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Posted by jjmaxwell4 2 hours ago

Things to know when you get cancer – 2026 Edition(jjmaxwell4.com)
386 points | 82 commentspage 2
zetazzed 1 hour 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.

ValueTheory 1 hour 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 1 hour 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.
jeffybefffy519 1 hour ago|||
But OpenAI said we have AGI now...
dekhn 1 hour 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 1 hour 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.

dekhn 1 hour ago||
I don't see any scenario where showing that we can tremendously improve medical care, even if it's IP/trade secret from an AI company, isn't a win, when integrated over all the variables.

If they succeeded, you can bet everybody else will be duplicating their results within 2-3 years.

matteoraso 1 hour ago|||
AGI isn't magic. Not even an excellent oncologist can reliably diagnose you without actually looking at you first.
jacobgkau 1 hour 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."

dekhn 1 hour ago|||
Gemini says what I think makes sense (there are multiple responses which could make sense)

[ if I gave you a picture of something on my skin could you diagnose it as a melanoma ]

No, I cannot diagnose skin conditions or identify melanoma from a photograph.

AI-based image analysis cannot replace a professional medical evaluation. Skin conditions—especially potentially serious ones like melanoma—require a physical examination, and often a dermatoscope or biopsy, by a qualified healthcare professional such as a dermatologist.

qurren 1 hour 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.

sublinear 1 hour 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 1 hour 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.
aantix 57 minutes ago|||
Disagree. You don't take the evaluation at face value. You still push back and explore every thread. You don't abandon your own logical reasoning.

But you definitely want to scour the entire search space for solutions.

And the most efficient means for that is LLMs.

It's my experience that doctors are compartmentalized in their thinking, limited in their time, and definitely will not be extensively exploring your case.

E.g., I had 30 years of resistant hypertension. Multiple medications. Saw many cardiologists. Nephrologists. I was told to "just lose weight." BP was erratic over the years. ER visits. It was awful.

I googled. Pheochromocytoma. Hyperaldosteronism. Asked the cardiologist, "Could it be this?"

"NAAAAH, just lose weight."

But I insisted on a referral to an endocrinologist. And when I suggested it to them, given my extensive history, they were basically like, "Oh yes, we'll get you tested. I'm surprised you haven't been tested before?"

I had a left adrenalectomy 6 months later. BP has been controlled ever since.

They don't know everything. They can't.

jjmaxwell4 32 minutes ago||
Yeah I did not mean that as a indication to not trust AI. But rather to use it as a companion and pressure test things doctors say with AI and things AI say with doctors.
snazz 1 hour 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 1 hour 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.
the_af 1 hour ago|||
True! However, don't both biases point to "don't (primarily) decide by googling or asking an LLM"? You'll either be extremely scared or extremely reassured.
jjmaxwell4 25 minutes ago||
Yeah, while what I wrote was true the takeaway should have been something like:

- You should pressure test anything an AI says with your doctors, and anything a doctor says with AI.

going_undercove 1 hour ago||
This article is very relevant to me. Just this last Sunday I watched my mother die of melanoma.

My big takeaway from the whole ordeal is that you need to take a very active role in your own treatment. Unfortunately I was only able to become actively involved in managing my mother's treatment in the last few weeks. What I saw was a clear pattern of (what I'd regard as) negligence. There were so many missed opportunities to provide the care she needed. I came to the sad realisation that if you're not cracking the whip, many doctors will take the path of least resistance, and that in many cases, the only way to get documentation or help as a relative is to be ready to kick up a stink in-person.

I'd be happy to go into more detail.

akshaydeshraj 1 hour 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 1 hour ago|
Also China...China is generally better for advanced medical technology and complex hospital-based treatments.
sehugg 1 hour 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 1 hour 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.

arjie 42 minutes ago||
So if they increased the amount of accepted claims by 5% they’d be underwater? Seems like they’re right on the edge here.
lategan 48 minutes ago||
Focus on the good. It's not Crohns, so unless you've been given the "you have six months" speach, your quality of life is not over, nor is your life.
baoooooooooooo 1 hour 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 1 hour 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. In the end 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.

amoorthy 1 hour ago||
Solid advice. On the point about surgery, seems obvious but surgeons are inclined to operate. They aren't inclined to tell you the surgery is unnecessary. They always say it's routine and they've done it many times before. All true but surgery can be very tough on your body as I saw with my late father. Complications happen more than anyone will admit.
silvestrov 1 hour 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 1 hour 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."

djeastm 31 minutes ago||
What are we all filling out those forms before the visit for if the doctor's not even going to read them before we see them?
tredre3 1 hour 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.

prmph 6 minutes ago||
I usually just try to give them a detailed picture of my symptoms, as far as I can, and listen to them. When it seems like they are getting ready to wrap up, I simply bring up my concerns, if they have not been addressed. The attitude should be one of seeking their reassurance that they have adequately considered more serous possibilities.

It does not always work, but a lot of doctors in my experience take some time to kindly explain why they think the other possibilities I'm concerned about are unlikely, and sometimes my questions actually prompt them to add some additional investigations.

arjie 40 minutes ago|||
I have a private EMR system and we plug in everything into it through an agent. Every medication, every sniffle. It’s fun!
DannyBee 1 hour 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.

iamjackg 59 minutes ago||
Is there a completely local option for something like this? I love the idea, but I don't love having yet another middleman in between everything I say and the model provider of my choice.
DannyBee 50 minutes ago||
Device wise - i never found one as good and i played with a bunch. However, you have three options with plaud that i'm aware of:

1. If you want something totally open source: https://github.com/RemiPelloux/OpenPlod

Local-first Plaud Note Pro recording vault, transcription, and Markdown workspace. Which sounds like what you want.

2. the Plaud SDK will let you pull from the device and send it wherever you want without touching their servers.

3. You can also use the mobile app, disable cloud sync, and export each audio file as mp3/wav to your phone/tablet/whatever if you don't want to use #1 or #2.

You can have it upload to your private cloud without doing any of these, but it still transits their servers first i believe, which it sounds like you are trying to avoid

Hamuko 1 hour 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.

computerdork 47 minutes ago|
Have had terrible pain and muscle clenching in my body since I was a teen (am 52 now) and for the past 15+ years, have been intensely working with the medical system to figure out the cause (have gotten a lot of great relief!). Agree with everything said in this blog in working with the medical system. To put my spin on it:

- You are the least-constrained team member in your healthcare: At an appointment, your doctors only get to spend ~30 min on your problem and it's unrealistic to expect them to be as deeply involved as you are on your healthcare. Yeah, you yourself can spend days or even weeks researching you health problems and planning your healthcare.

- Research your health problems: you don't need to be an expert to read about your health problem, learn the basic anatomy involved and the high and mid-level details of the surgery or treatment. You'll have to look up a lot of terms, but it's not that bad and the articles aren't that difficult to understand at a high-level.

- You are also the manager of your healthcare: Planning and seeing the big picture is critical. You can optimize a lot of the planning of appointments, exams and surgeries buy thoughtful planning. And, you can definitely catch a lot of opportunties and mistakes in decisions that are made. Just like in a tech project, a couple of good random ideas can lead you to some fantastic outcomes.

There are many more, but yeah, working with the healthcare system is an skill that can be studied and learned. Really useful.

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