Ask HN: I Have Cancer. What Should I Do?
I found a marble-sized lump under my armpit a few days ago. I quickly got it checked out, and the preliminary report just came back that it's probably cancerous.
What the hell should I do?
I'm 25, and otherwise healthy, so was not expecting this.
I really care about this new team and was excited to work with them. I feel horrible about joining a young business as an albatross instead of an asset.
I left my old job on good terms but have no idea how they could justify re-hiring an employee who left and may not be productive / able to work.
If I start at my new job I'm afraid I will endanger the business and raise everybody's premiums. I think they have a fairly generic group plan.
If I don't start my new job, how will I support myself?
My fiancé also works at a small startup so if I joined her insurance the same issues would apply.
I think I can still purchase my old insurance through Cobra, but I don't know how long that will last.
Thanks.
171 comments
[ 3.8 ms ] story [ 340 ms ] threadSecond: if what you're facing is lymphoma (not unlikely given what you've said), you've probably already been told this, but: lots of good outcomes, especially for younger patients. I've known multiple people that faced it (more than one of them older), and all of them beat it.
Third: what you really want to know: do nothing differently. Retain your new job. You're fortunate in that you have a career in which you'll be able to remain productive during treatment.
Having an illness doesn't make you an albatross. Your condition almost definitely won't meaningfully impact your employer's HR costs (speaking from some experience here), and those costs are not your problem. You are not endangering your new employer. Don't listen to anyone who suggests your are.
Stay frosty, and do not casually make decisions that will impact your insurance coverage.
Breathe.
Your chances of living happily for a long life are very high. In doing so, you are a valuable person with immensely insightful lived experience.
What decision makes the most sense for someone living to 89?
Make that one.
https://www.youtube.com/watch?v=_Or8xLOGBu8
I don't know if a company's insurance premiums actually rise if an employee gets sick. Even if they do, that's not your problem.
Would you take it? I imagine not, but that's essentially what you're proposing.
Everyone will want you to survive, and anyone who begrudges you for being human because it cost them a trivial amount of money shouldn't really factor into your health decisions.
The healthcare system in the USA has many problems, but this thread isn't about that.
I'm quite right wing, but that's why imho medical costs should be socialized. But of course, there are many problems that come along with that.
I couldn't agree more. Most importantly, our career choices shouldn't be coupled to our health needs. It's ridiculous, and it's even more amazing that the US health care industry has somehow convinced conservatives that this is a good situation. As we can see from the OP, the coupling of job to health care in the US literally stifles innovation and job mobility.
I heard someone say that health care is completely provided in Australia for about 2% of your gross pay because the leeches have been removed from the process ... is this true?
P.S. Leeches = anyone that inserts themselves into the process without adding meaningfully to the quality of care provided.
[0]http://content.healthaffairs.org/content/29/9/1569.abstract
There are zero cases of bankruptcy due to medical illness, or people being denied care because of a lack of insurance.
I feel horrible about joining a young business as an albatross instead of an asset.
Don't. It's not your fault. You don't even know that you're going to have any effect on their premiums and even if that happens, it's going to be a small effect in comparison to everything else that startups have to deal with.
If I start at my new job I'm afraid I will endanger the business and raise everybody's premiums.
Don't worry about that. You shouldn't feel guilty about anything... unless you're a health insurance lobbyist or executive or a legislator who fought healthcare reform, which you're obviously not.
Just focus on getting well and giving the people around you, your job, and most importantly, yourself, your best. Seriously, fuck everything else. This is your life.
Besides, an 18-person company that can't survive one employee getting cancer (and I suspect that it can) is a company that doesn't deserve to stay in business.
So: take the job, get covered, and work when you can.
I left my old job on good terms but have no idea how they could justify re-hiring an employee who left and may not be productive / able to work.
You'll be able to work, although not at 100%. It's not like life stops when you undergo chemo or radiation. Yes, those therapies are brutal (my mother had cancer, twice) and you'll probably need to take a few days off for each one, but you can still be productive some of the time.
Let's say that you need 6 cycles of chemotherapy (over 18 weeks) and that each involves three days during which you can't work. (There's a lot of variation. Some people drive themselves to chemo. Some people need a week to recover. Three days seems to be average, from what I've heard.) That's only 18 sick days. It's nowhere close to a deal breaker.
Focus on getting well. Don't feel guilty because you didn't do anything wrong.
1. Get all your information first. Just because it's been deemed cancerous doesn't clarify what's ahead. It could range from intensive treatment, down to rather localized surgery. Talk to your specialists about the specifics and you'll know what you're in for.
2. Cover yourself foremost. I understand the altruistic desire to not affect those around you but you do need to take care of yourself. Ultimately that has to be your top priority. That said don't assume you would just be a burden on a team. Once you get all your details you may find you could still contribute during treatment.
3. Don't panic, that will only stress you and make things worse. We still call cancer "The big C" but in reality the outlook varies widely and many are completely treatable. Once you have all your information lined up you'll feel better.
My email address is in my profile if there is any way I can help further or if you just want to talk. All my best.
Edit: In retrospect these should be 3, 1, 2 in order of priority.
Whether you are or not, though, it's true don't panic and cover your ass are critical. Fortunately we live in an era of obamacare, though, as well as regs about covering prexisting conditions. A hitch in what the top commenter said is that you may not in fact be able to keep your job through treatment. I had three week rotations, where the first five days of each rotation (sat - weds) were sitting in the hospital all day hooked up to an IV, and it's not a reasonable work environment.
Obviously gather all the information, but I'd say get ready to get the cobra if you can't hold it down at work with whatever scheduling arrangements the hospital can make, and if that runs out on you you'll still be able to pay for something that will cover you.
Should the OP tell his new employer right now? Or hold off until down the line?
OP: As far as your lump, dammit indeed. Good luck and beat that thing!
Think of it this way: that they hire someone else who thinks they're healthy doesn't guarantee they're hiring someone that stays healthy. In fact, they might just think they're healthy because they're less cautious and end up in a much worse spot than you.
Life happens. If the company is not equipped to deal with that, it's not your fault. It's part of running a business.
Besides, most of the problems we're talking about here are related to the shitty American healthcare system, not the business itself.
1) Calm down.
2) Gather information. More specifically, if you know a doctor, contact said doctor. If you can't, find a way to meet with a physician as soon as possible and get a second opinion. Get someone to explain to you what this diagnosis means. Explore fully your plan, Cobra, etc.
3) Tell fiancee, family, etc (not in an alarming way). Or not. That is, decide whether you want those closest to you to know. This is very personal and we can't choose for you.
4) Save money
Above all don't panic. The most important step is getting informed on what is happening and what your alternatives are and what options you have.
Perhaps right now you don't see this, but like others have said, you can beat this. Now is the time to act swiftly and gather information. Don't waste time. See a doctor ASAP.
Take your new job and work until your dr advises otherwise.
Being alive > personal finances > startup finances
Contemplate the differences between time and money, time has a fixed and unknowable amount which is constantly ticking away, money is virtually infinite and you can always get more of it, and you can live on very little of it.
Paul Allen didn't kill MSFT and when your read his story MSFT sounds like the morally bankrupt entity and not Paul Allen.
First of all, it's good you found it now rather than, say, months from now.
Second and most importantly, focus on taking care of your health first. I once knew someone who had something similar to what you're experiencing. It was lymphoma and he was just about to begin what was a very competitive program.
He was fortunate enough to be able to defer it.
Your health comes first, no matter what. So look hard at all your options (eg. parents, friends, etc) before killing yourself to deliver on someone else's bottom line.
Life's way too short.
In terms of insurance coverage, the only thing that matters is make sure you have coverage. Don't go cancelling or changing coverage at this point -- especially to the benefit of the employer. Now that you have a known/likely diagnosis, no insurance will want to touch you.
To downvoters: I'm mentioning this only because I'd try it myself in this situation. I am not claiming it's a proven cure or that the OP should not try other things. Obviously he should talk to his doctor and discuss whether this would be detrimental in combination with the best possible proven treatments.
This may be completely medically wrong, so please investigate further before acting on this in the least, but a thread a while back on HN linked to an article that recommended fasting (for several -- even 5 days at a time) as a way of causing improperly behaving cells to be used as food. I think the author of the article may have said he'd do that if he got cancer. Anyway, among many other options that's one I'd think about (obviously IN ADDITION TO seeking all medical treatment available at any price).
(Update: here's the link I think was at some point posted elsewhere on HN... http://thequantifiedbody.net/water-fasts-as-a-potential-tact...)
Also, if in several months you get bad news about this (hopefully not) you might want to consider talking to Alcor about cryopreservation.
https://news.usc.edu/63669/fasting-triggers-stem-cell-regene...
Seems like it might not be harmful at least.
Here's the article that I believe was at some point on HN, which I was referencing in my first comment. The guy could totally be a quack, but like I said it seems plausible enough that I'd give it a try along with everything else if it wasn't declared harmful by my doctor.
http://thequantifiedbody.net/water-fasts-as-a-potential-tact...
https://news.usc.edu/63669/fasting-triggers-stem-cell-regene...
Science!
Yes. Bullshit deserves to be downvoted and flagged. Every time someone discloses they have or possibly have cancer people come out of the woodwork pushing total bollocks.
"You got cancer because you're stressed"; "you can cure cancer with fasting"; "you can cure cancer by not eating sugar"; "you can cure cancer with this particular herb or spice"; "you can cure cancer with medidation and exercise".
It's fucking disgusting and I proudly downvote and flag this bullshit.
See also John Diamond's books about the things people said to him when he disclosed his cancer.
You say fiance; if you are not actually married her plan may not cover you? Unless they cover "domestic partners" not actually married (some will, some won't).
Anyway, manage the insurance situation. This sort of thing (unexpected, and potentially costly) is EXACTLY what insurance is for. Much more so than birth control or annual checkups which are entirely predictable expenses. Don't feel guilty about using it for what it's meant for.
Take the job, it will keep your mind busy on something besides your health. You're not contagious; you are not endangering anyone by going to work.
Ask me how I know.
If you get shafted by your employer during maternity and they pull coverage early, and give you misinformation re: COBRA timing, and it's not an open enrollment window with the state exchange, even if you can convince the state exchange to let you in before the next open enrollment period, the soonest they might do that is at the end of the month.
And if you have any ongoing treatment issues, the temporary/indemnity insurance you'll have to buy won't cover any preexisting conditions.
TL;DR–if you get left in a lurch, you're still stuck on temporary insurance which won't cover preexisting conditions.
As for the insurance, could someone explain this to me. I thought that with ACA (Obama Care) the pre existing condition was not enforceable anymore an you could get a private insurance based on your age, income, etc, not medical history. Am I wrong about that? If that's not the case, than what's the point of all this ACA nonsense to begin with. I thought that forcing me and other people to buy insurance was exactly so someone like the OP wouldn't be left out in the cold when they really need the help. Am I missing something.
Also, if pre existing conditions do not matter any more, how can the insurance company raise the premiums for the company the OP would be working for. It doesn't make much sense to me. In any case, take care of your self first and foremost.
You do, but not for the reason you think. If you have a coverage gap of more than three months you'll see a fine added to your income tax at the end of the year, which for most people on HN would be 1% of household income above the filing threshold[1]
[1]: http://www.irs.gov/Affordable-Care-Act/Individuals-and-Famil...
Being sick won't keep you from getting coverage
Your insurance company can't turn you down or charge you more because of your pre-existing health or medical condition like asthma, back pain, diabetes, or cancer. Once you have insurance, they can't refuse to cover treatment for your pre-existing condition.
This is true even if you’ve been turned down or refused coverage due to a pre-existing condition in the past.
Medicaid and the Children's Health Insurance Program (CHIP) also can't refuse to cover you or charge you more because of your pre-existing condition.
When you get care for a pre-existing condition, you’ll still need to pay any deductibles, copayments, and coinsurance your plan requires. It doesn’t matter whether you’re being treated for a pre-existing or new health condition.
One exception: Grandfathered plans
The only exception to the pre-existing coverage rule is for grandfathered individual health insurance plans -- the kind you buy yourself, not through an employer. They don’t have to cover pre-existing conditions.
If you have one of these plans you can switch to a Marketplace plan that covers pre-existing conditions.
You can do this during open enrollment, but be sure to contact your insurance company first to learn about how and when you can cancel your current plan. You can also buy a Marketplace plan outside open enrollment when your grandfathered plan year ends. Your plan ending gives you a Special Enrollment Period to enroll in different coverage."
From https://www.healthcare.gov/health-care-law-protections/pre-e...
Second, if you do get bad news, don't change anything. Be honest with your employer, and go on with your life. At your age, chances are you'll be able to continue working through the treatment and long after that. It's unlikely that your company's premiums will go up, but that shouldn't concern you.
Third, if you do get bad news, ask the doctor for a professional to talk to. At your age, you need some guidance and perspective from someone you trust.
Take the job and follow the treatment regime.
You will beat it, too.
Which is probably why cancer survival when it can be surgically removed is fairly good, but incredibly poor in general when it can't and must be treated by medicine.
I don't know if Burzynski has something better, but I have seen the documentary and researched the background. It is clearly not a case of the FDA trying to stop bad medicine. He has been in trouble mostly due to protocol and a clandestine attempt to take his patents. He has been in court many times, and won every case, and never was he in court due to damage to clients, it was always about some break of protocol, such as how medicine is delivered across state lines etc.
Anyway, in general you aren't allowed to even try Burzynski's medicine until all FDA approved medicines have already been tried. Only then can you apply to be part of the FDA trial for his medicine.
I should note that I haven't actually signed up for insurance at my new employer yet, as that's typically done after the first day. And my old employers' coverage ends on the 31st. I'm going to check out Cobra to tide me over. Does anyone have an opinion on the prospect of sticking with Cobra and perhaps asking my new employer to help out with the premium versus being on their health insurance? If I did need to eventually transfer to their insurance I think new Healthcare Laws would mean I couldn't be denied coverage due to pre-existing condition. I'll do some digging.
And btw fiancé has been helping from the beginning and we are dealing with this together -- she's a keeper.
There will be a gap between quitting and getting the paperwork and mailing in your premium. They will reactivate your old insurance retroactive but that's something to be aware of.
If your new employer doesn't offer health care, go buy some: switching jobs is a "qualifying life event" and lets you buy outside the yearly sign-up window.
If they do offer health care, then you're set. Wait for that. This one-week gap isn't going to mean anything or change anything.
Just don't do COBRA as an alternative to the employer's group plan.
Staying on COBRA would likely suck, even if your new employer kicked in something to cover it. COBRA can be remarkably expensive, and anything extra the new company paid you would also be taxable income in ways that employer subsidized plans wouldn't along with being awkward if you later signed up ("Lump, we're cutting your pay since you're getting onto our insurance now.").
I'll note that once the ACA plans became available, coverage for my wife and I (on a pretty good Gold plan with no subsidy) was somewhere around 60% of the cost of COBRA for the two of us from her previous job - and the ACA plan wasn't an HMO or anything like that, it was a standard PPO with a decent network.
Delaying a change to the new employer's plan would likely not fly - much like the exchanges, you have two times you're eligible to sign up: during the open enrollment period, and after qualifying events such as a change of employment or marriage. If you bypass the new employer's plan, you're stuck until (most likely) January, 2016 after an open enrollment period in November/December.
What signs/symptoms prompted you to seek further help?
Get a biopsy. Getting cut open sucks, but until they take a tissue sample, they really can only guess. Get it as soon as possible.
If you decide to take 'normal' western treatments (chemo/radiation), before you start, bank sperm or eggs, depending on your sex. I had a difficult time beating mine, and the chemos I eventually took left me sterile.
If you are an American, get in contact with the American Cancer Society. I can't say enough good things about this organization. They should be able to help with financial options for you, as well as alternative therapies and medical trials. If you qualify for some of the trials, the cost may be reduced.
If you decide to go with chemo, it affects different people differently. I personally had 5 different types, with effects ranging from nauseous for a couple of days to unable to move. You may be able to work through it, you may not. But your co-employees will generally have nothing but empathy for you.
Don't delay treatments. The success rate only goes down with time.
I'd file this under good advice OP, regardless of where your head is at right now.
> Don't delay treatments. The success rate only goes down with time.
No kidding!
> Steve Jobs died regretting that he had spent so long attempting to treat his cancer with alternative medicine before agreeing to undergo surgery, his biographer has disclosed.