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In 2020 at age 46 I was diagnosed with stage 4 prostate cancer with high volume bone metastases. Beyond SoC (6 rounds of docetaxel chemo and chemical castration (almost all prostate cancers require testosterone to grow)), I was offered participation in an immunotherapy clinical trial (Keynote 991). After considering it, I refused the trial. Previous immunotherapy trials had been unsuccessful and I didn't want to spend the next two years going to the hospital every three weeks.
Instead I read every study and article I could get my hands on that might be relevant. Thank you SciHub! I also radically changed my lifestyle. Healthy eating, daily walking and exercising. From my reading I learned the importance of cholesterol in testosterone production and I modified my diet to an extremely low saturated fat intake and convinced my family doctor to proscribe atorvastatin. According to a phase 2 trial atorvastatin increased PFS by 3 months, the same as the incredibly expensive second line SoC treatment of enzalutamide.
After 4 years my PSA (Prostate Specific Antigen, used to track prostate cancer activity) has gone down from 318 at diagnosis to 0.02 μg/l. This is considered an extremely good response. I obviously don't know how much of this is due to my interventions vs SoC.
Last year I stopped my extreme diet and went back to focussing on enjoying my life. So far my PSA remains stable.
I haven't seen an oncologist/urologist in three years. The added value simply isn't there and I did get frustrated by the total lack of interest in what I was doing.
I voted No, but I don't think there is anything wrong with pushing the button. The "gods-eye" view of utility is simply wrong (or incoherent) and it's what causes most of the utility paradoxes. No one experiences not existing after pressing the button, so no harm done.
[Edit] I should qualify that voting Yes on this question could potentially do harm. So if you're going to press the button, better to do it silently.
I have terminal cancer and have believed in AGI doom for much longer than I've know I have cancer. Neither of these things made me depressed. Perhaps that is because I'm pretty close to an existentialist.
I would also like to add that even if you're not making long-term investments (I'm certainly not), maintaining good health (as best you can) is always worthwhile because it directly leads to higher quality of life.
I'm not exactly in this position, but I think it is somewhat adjacent. I have stage 4 prostate cancer and after initial treatment (chemo + castration) decided to stop seeing my urologist for periodic checkups. I do regularly get my blood tested by a lab outside of our (European) healthcare system.
This was not exactly due to the establishment being "wrong", but a combination of factors:
- Quality of care wasn't great and I can't stand the paternalistic nature of healthcare (in my country).
- After five months of pretty intensive self study and an occasional question to my doctor I felt that I had a sufficient understanding to improve my treatment beyond "standard of care". It probably helps a bit that my brother is a doctor.
Three and a half years after diagnosis I'm doing better than expected, but of course there is no way to tell if this is due to luck or my own treatment.
At first I was a bit frustrated that none of my doctors seem to care, but I understand that they've been thoroughly trained to ignore anecdotes (and they're probably also overworked).
I feel it important to mention that I'm not into alternative medicine. I got my GP to prescribe off label medication and the rest is just lifestyle adjustments (diet and exercise).
Feel free to ask me questions.
I have stage IV cancer and personally vastly prefer death to being frozen. I'm frankly baffled by those who think cryopreservation is a good idea given the threat that unaligned AGI poses.
[edit to add:] BTW, this isn't rationalization. I've felt this way about cryopreservation for many years before I knew I had cancer.
Side note: vitamin D supplementation should not be used to replace sun exposure.
Strongly agree, but I don't think it is because vitamin D supplements aren't "real" vitamin D. It is very likely that sun exposure triggers other important processes.
Thanks for this article. I was diagnosed with metastatic prostate cancer last year. With the caveat that you've obviously spent more time than me on understanding the general conditions of cancers and that I'm in Europe, I'd still like to give my impressions. I think way too much money is spent on cancer drug research compared to fundamental research understanding the human body. Doctors and patients are way too eager to spend a lot of money for small amounts of improvement in overall survival. I think you are too optimistic about immunotherapy. I was offered to participate in a trial and looked into it and for PCa the record is abysmal. The side effects are also significant. I decided to decline the trial (which did feel a bit selfish.)