do the same thing, of course, but at least then there's a real (accountable) person responsible for deciding that "threshold."

sublinear•22m ago
> Or should it say it can't be sure and to ask a doctor?

It's an extremely slippery slope to having it say that about even the most basic medical information.

If you don't believe me, try any google search related to something as simple as hangover tips. The AI summary will tell you to call SAMHSA and then brutally stonewall you on anything else even tangential to alcohol.

dekhn•13m ago
I can't reproduce your claim. I get a medically correct response from the AI summary and then a link to the Mayo clinic at the top of the search results.
silvestrov•31m ago
> new folder on my Mac, and after appointments I’d dictate what happened and what the doctor said

I cannot recommend this enough, including writing down almost every day about symptoms and progress. I didn't have cancer, something else, but it was very valuable to be able to go back and see exactly how long time a symptom has been present and when it disappeared.

Doctors also seem to react well to being able to be precise in descriptions of what happened when.

BrokenCogs•25m ago
That's because the baseline response doctors are used to goes something like this:

Doc: "Do you have any other medical conditions besides your {red eye,stomach ache,itchy foot}?"

Patient: "No."

Doc: "Are you taking any meds?"

Patient: "Yes I am currently on chemotherapy for my cancer."

Doc: "Okay... so you have cancer?"

Patient: "Yes I have lung cancer."

tredre3•22m ago
> Doctors also seem to react well to being able to be precise in descriptions of what happened when.

They do. In my experience they're usually pleasantly surprised when you have dates and timelines rather than "oh I don't know, about a year ago?"

That being said the reaction differs if you offer a self diagnosis (assisted by google or chatgpt) rather than just symptoms. There will not be pleasantness. It's a toss up between a dismissive "yeah maybe" and "uh uh, did google tell you this?" Many doctors will 100% listen and consider what you say, but in my long life I've learned that offering a self diagnosis must be done very tactfully.

On one hand it's understandable, us as programmers don't enjoy having a nocoder arrive with "yeah so chatgpt says this is no good" and having to explain to them why they're wrong. On the other hand modern patients do their own research before consulting, so it's worth at least considering what's being said.

DannyBee•
sehugg•29m ago
This goes for any medical expense, but also beware of the "Coordination of Benefits (COB) Questionnaire" required by your insurance company. They want to confirm your other coverage (e.g. Medicare) once a year, and sometimes the only way you know they are expecting it is when you get a call from your doctor's office that your claims are being silently denied. The insurance company won't send you an email, a call, or a ding in the portal, the language is buried at the bottom of a page of one of those PDFs you have to explicitly download.

I've had luck with just calling once a week or sending nastygrams asking why my claims are still denied, they usually say "oh that didn't go through I'll manually process that" and approve a few more each time. Incompetence vs maliciousness etc.

datlife•22m ago
>Incompetence vs maliciousness etc.

Looking at financial reports of the major health insurance stocks in the US makes me wonder if they are really "incompetence".

Take United HealthCare (UNH) for example, they reported $112.7 billion and net income of $4.11 billion in Q3/2026. That's great amount of revenue and profits to have enough resources to not stay "incompetence". It's not a coincidence.

baggachipz•27m ago
The first point is by far the most important. The US healthcare system (and probably others) is an unfeeling machine and you have to treat it that way. Ask for earlier appointments, cancellations, and referrals to other specialists. Navigate it as if nobody knows (or cares) what you're up to. Doctors tend to only exist within their silo and it's often on you to request a different type of doctor or even another one of the same type. Be a pain in the ass, your survival may depend on it.

Personal story: I was having trouble using my left arm. Like, couldn't lift or type or do much of anything with it. Was told it was a pinched nerve by physiatrists and orthopedists, despite having no pain. Only when I specifically requested for a referral to a second neurologist did he order the head MRI which exposed a brain tumor in my motor cortex. We were able to move quickly and get me on a treatment plan which has bought me a lot of time. Had I not advocated for myself, it would have probably mutated into a much worse type and killed me soon.

Loughla•22m ago
I had to quite literally sit in a doctor's office and make a public nuisance of myself to get a referral for a family member to a specialist for cancer when the regular doctor said it was just back pain. Then I drove the 2 hours to their office to get the appointment. It was lymphoma.

People can't ignore you as effectively if you're in their physical space. When it comes to your health or the health of your family, do not back down. Doctors are used to nuts who googled the symptoms or joined a Facebook group and have all the answers already. Make it clear you have NO answers but NEED them asap.

helterskelter2•1m ago
I've had similar experiences. It's kind of terrifying, actually, you have to walk the line of being annoying enough to get what you want but not so annoying they completely ignore you.

A few things I've learned is to apply the Socratic method to them, preferably in front of their colleagues. If you've got scary symptoms they try to brush off, demand they write down what your symptoms are and why they aren't concerned, then demand a copy of all relevant records (it's your property) -- this often gets them to reevaluate your risk in terms of their career.

Worst case scenario, you can make up medical history. I had a family member pass recently from colorectal cancer. They had symptoms but their PCP kept insisting they were too young. My family member suddenly "remembered" her aunt died of CRC when she was a kid. This got her referred to a gastroenterologist, and they found out she was stage 4...after her PCP delayed her diagnosis for like a year. She actually had grounds for a malpractice suit but who's got the energy or money for that when they're fighting stage 4 cancer?

Also, know the state agency responsible for policing health insurance. This family members insurance company routinely tried to deny life saving procedures, but a call to the right govt agency set them in line each time.

zetazzed•26m ago
As a fellow cancer-haver, I would give a piece of proactive advice for those (in the US) who do NOT have cancer or even suspect they have it:

Find a decent primary care doc who is not impossible to schedule with. Someday, if you do have a problem, the primary care doc will be able to send you off for scans, etc. much more easily when you are an existing patient. Getting appointments as an existing patient is much easier.

exhilaration•25m ago
My suggestion is that if you're within a 2-3 hour drive of major cancer centers - just use the US News list https://health.usnews.com/best-hospitals/rankings/cancer - go there instead of your local community hospital. The top cancer hospitals in the world accept your health insurance (probably), so why not go there? Use your vacations days, book hotels if you have to - this is the time to go all out.

My experience: I was horribly sick for 10 months, none of my local doctors could figure it out, then I drove to Penn Medicine in Philadelphia and they did the right labwork in the first visit. These top centers just have different mindset than your community hospitals.

stochastician•22m ago
The second opinion advice is great, and what I tell everyone I know who gets cancer.

My mom was diagnosed with stage 1 cancer in 2006 in Idaho. I was a PhD student at MIT at the time and a friend in lab helped me get an appointment at Dana-Farber. I thought it was probably overkill (it was a common cancer) but we did it anyway. They said everything in Idaho was standard of care but suggested one extra test, which Idaho team then reluctantly did, which revealed distant metastasis (stage 4! ), dramatically changing her treatment trajectory. She lived another 15 years (I miss you Mom).

Asking for a second opinion sucks. A lot of us are preconditioned from birth to trust our clinicians. But you're going on a journey and your life (or the life of your loved one) is on the line. Insurance often covers it. Your doctor will NOT be offended.

Think of it this way : if you were deploying code to the mars rover, and your colleague asked to do a code review before you pushed go, would you be offended? This is even more important than that.

mrmincent•4m ago
Yeah absolutely on the 2nd opinion, my dad went into his GP and said “I think I have lung cancer”, after a period of difficulty breathing and low energy. The GP diagnosed him with low iron and gave him some iron supplements, didn’t even get a scan. A few months later he had to have a couple of litres of fluid drained from his lungs while on holiday, turned out to be mesothelioma. Obviously we’d prefer it to be low iron, but better to know what is going on and be able to respond to it.
wnevets•18m ago
> No one cares more about your case than you, so take control and send lots of follow-ups.

This advice can be applied to most things in the life. Expecting the machine in any context to take care of you will likely leave you disappointed.

Traubenfuchs•10m ago
> but I’d move to schedule it at a top cancer center as soon as you are relatively sure of your diagnosis

Oh the privilege.

qurren•6m ago
AIs often keep blabbering "ask a doctor" after every medical question and I absolutely despise this behavior.

99% of the time I'm asking the AI medical advice questions because (1) there is no specialist available on short notice (2) most specialists I actually see do not give me the sense they take things seriously enough (3) a lot of specialists are just incompetent.

jeffybefffy519•26m ago
But OpenAI said we have AGI now...
dekhn•20m ago
I think it's a truism that naive computer science people who have watched the rise of computers, the internet, and AI will always believe that curing diseases is a straightforward process and that new tech will rapidly fix all the old problems.

The folks who actually go work in the field, understand the structural problems, the costs/benefits, and the long slog to bring successful treatments to patients are skeptical. But we're still more than happy to be proved wrong- if Anthropic (more than OpenAI) is working on life sciences and drops some amazing information that transforms cancer care with massive positive results, we all win.

imoverclocked•1m ago
> we all win

Do we all? Or does anyone with enough money to pay for Anthropic's IP, win? Nothing states that Anthropic/OpenAI/... have to share information they have generated. As the crunch for income becomes real, I doubt valuable things will remain free.

snazz•26m ago
This is the opposite of the experience people have when googling symptoms, though, where you often find articles suggesting that you’ve got some very serious condition when you do not. Interesting that the human bias when reading WebMD type articles is the opposite of the bias of LLMs.
mnw21cam•3m ago
That's not universal. I work in genetics, and we did an investigation a few months back, by asking various AIs whether a particular mutation causes $DISEASE. Invariably they were very strongly biased towards saying yes, even for completely obviously benign variants. I think that's because the majority of the literature out there describing variants is describing pathogenic ones, because why would you write an article about a benign variant, so the only material it has ingested is articles describing variants as pathogenic. In reality, the average person has millions of variants, and almost all of them are completely benign, so there should be a very strong pre-supposition that a given variant is benign unless there is fairly strong evidence saying otherwise.
21m ago
Get one of these: https://www.plaud.ai/

You can do whatevvr you want with the audio files - have them transcribe them, summarize them, hand them to an agent, upload them to your cloud, whatever.

The standby and talk time is really great on both the pins and the credit card sized versions.

I have a lot of friends that now use them with elderly parents/their own medical care when they need to really be able to have something automatically record/transcribe the visits.

Hamuko•2m ago
>Doctors also seem to react well to being able to be precise in descriptions of what happened when.

They also do that if you show them pictures of your poop when you have a bowel thing going on.

mmoustafa•19m ago
I had a heart condition (myocarditis) recently after a viral episode, despite the obvious prognosis the ER doctor treated me for a heart attack instead without consulting a cardiologist which sent me to the ICU.

I should have mistrusted the doctor and trusted the AIs more, unless they gave me compelling reasoning. Don’t give up your decisions to anyone, incompetence is abound.

elmer2•16m ago
It's worse everywhere else. There are no specialists in all of the government-run systems I've dealt with and at some point, you really have no options left.

Canada introduced MAID for this reason.

louthy•14m ago
> It's worse everywhere else.

You’ve dealt with every health system on earth as a patient?

computerdork•5m ago
It's an over generalization but think this person has a point. The US health system has it problems (cost!!), but have read that since it's money driven instead of a government service, compared to other healthcare systems, it's often got a shorter wait time to see a doctor. This makes sense, a lot of students want to become doctors in the US, because they can make a lot of money
onlyrealcuzzo•11m ago
> Only when I specifically requested for a referral to a second neurologist did he order the head MRI which exposed a brain tumor in my motor cortex.

Oh my. I did not expect this.

I'm glad you caught it early, and I hope you have the best outcome you can, and thank you for sharing your story.

xmprt•10m ago
If you've dealt with the American medical system then stories like this aren't very surprising. I'm not going to act like this is everyone's story (a lot of people have pretty smooth experiences) but it happens a lot more often than it should.
SoftTalker•7m ago
It's not unique to America. Specialists are in high demand everywhere and seeing them means you have to pass through a screen of generalists who first rule out all the common explanations for your symptoms.

But GP's point is otherwise true. It's just a job to them. They see dozens of sick people every day. There's no way to be empathetically engaged with all of them or really any of them and still be effective. It's not personal, and they aren't ignoring you. You're a bug report in their ticket system. Understand that and you'll be able to deal with the system more effectively.

Things to know if you get cancer in 2026

https://jjmaxwell4.com/writing/things-to-know-when-you-get-cancer/
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