All of Oleander's Comments + Replies

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 rele... (read more)

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.

1Igor Ivanov
Thanks for sharing your experience. I wish you to stay strong
Answer by Oleander110

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 quest
... (read more)
3Dr Valmonty
Firstly, I am very sorry for what you are going through.  As a training surgeon, I would admit that I'd have a similar approach to yourself. Of my colleagues, I'd only say one in four are particularly 'conscious' thinkers despite being intelligent. Many work on auto-pilot in line with guidelines, which is the safest legal position and requires less effort in terms of decision-making.  It also alleviates the need for people to read and study the evidence base in detail. Whether through laziness, being over-worked or feeling legally vulnerable, individual patient factors are under-emphasised in favour of following the algorithm.  I would advocate for 1) shopping for a physician who appears to exercise professional autonomy; 2) empowering yourself by reading; 3) if you want to go off-protocol, bring the evidence to an appointment so your physician can make themselves aware; 4) making your personal priorities clear both verbally and in documentation, i.e. advanced decision directives. I am not saying the doctors or guidelines are wrong, but they are standardised and generalised in a manner that gives 80% optimal care to 80% of people, roughly speaking
3mukashi
I wish you recover soon with all my heart

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.

6Brendan Long
Like nitric oxide production, which lowers blood pressure: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5593895/

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 offe... (read more)

3waveman
Bear in mind a lot of studies are for me-too drugs i.e. slight variants of existing drugs that have the tremendous advantage of being patentable, even if they are no better. Such trials provide little benefit to humanity. As a fellow member of the reluctant brotherhood I have seen many friends enter trials only to suffer greatly with no, or even a negative, effect on survival. (Sometimes, I suspect, people will have treatment because it allows them to avoid facing The Horrible Truth*).  *That they are indeed mortal.
2ChristianKl
When it comes to talking about the prospect of immunotherapy what's possible with today's technology and what's possible with better technology are not the same. The approaches we have today with NK cells are relatively unsophisticated compared to what's possible.