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kulahan 15 hours ago

There is cancer in your body every single day. Your immune system handles it just fine. There is an explicit difference between cancer that needs treating and cancer that should be ignored because it's a waste of time and resources to treat. You're not a doctor, you're not qualified to tell the difference, you're not trained on cancers, you're not even in the medical field. The monopoly is held for exactly this reason.

We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own.

throwawaylaptop 14 hours ago | parent | next [-]

My father has a high rate PSA change a few years ago so I learned everything I could about prostate cancer for about 4 weeks.

I then talked to several doctors I know (family practice and two internal medicine).

It was embarrassing how little they knew. And even more shocking actually, is how wrong they were about things.

Two of them told me the risk of infection from a prostate biopsy was basically zero. I asked for clarification with actual numbers, and even led them with "for what kind? Like 1 in 100 or 1 in 1000?"

One said basically zero, the other said 1 in a million.

Neither knew to mention the two common types, and to make sure we go with the one type that carries less risk of infection.

Even then, the less risky one is about 1 in 1000. If you have bad insurance you might go with the older type which is about 1 in 100. And that's with them giving you antibiotics beforehand....

Basically they got everything I asked about wrong compared to specialists you can read online.

Ps, my dad got an MRI with two 1cm growths.

He changed his diet and added fasts, and did nothing else. His doctor basically writing him off in anger.

5 years later, PSA lower than before the incident. Paid for a scan last year, zero growth.

Internet/YouTube experts/doctors really do beat most general doctors. The odds of you having someone in the top 10% of their field, let alone top 1-2% in your local town is pretty low. Even my bay area doctor friends work at pretty basic general bay area hospitals. Imagine who's left in Modesto, CA.

kulahan 14 hours ago | parent [-]

I'm glad your dad got better, it had nothing to do with his diet and fasting. It's no different than Steve Jobs stubbornly becoming a fruititarian to treat his cancer. If his immune system had fought it off, then fruit would be a cancer cure and all his doctors would be idiots.

Youtube/Internet experts are one of the largest propagators of medical misinformation and are actively harming people every day, and if I've ever been in favor of restricting free speech, it's giving out medical advice without a license. If we can restrict giving legal advice, and everyone understands how painfully stupid you'd have to be to represent yourself in court without a law degree, then we can restrict giving medical advice, and hopefully people can realize how painfully stupid you'd have to be to manage your own medical treatments without a medical degree.

throwawaylaptop 13 hours ago | parent | next [-]

Regarding Steve Jobs, that's unfortunate for him because even my grandmother in Poland used to say "sugar causes/feeds cancer" when she tried to get us to stop sweetening our tea back in the 80s before we left.

Somehow she knew what several doctors and researchers are now documenting, that cancer cells have a much harder time growing without ample amounts of glucose.

throwawaylaptop 14 hours ago | parent | prev [-]

Oh great, another expert. Except without the 30 years of research and experience.

One guy wins the nobel prize for detailing a function of fasting and its effects on the immune system and cell repair/death... But fasting doesn't help! We know this, because a guy on hacker news said so.

Veserv 15 hours ago | parent | prev | next [-]

Your response is a non-sequitur. The original statement was about intentionally not detecting cancer. You are talking about whether the cancer is medically necessary to treat.

You are just assuming that all cancer must be treated if detected, even if it is medically unnecessary, therefore we must not detect medically insignificant cancer which would be net harmful to treat. You can detect things and determine no action should be taken. I can understand if that might be the modern standard of care, but if so then that is the problem; not early detection of cancer, which could be medically insignificant, but which may also allow the early detection of medically significant cancer.

kulahan 14 hours ago | parent | next [-]

I'm pretty sure every medical show had an episode where the "money-grubbing hospital admin" character want to start selling full body medical scans, and the "very well-respected and honor-bound doctor" character points out how this is quite literally one of the most useless and corrupt ways for a hospital to make money.

There are probably a dozen things wrong with your body right now. That doesn't mean they're even affecting you. While you may have some type of cancer that is at the absolute first day of detectability, or a bone slightly out of place, or a weird spot on your heart, someone else has a case that is 6 months deeper and needs more dire treatment.

There is zero benefit to society to massively overburden our healthcare system (this is true of any nation) by searching constantly for random problems that may or may not exist.

If there were good reason to do this, you'd have regularly-scheduled checkups, like with colon or breast cancer.

jauer 14 hours ago | parent | next [-]

at the same time you have endless stories of people losing family and friends to cancer because a doctor dismissed complaints as anxiety or needing to exercise more leading to cancer not being discovered until it was too late to treat.

The answer can't be to put our collective heads in the sand.

creer 9 hours ago | parent | prev | next [-]

Perhaps BOTH the "money-grubbing hospital admin" and the "very well-respected and honor-bound doctor" are wrong for not involving their patients in these decision? And their insurance for that matter.

Recently my US-system, world-ranking university hospital complex was first convinced that my insurance would not pay for XXX (and consequently did not recommend it and delayed it). Then after I insisted and got that done, they told me how surprised they were (1) that my (US) insurance did in fact cover every single bit of everything we eventually got done and (2) how MUCH that same US insurance in fact paid them for each of the bits. On the first try. That insurance company has horrible problems, but I can't complain that they didn't cover the hell out of the thing. You know - on the same year we read everyone else's horror stories.

The whole system is very sick.

xyzzy123 14 hours ago | parent | prev [-]

You also have the issue of information creating liability. A thing that nobody knows about is nobody's problem, a thing that COULD be a problem but probably isn't in someone's professional judgement creates liability for the decision maker.

toast0 14 hours ago | parent | prev [-]

It's a human factors thing. If two patients both have a cancerous tumor that does not need treatment, the patient that did not have a screening is better off. The patient who was screened will deal with anxiety from having a positive screening result in addition to any negative effects from the screening and follow ups. Many patients are not comfortable living with a detected tumor, even if the standard of care is to watch and wait. Of course, the opposite scenario is also true --- if both patients have a tumor were removal would be best, the one that gets screened has a better outcome.

Maybe if we were all pretty rational people, we could better manage positive screening results and follow up actions that lead towards taking no specific action; but that's not where people are at the moment.

There's a tradeoff of early detection of fast growing tumors that are likely to cause issues vs detection of slow growing tumors that are likely to not cause issues except if they're detected. You can see how the consensus is shifting on things like breast, prostate, and colon cancer screenings over time. My TLDR is that we developed tools and methods, started applying them and have generally reduced the screening frequency over time as we understand more about the tradeoffs.

Veserv 14 hours ago | parent [-]

Except that the medical system already does that for various types of common cancer screening such as breast cancer. It is frequently detected extremely early when it is medically insignificant and patients may be recommended to just wait and watch with more frequent screening. Increased vigilance would have been impossible without early detection and early detection for breast cancer is viewed very positively and is very positive for society.

We have a system that partially results in anxiety because cancer screening is frequently only done when cancer would already be medically significant. A positive result usually means medically significant cancer because as a society we already chose to not screen when it would be medically insignificant. This is perfectly reasonable if the test is expensive, inaccurate, or harmful as even just the harms from doing the test in bulk could result in societally worse outcomes than occasional early detection. However, the rise in "medically unnecessary" screening indicates that we have turned the corner on that in many cases; that or it is easily billed corruption which is a separate problem.

jamesrom 15 hours ago | parent | prev | next [-]

> We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own.

Strawman. No one is suggesting adding extra stress to healthcare workers. It's also not you or your doctors call to make: let's gatekeep this patients cancer because our hospital can't deal with the workload. What a truly wicked idea.

To help alleviate the extreme shortage of available healthcare workers we should instead allow those wanting to pay for these elective surgeries, to pay for them! Drive money into healthcare, scale up treatments, drive money into research. Let the system work.

Don't just turn off the lights and shut the door.

kulahan 15 hours ago | parent [-]

It's significantly more wicked to pretend that tests, treatments, and more aren't done by healthcare workers (yes, even private ones), and to inundate them with unimportant medical procedures while truly sick people are dying.

Yes, this is true even if the person opting for the elective surgery has millions, potentially even billions of dollars to pay with. Having money doesn't make your illness more important.

Don't get all holier-than-thou on topics like this; it's already a difficult-enough topic.

Ajedi32 14 hours ago | parent | next [-]

I often wonder if people who make these kinds of statements simply don't know how market forces work, or if they know how market forces work but just choose to pretend they don't exist in certain contexts where that reality feels particularly unfair...

Demand suppression doesn't work. "Having money doesn't make your illness more important" sounds like a noble sentiment, but by applying it in the real world you'd actually be reducing the total size of the pool of resources available to treat everyone. Talk about holier than thou...

jamesrom 13 hours ago | parent | prev [-]

> It's significantly more wicked to pretend that tests, treatments, and more aren't done by healthcare workers (yes, even private ones), and to inundate them with unimportant medical procedures while truly sick people are dying.

Strawman+ad hominem. No one is suggesting to pretend _anything_. Charge premiums for these tests based on how "unimportant" they are. Use market forces to move money from those willing to pay, to those who cannot.

cogman10 14 hours ago | parent | prev | next [-]

What determines if a cancer should be treated is the type, size, growth, and age of a patient.

Type and size and growth you can't find out without doing some sort of test/screening.

I agree that oncologists are ultimately who should be making the call on what needs to be treated and how. But I think your characterization of how common non-dangerous tumors are is off.

13 hours ago | parent | prev | next [-]
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bill_joy_fanboy 15 hours ago | parent | prev | next [-]

> You're not a doctor, you're not qualified to tell the difference, you're not trained on cancers, you're not even in the medical field. The monopoly is held for exactly this reason.

The idea that a position of authority means ~anything~ anymore is completely ridiculous.

What did the medical field do to earn such credibility with you? Any intelligent person should have developed a high degree of skepticism regarding the operations of the medical field as of 2025.

cogman10 14 hours ago | parent | next [-]

> What did the medical field do to earn such credibility with you?

For oncology? A whole lot. It's actually miraculous what they've developed to treat cancer. Cancer treatment has gotten so good that it's common for oncologists to caution against the 5 year study survival rates due to new and better treatments rapidly coming online. A 5 year study is necessarily 5 years out of date.

Medicine isn't a unified field. Having broad skepticism is an irrational position as there's a huge difference between the oncology field and the nutrition field.

imglorp 14 hours ago | parent | prev | next [-]

This opinion makes me sad.

There truly are experts in areas we can't--or shouldn't--all try to duplicate ourselves. Civilization is advanced by specialization. We identify these experts with a reputation system so you might call them authorities.

Similarly, there truly are institutions that have decades or more of people, procedures and culture to benefit society and a track record of these benefits.

The malicious erosion, by propaganda and by rhetoric, of the public's trust in our authorities and institutions is one of the biggest crimes of this century.

jjk166 13 hours ago | parent [-]

It wasn't propaganda and rhetoric which eroded the public's trust. It was repeated attempts by authorities to argue based on their authority, instead of using their knowledge to actually make compelling arguments. When inevitably these experts and institutions got things wrong, they lost credibility because they staked their credibility.

We were never supposed to listen to experts because they were experts, experts were supposed to make good points people would listen to. It's shocking that we've grown so accustomed to crappy institutions that we've forgotten what a properly functioning institution even looks like.

tjohns 14 hours ago | parent | prev | next [-]

> The idea that a position of authority means ~anything~ anymore is completely ridiculous.

In that case, should we just get rid of licensure for professional engineers while we're at it? No special education or experience needed to build a bridge, nuclear reactors, or life-critical systems... since authority is meaningless now in the age of the internet?

The medical field isn't perfect, but it's hubris to believe that most people will perform better at treating disease than somebody with 11 years (minimum) of specialized education and countless hours of experience in a real clinical setting.

advael 14 hours ago | parent | prev | next [-]

There's a pretty stark difference between medical science, medical practitioners, and medical institutions.

Medical science has done a lot to earn credibility over the last couple hundred years. It fully eliminated a disease that was a leading cause of death in multiple human civilizations. It reduced rates of infant mortality by staggering numbers. It created vaccines and surgeries that have each saved countless lives and effectively cured life-altering disabilities and injuries, and demoted tons of diseases from death sentences to mere manageable disabilities or even mild temporary inconveniences

Medical practitioners are a mixed bag that ranges from total altruists to total mercenaries. Most people can learn a skill and incentivizing any skill via things like money or social status creates some goal-misalignment, but also dramatically increases the prevalence of the skill and also the community surrounding it, including research, pedagogy, and infrastructure. I think there's considerable value in not automatically trusting every medical practitioner, but on the whole many of them have earned credibility

Medical institutions have mostly been responsible for the existence of trustable practitioners and research, though in the rich world and especially the US specifically there are significant misalignments that come from capture from power-hungry parties in both government and the private sector. The American medical establishment in particular seems at this point near unsalvageable, having broken so badly that it often deliberately tanks quality of care to enforce state power or to turn a profit. We should probably rethink a lot of how institutions fund research, administer hospitals, prioritize care, act as financial buffers, what legal and enforcement authority we vest in medical practitioners sanctioned by the institutions, etc. So I agree with you there, especially in the United States specifically, though much of this was apparent well before 2025 (practically before I was born)

14 hours ago | parent | prev [-]
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alistairSH 15 hours ago | parent | prev | next [-]

At a population level, that makes sense.

But, as the article notes, we don't know if any particular cancer will kill an individual.

It's a conundrum. But, "Meh, let's not test since it might not kill you." doesn't feel like the right answer.

lm28469 15 hours ago | parent [-]

It also has to make financial sense, everyone's insurance would be much higher, cancer treatments are $$$, in countries with a public healthcare system it's a no go

jjk166 13 hours ago | parent | next [-]

It cheaper to treat cancer if it's caught early. Reduced screening isn't reducing the need for cancer treatments - everyone who has cancer still has cancer. You might get an increase in follow up tests due to false positives, but these are cheap.

darth_avocado 15 hours ago | parent | prev [-]

Ehh. It’s only that expensive because we let be. You can get a basic cancer screen in India for 2500 rupees which is about $35.

lm28469 15 hours ago | parent | next [-]

Because everything is mostly following on local purchasing power. You can build a beautiful modern house in buttfuck nowhere Belarus for 20% of what you'd pay for the same exact house in Germany.

The screening isn't even the problem, finding you have _a_ cancer is one thing, pinpointing where it is, how to treat it, treating it and recovering from it cost orders of magnitude more than the initial diagnosis.

darth_avocado 14 hours ago | parent [-]

The point I was trying to make was that cancer screening is expensive only because we have a highly inefficient healthcare system. (India was an example and their healthcare system has its own flaws) Sure we can point to PPP, but the reason why screening is that cheaper elsewhere is not ONLY because of PPP. Since you mentioned Germany, public health insurance covers early detection cancer screen every 3 years (2 for skin cancer) once you’re 35. The concern about “raising insurance costs significantly for everyone” in US only exists because of the way healthcare is set up here. It shouldn’t be that expensive to screen and it shouldn’t be that expensive to treat.

https://www.informedhealth.org/what-screening-tests-does-ger...

lm28469 14 hours ago | parent [-]

> The concern about “raising insurance costs significantly for everyone” in US only exists because of the way healthcare is set up here.

100% definitely not lol, you need 2-3 months to see any kind of specialist in germany, 5-10 hours before someone sees you in the emergency room. The healthcare system of every western EU country is getting worse year after year because of the aging population, and on top of that we're taxed more, for shittier services.

I pay 800+ a month and it doesn't even include a yearly blood work unless I beg for it. Just look at your own link, in germany we screen for two cancers for each gender and it's already so fucking expensive, there are dozens of cancers you could theoretically screen for.

Skin cancer screening is actually a good example, we diagnose way more than before, and it has virtually no impact on death stats: https://www.nationalgeographic.com/premium/article/melanoma-...

> More than 80,000 Americans are told each year they have melanoma skin cancer. If that sounds like a lot, it’s because the numbers are six times higher than they were 40 years ago.

> Overdiagnosis is one of the most harmful and costly problems in medicine

darth_avocado 13 hours ago | parent [-]

> you need 2-3 months to see any kind of specialist in germany, 5-10 hours before someone sees you in the emergency room

That’s like pretty much the standard in the US as well? The unless you’re dying, you’re pretty much in an extremely long wait before you get seen in an emergency room, and then later get sent a $10k+ bill at the minimum. And there’s very few specialists that you can see immediately. In fact, for the majority of people, the step before “how fast can I see my specialist” is the “what specialists are in network”.

And as far as costs are concerned, I pay $2000/month for two people and it will only go up once we have a family of 4. This isn’t even the top tier plan, just a good enough one. Not to mention the thousands of dollars in deductible that you have to pay before the plan kicks in.

And we have an aging population as well. And that’s not going to change regardless of who’s paying for the care.

You’re being taxed for it, we’re paying out of pocket. The only difference is that you get shittier services when taxed, and here you don’t get the care if you can’t afford it. And if you end up in the ER and they have to treat you despite you not having the coverage, the taxpayers cover it anyway.

dekhn 12 hours ago | parent [-]

In the US, depending on your health plan, the fastest way to see a doctor is Urgent Care. They will typically see you nearly immediately, and send you to the emergency room (with paperwork already handled). You will still be charged, although at least in my case, it's just a copay.

darth_avocado 10 hours ago | parent [-]

> In the US, depending on your health plan, the fastest way to see a doctor is Urgent Care

Correct. It’s faster than getting your PCP to see you and it’s faster than Emergency Room (which GP was comparing the wait times for in other countries). But how much you wait really depends on a lot of factors: how many other patients are sick that day, what time of day are you calling, does the urgent care take appointments, how many urgent care centers are in your area etc. In my area if you call at 8 in the morning and the urgent care you are calling gives out appointments, you’ll probably be seen the same day. You’ll have to wait for your appointment, but once you show up for the appointment, you’ll be seen immediately.

If you’re calling in later (after 10 in the morning) or walking in to a facility, you’ll probably be waiting at least 2-3 hours if you’re lucky. All of this of course comes with higher costs (not as much as ER though).

The problem with urgent care though is that it’s more expensive if you’re running tests and is only designed to fill in for conditions that you’d ideally want your PCP to take care of, but can’t get an appointment for. True emergencies still go to ER. In fact some urgent cares don’t even have equipment like xray or sonography machines, so if you need one, you’d end up in ER anyway. (and get charged for both)

harvey9 15 hours ago | parent | prev [-]

Some tests are cheaper than others in any market.

darth_avocado 14 hours ago | parent [-]

And some markets in their entirety are cheaper than others because life saving care isn't marked up a 1000%.

xupybd 14 hours ago | parent | prev | next [-]

People have a right to make their own medical choices. Saying on people with the correct credentials should have input is offensive.

nfw2 13 hours ago | parent | prev | next [-]

> you're not in the medical field

citation needed

poszlem 15 hours ago | parent | prev [-]

That's kind of like saying that there is diabetes in your body every single day, and your body handles it just fine by producing insulin. Obviously that statement is nonsensical and essentially devoid of any useful insight.

I'm not even going to comment on this: "You're not a doctor, you're not qualified to tell the difference", because this is such a weird statement that I don't understand how anybody could utter it on this website.

If that is your standard for critical thinking, you are paving the way for anti-science rhetoric to dominate public discourse.

Treat people like stupid idiots if you want but then don't be surprised by the way they vote in elections as a result.

stvltvs 14 hours ago | parent | next [-]

It's literally true that cancerous cells happen all the time in our bodies and no treatment is necessary because the immune system handles it. The ideal diagnostic test would only detect cancers that need intervention.

kulahan 15 hours ago | parent | prev [-]

No, it’s nothing like that.

I won’t even get into the irony of you not realizing that not all forms of diabetes are related to insulin (diabetes insipidus) while simultaneously claiming that you don’t need to be a doctor to be qualified enough to make complex medical decisions.

In the first place, the analogy is wrong. You need insulin, you need blood sugar. Both SHOULD be present. Cancer never SHOULD be present, it just happens to be there often, like any other thing your body clears out.

Edit: the word “diabetes” originally comes from a word meaning “to pass through”. Literally the only thing linking all diabetic conditions is needing to pee a lot

poszlem 15 hours ago | parent [-]

That's amazing, and also totally misses the point, but I guess it let's you keep feeling smug, so that's a plus. If you’re aiming for the full "ackchyually guy" meme, mission accomplished. Meanwhile you’re not touching the core of my argument: we’ve already seen what happens when you lecture people to “trust the science” instead of actually engaging with them. They just go vote for someone who will talk to them, and that’s exactly how you end up with a Kennedy in charge.

missinglugnut 14 hours ago | parent | next [-]

Chill out...the most condescending comment here by far is yours, and the "well ackchually" that sent the thread of the rails is your comparison between cancer cells and needing insulin. If you don't want people to poke holes in an analogy like that don't make it.

kulahan 14 hours ago | parent | prev [-]

This entire comment is you whining, but not clarifying whatever point you seem to think I've missed. I'm happy to engage with you, if you have something of substance to add?