Hacker News new | past | comments | ask | show | jobs | submit login
Is early-onset cancer an emerging global epidemic? (nature.com)
227 points by v4dok on Sept 9, 2022 | hide | past | favorite | 255 comments



> "However, the effects of individual exposures remain largely unknown. To study early-life exposures and their implications for multiple cancer types will require prospective cohort studies with dedicated biobanking and data collection technologies."

What that means is analytical body-burden data collection should be a medical norm, for a variety of substances: polychlorinated biphenyls, triazine herbicides (atrazine), industrial solvents like trichloroethylene, brominated fire retardants, nitrosoamines, plastic-sourced phthalates, perchlorates, hydrazine, hexavalent chromium and so on.

Collecting such individual data via blood & urine samples (possibly fat biopsies & breast milk as well) on a yearly basis should really be part of a standard medical checkup procedure. That would provide a dataset which could be used to address that question.

This is hardly a new proposal, for example see this 2001 PBS report, in which journalist Bill Moyers got his body burden test results:

https://www.pbs.org/tradesecrets/problem/bodyburden.html

The results are not unusual. Each of us has some load of industrial chemicals stored in or passing through our bodies. These chemical residues – termed the "chemical body burden" – can be detected in blood, urine and breast milk.


Contaminated ground water around military bases from the use of fire extinguishing foams.

https://www.ewg.org/interactive-maps/2020-military-pfas-site...


Also a lot of contamination due to jet fuel leaks in and around US military bases.


Even Nature stated microplastics are everywhere, yet we do not know what effects it will have.

https://www.nature.com/articles/d41586-021-01143-3


What do you mean, "even Nature"? They have no incentive to downplay the omnipresence of microplastics


I understand it as "not only alarmist sources but also a reputable journal".


Don't hold your breath. One example:

Coronary calcium deposit scans are cheap and extremely effective at giving a probabilistic window of possible future heart attack, but doctors don't order them prior to a CVD event, and insurance doesn't cover them as a pre-CVD elective.

Instead we're told: We have no way of knowing if or when you'll experience infarction, it's one of God's Great Mysteries. Just don't eat eggs and pray.

You're absolutely right, but the entire medical industry has no intention of actually reducing mortality. It's a cash grab from top to bottom, and preventative monitoring of the kind you suggest already has precedent in coronary calcium scanning. It's not going to happen if it reduces the overall predicted revenue per patient.

In the same way that a single triple-bypass surgery is far more lucrative than a hundred coronary calcium scans, a full course of cancer treatment is absurdly more profitable than regular tissue carcinogen testing.


I would take a citation on literally any single one of your statements


If they’re cheap and you’re concerned couldn’t you just get one out of pocket ?


“Just don't eat eggs and pray.”

If you avoid smoking, have a healthy diet, get adequate exercise and consequently maintain a healthy weight you’ll do far more to prognosticate your MI risk than a calcium score.


Is this even worth doing when people are still smoking, drinking alcohol, living in polluted areas and eating red meat? These are all known risk factors with large effects on cancer risk in younger people.

I think the effort is better spent as follows:

- ban sale of combustible tobacco products

- ban advertising of alcoholic beverages


> still smoking, drinking alcohol, living in polluted areas and eating red meat

One of these is not like the others. I can decide to not smoke, not drink alcohol and not eat red meat. It is a personal choice, and my choice doesn’t affect the health outcomes of those around me. (Mostly. Second hand smoke is a thing, but we did a lot society wise to act against that.)

On the other hand living in poluted areas is absolutely an economy thing. People don’t live in polluted places because they love the sweet buzz it gives them. They live there because by far and large that is the place they can afford to live at. And these areas are not polluted because god made them so. They are mostly polluted because industry or transportation polluted them.

In other words rich people polluting poor people. (By and large.)

I find it very interesting that you choose to ignore the one cause people can’t do anything on their own, and choose to formulate policy proposals against the ones they can.


Well people can certainly move to some extent. Nobody with functional brain considers metropoles to be healthy place to live. People stay there mostly for the money, I know I do and I accept the risks (and working on improving the situation).

Moving to mountainous/overall remote regions is relatively cheap. But people like easy life, close work, shopping, services and so on.

World is certainly not as binary as you paint it


Most people don't even think about the impact where they live has in their health


In fact, all these things have socioeconomic determinants.

Air pollution has a relatively small effect compared to the others.


Smoking and alcohol are unfortunately too convenient as coping mechanisms go. A stimulant-anxiolytic to keep you going through a shift, and a sedative to slow down and stay numb. And they (nicotine especially) feel just too effective—at the start before you build up dependence at least.

Lifestyle modification can only go so far when the stress of living remains high. Swap the burnt stuff with something that puts less tar in your lungs, maybe, but any further is… sigh.


Air pollution is in fact a big impact to shorter lifespans and many health issues.

There's also a post on HN yesterday about research into air pollution from pm2.5 particles triggering cancer.


has smoking, drinking, and eating red meat gone up in the past several decades? because, according to the first sentence of the abstract early onset cancers have gone up in the past several decades.


I think his point by was that instead of chasing the cause of the recent uptick, it would be better to focus on the known causes


PFOS in the environment has gone up in the past several decades.



In a practical sense, if you do not track something, you have no way of knowing whether it has an impact and whether it outweighs currently known carcinogens. And why immediately go after something people actually willingly put in their bodies as opposed to something that ends up there... somehow?


It would be nice to have this information to see if any trends are discovered (all of this is theoretical, I question whether measuring excreted compounds rather than stores is is relevant but that’s a separate point) however it is unclear what value this information will provide and seems unlikely it will generate anything actionable.

With that in mind, it’s hard to justify the colossal costs that would be involved in administering such a program. Young (< 50) healthy adults shouldn’t even really be getting annual checkups (in my professional opinion and per several guidelines) and annual blood work is definitely not indicated.

Annual urinalysis is not indicated as part of the general work up for patients of any age, so this would be adding a whole extra step in specimen collection and not just adding on a test.

Healthcare is generally a zero sum game and if we divert $ and lab resources to something like this that means other tests and procedures are not being done.

A small prospective study as the authors suggest would be interesting, yet still expensive. It’s a huge stretch to say everyone should be getting this and ignores the harm that this would cause.


Hmm, you could use that argument to dissuade all of scientific research. Science is zero sum, if we devote resources to it then you are taking them from someone else!

But at the end of the day we all know there are significant potential benefits to this type of testing. Not only that, more demand can increase jobs & labs in the first place.

Just because the system is dysfunctional is not a good argument for ceasing progress.


Suggesting we perform niche lab examinations annually on the entire population is not scientific research, that’s jumping straight into a screening program.

Such an initiative would require more lab resources than currently exists in the US.

I’m questioning whether this is the best use of $100-200 billion a year. Instead, I suggested a small study (appropriately powered) to further investigate.


> But at the end of the day we all know there are significant potential benefits to this type of testing. Not only that, more demand can increase jobs & labs in the first place.

But at the end of the day we all know there are significant potential benefits to [testing cars every year]. Not only that, more demand can increase jobs [in testing centres] in the first place.

The question isn’t whether there are benefits. It’s whether the benefits exceed the costs. You need to actually measure those to find out. You can’t just assume it. Jobs in testing centres and labs are not a benefit. If they are doing useless work they don’t just cost money. They cost the potential output from the jobs those people could have done instead. The TSA doesn’t just massively inconvenience millions every year to almost zero benefit. It also wastes the labor of tens of thousands of people who could have done something better and more useful with their lives.


> Young (< 50) healthy adults shouldn’t even really be getting annual checkups (in my professional opinion and per several guidelines)

How does letting people have undiagnosed cancer in their 30s and 40s fit in with this?


The reason is that many medical tests have high false positive rates, and the follow procedures have side effects (sometimes). When you administer tests and followups at population scale for a disease with a low prior probability you will do more harm than good, on the average.


An annual physical exam isn’t really powered to detect cancer in the modern world, it’s a relic from the past.

If you develop cancer in your 30s (sadly too many people) a physical exam or blood test almost certainly wouldn’t have made the difference.

We have mammograms for breast cancer and women > 40. Unfortunately there isn’t enough evidence to support a screening program for people younger than that where the pretest probability for malignancy is so low and there are harms associated with tests.


> Young (< 50) healthy adults shouldn’t even really be getting annual checkups (in my professional opinion and per several guidelines) and annual blood work is definitely not indicated.

Tell this to my mom.


I am sorry for whatever happened/happens to your mom. That being said, when looking at cold hard data, this is a valid point.

We all have various weird stuff in us, the older the more. Cystes, weird bulges, benign cancers that wont kill us for 50 years. If you are a male say above 40 or 50, you probably have some very early (or not) prostate cancer.

Often you need an invasive procedure to get more info. Even then its quite often not 100% clear if surgery is overall safer and better than keeping and monitoring.

We like this idea of omnipotent medicine but its a pipe dream. Difficult procedures are extremely expensive regardless of location (US stands apart as always but still a valid point), and even ignoring price there simply isnt enough staff/equipment. Covid and often selfish clueless people certainly didnt help.

Medicine tries to fix as much as it can, which is mostly not enough. The hard part is accepting that when it becomes about a close one. There is no easy solution.

Source: wife is an emergency/gp doctor, went through this countless times. And much worse, even smart people become completely irrational, cruel or selfish very easily in such situations.


I interpreted the comment to mean, "my mom always reminds me to go get a checkup that I don't need."


LOL yes this is what I meant!


>I question whether measuring excreted compounds rather than stores is relevant

I would have to figure that chemicals sitting in fat cells that rarely divide are probably not causing cancer. Cancer occurs mostly in epithelial tissue; in my case, the germ cell. Excreted compounds are probably a better measure of actual blood levels. I'm not a nephrologist or anything, though.

>A small prospective study

will almost certainly find nothing, because the rate of early-onset cancer is too low to detect changes in a small population. You probably need >100k participants to have a good chance of finding anything.

>it is unclear what value this information will provide

I mean, that's the billion-dollar question, isn't it? Should probably try to control for obesity first, it's the most obvious candidate (changes since 1990, so not, e.g., smoking), but it certainly wasn't my problem (BMI 21).


A billion dollars is not enough for what’s being proposed here.


> Young (< 50) healthy adults shouldn’t even really be getting annual checkups (in my professional opinion and per several guidelines) and annual blood work is definitely not indicated.

Remind me to never use you as a medical provider.



> Collecting such individual data via blood & urine samples (possibly fat biopsies & breast milk as well) on a yearly basis should really be part of a standard medical checkup procedure

No so long as sickness is so profitable. The incentives aren't there like you would think.


It's not so much that sickness is profitable as the abject laziness and refusal to properly dispose of chemical byproducts in industry, as that costs money which hurts the bottom line. This is absolutely rampant worldwide and governments are corruptly influenced to look the other way to more or less degree depending on the country you are in.


What about in every western country where it isn't profitable?


I disagree with the comment you are replying to, but I also disagree with yours too.

Healthcare is crazy profitable. Insurance companies, healthcare providers, suppliers etc form a decent chunk of most western economies, the US of A in particular.


I'm specifically not talking about the states, and talking about countries with public health care.


~40% of is spent on “External service providers” out of ~$2B budget by my local public health board. So there is leeway for private profit in public health in my country at least. https://www.cdhb.health.nz/wp-content/uploads/d682178a-cante... See page 79 of PDF or page 71 printed (note about ~50% of budget is for personnel)


Invasive biopsies in common medical screening? Yeah, that just isn't gonna happen. Nobody is going to test for any of those chemicals either due to the huge cost and questionable benefit.


>> Increased use of screening programmes has contributed to this phenomenon to a certain extent, although a genuine increase in the incidence of early-onset forms of several cancer types also seems to have emerged.

How do they separate these two. Early testing is becoming more common so you expect to see more cancer simply due to looking for it.

Doc: Early screening has increased the 5-year survival rate for various cancers.

Patient: Of course it has, but will I live any longer?


Early-stage cancer survivorship rates are much higher, and early detection catches cancers at an earlier stage. Studies have been done that show the benefit of early screening, separate from the bias.


Do those studies account for the (emotional and monetary) cost of false positives from those early detection?


I don't think monetary cost was accounted for, and I assume by emotional cost you don't mean the hits to someone's health due to emotions (which are accounted for). It's really hard to get diagnosed with a cancer, but early detection is very helpful for improving outcomes.

In the US (in particular), there is a lot more monetary cost to someone's late-stage cancer treatment, and then eventual death, than there is to early-stage cancer treatment, so I would assume that early screening tests are monetarily net beneficial based on the reduction in cancer deaths.


The only cancer routinely screened for in people under 50 is cervical cancer. Even then, the test detects precancerous lesions mainly. As such, ascertainment bias is not a major methodological concern.


Ok. Overall, though, there aren't a lot of cancer screenings otherwise either. You might get a colonoscopy, but you probably aren't checking for bone cancer either.

But you would probably get an MRI of your brain if you were having headaches. An ultrasound to check for gallstones, a CT scan to see if that's your appendix that is hurting. And we are getting way more scans than we used to. A lot of tumors are found as a result of modern imaging technology. More are found by self-examination: We know to watch moles and to do breast or testicular exams at home, for example.

When we find precancerous stuff, we can often keep an eye on it and/or do something about it, hopefully before it gets out of hand.


Lots of cancers are screened in younger people outside of routine: melanoma, colon cancer, breast cancer, etc. are all things that doctors will test for if a person has certain signs (like a suspicious mole or rectal polyps).


That isn’t screening though, which by definition occurs in people without symptoms or signs. It is true that better access to healthcare or higher health literacy or more scans being done for other reasons will increase the early detection rate of cancers in younger people. But this almost certainly doesn’t explain the increasing incidence as the article talks about.


Colon cancer guidelines have changed screenings to 45.


Yes, but that’s recent and after most of the data in the article was collected.


You should be able to see the 'real' increase from death rates, assuming the cause of death is correctly identified as cancer pre or post mortem.


Cancer death rates are going down [1], which to me means we are probably better at treating cancer but also probably finding it more often even when not life threatening and might have gone on unnoticed in an earlier time.

Also we are getting better at treating other diseases and living longer, leading to being more likely to get cancer since if you live long enough you will almost certainly get some form of it.

1. https://www.cdc.gov/cancer/dcpc/research/update-on-cancer-de...


It's slow progress, but we can dream of a day where getting a cancer diagnosis is not a death sentence, but rather something like HIV. Not really curable, but with the right treatment, you can live a fairly normal life. You die with cancer, but not of cancer.


This is the reason most medical studies look at all cause mortality. Cause of death reporting is prone to all kinds of medical judgement and human error that cause reporting specific causes of death to be problematic.


I feel like there has been a great increase in mental health issues: anxiety, depression, etc., especially among youth. I don’t recall these being major issues from when I was a youth in the late 80s and early 90s. I’m told that I’m wrong and people just didn’t talk about it so I wasn’t aware of it. But even amongst close family members and friends it wasn’t a thing. Now, I’ve seen some claim it is the post 9/11 world or social media, but I have to wonder if there is some chemical we are exposed to more that might be causing mental disorders in addition to early onset cancers.


> but I have to wonder if there is some chemical we are exposed to more that might be causing mental disorders in addition to early onset cancers.

It's always easy to point the finger at a single cause, but the reality is that it's a series of factors that together act like a sophisticated, compound "attack" to the psyche:

- Social media weakens your self-confidence and makes you feel in a constant state of inferiority, i.e. your present self.

- The "post 9/11 world" you mention, is simply a result of a general worsening of Western political relations over time, which are becoming especially evident recently. That state of turmoil weakens your sense of stability and security, making the future look bleak - i.e. your future self.

- Further blows for the knockout: climate change, pollution / micro-plastics / rising costs of living, etc.

I'm actually surprised depression, anxiety and other mental disorders aren't more common...but perhaps they will be.


Excluding the microplastics thing, I think that your two latter points are actually both derived from the social media changes.

Life today for almost everyone in the West is better than ever before, but people are exposed to a lot of thought on social media that 1. life is worse now, 2. in your lifetime there will be terrible destruction happening, which contributes to a sense of fatalism and doom.

It is super appealing to the human psyche to think things are worse in [current-time period] than in the past. This is why there is an intuitive appeal to things like "Make America Great Again." Social media only amplifies this effect because people are exposed to things that are maximally appealing to their psyche.


> Life today for almost everyone in the West is better than ever before,

I'm 60. You've just got to be joking.

When minimum wage was $3.30, a one-bedroom apartment cost $285. Now the same apartment is well over $2000.

My university tuition averaged about $1200 a year - that was about 10 35-hour weeks at minimum wage. But I got small scholarships that paid for it. My girlfriend worked in a sub shop two nights a week and had a summer job. No one went into debt.

One working parent could support a stay-at-home parent and pay off a mortgage.

Or you could work part-time and have a modest life and pursue your dream.

People just walked into career jobs right out of university.

Listening to young people today, unless they're in one of a small number of very much in demand fields, the idea of stability, steady advancement, or buying a home seem impossible.


Life today is better if you're already established, i.e. have a well paying job, own a home, etc.

Being young in todays world is exponentially harder than it was, say, 40 years ago. Many young people have given up on the idea of home ownership. I'm 26 and I've had friends laugh in my face when I suggested owning instead of renting. It's simply unattainable unless you're in a lucrative field. I'm in Canada for reference (our home price to income ratio is one of the worst in the world).


I think you are just falling to this same nostalgia bias.

In terms of the material abundance that one experiences today, it is just on a different level from 40 years ago.

Housing ownership is also not the be all end all. And while the prices are higher, the rates are lower so that you will not be paying a greater proportion of your income on housing.

Compare to 40 years ago: https://fred.stlouisfed.org/series/MDSP

To look at housing and say that the high price of homes negates all quality of life improvements in the last 40 years seems wrong to me.


> - The "post 9/11 world" you mention, is simply a result of a general worsening of Western political relations over time, which are becoming especially evident recently. That state of turmoil weakens your sense of stability and security, making the future look bleak - i.e. your future self.

The relations have not simply become worse, they have been very deliberately driven to be worse:

https://www.tabletmag.com/sections/news/articles/media-great...

Just look at these hockey sticks. People talk about divisive rhetoric, but hot damn.


I don't remember hearing much about anxiety or depression, but do remember hearing about things like alcoholism, domestic violence, and 'laziness.' I'm pretty sure these are largely the same psychological issues- it's just people used to hide it, and deny it even to themselves- so you would only see the resulting dysfunction. Nowadays people are getting a diagnosis and treatment rather than just silently suffering and hiding it.


It's frustrating to see how many people don't understand this. To say mental health issues didn't exist until we started diagnosing and treating them is like saying oil didn't exist until we started drilling for it.


But I also think "back in the days" life was more fixed. Probably getting a full time job as employee, starting a family, getting a house was not really optional. Now there are much more choices. Add to that all the hyper-connectivity. I don't really think people were better off but were just forced to handle everything more calmly. Growing up in the 90s, what I've found is that things changed a lot when people were starting their jobs.


Not to mention living in America is like playing life on hard mode; at least relative to other OECD countries. There's a lot more things you have to take care of / think about in America. There's a level of mental overhead that does not exist in other developed countries that many Americans do not realize are optional. eg health insurance, education, unemployment safety net, or even little things like way too many coverage options when buying car insurance.

When you do not have to worry about your health or physical safety if you lose your job, you can chill out a little bit. You don't need to bend over backwards for your job, it is easier to enforce boundaries. This dynamic puts adult Americans under a lot of stress, and it manifests in many ways. And it propagates to the children too, through lack of attention or stressful home.


There's a level of mental overhead that does not exist in other developed countries that many Americans do not realize are optional. eg health insurance, education, unemployment safety net, or even little things like way too many coverage options when buying car insurance.

I occasionally try to stress how these things seriously improve living standards. Just health insurance itself does a great deal to eliminate stress. I can go and get a weird mole checked out. I can get an MRI when I've been having headaches to make sure it isn't cancer. I can get the spot on my pancreas scanned every 6-12 months to make sure it doesn't do weird stuff. All for less out of pocket than $300 per year and my taxes are less than state + federal + premiums.


It’s hard mode if you’re poor and easy mode if you’re rich. For the top 1-2 deciles I think most of these things are much better in the US than other countries. I’m a long time proponent of universal healthcare, but I’ve heard terrible experiences in Canada and the UK in getting relatively basic treatment in a timely manner.

I think a lot of HN doesn’t understand that all the shitty things about the US that people from other countries love to rag on basically don’t apply to many people in the US. If you have a job that is in demand you will not need to worry any more about these things than if you live in another developed country. Especially in American corporate culture, sure people are worried about their mortgage and some do live paycheck to paycheck, but the culture of excessive work in places like tech or finance is not generally about getting thrown out to the streets with cancer.


You're right and wrong. You are right that it is hard if you are poor and easy if you are rich. But you are wrong that HN or people outside of the US do not understand that it is only hard for poor people. It's just that external to the US, people care about the welfare of poor people more. The fact that you felt it necessary to state that caveat illustrates how systemic problems which victimize poor people can be excused and remain unchanged in the US.

For context I've lived for decades in both Australia and the US. Pros and cons in both cultures, and I love both.


I brought it up more to illustrate that the work culture of the US is not just a result of precarious financial situations due to lack of a safety net.


I would agree that it's not entirely the result of precarious financial situations. But even in tech and other high paying sectors, I would argue it still plays a factor, even if it is unconscious. Golden handcuffs are in part evident of this. Everyone in America wants to make enough money they can retire comfortably. Which is an entirely rational thing to want to do. But other countries do have higher paying pensions, so the fear of retiring destitute is less.

Also keep in mind employer expectations are a market just like any other. You as an employee compete against others willing to go lower. If you have a portion of the population in precarious financial situations, that will still impact you somewhat as they compete for jobs indirectly with you.


> Not to mention living in America is like playing life on hard mode;

Do you have any idea what living in third (or even second) world countries is like?

> at least relative to other OECD countries.

Such as Turkey? Or Mexico? Why do you think Mexicans escape to the US? Because their life was too easy and they wanted to have more of a challenge?


I explicitly wasn't talking about second and third world countries, so your comment is mostly moot. I don't know about you, but I prefer we compete with our peers on quality of life rather than the tiers below. We should strive to be the best, not just better than the worst.

> Such as Turkey? Or Mexico? Why do you think Mexicans escape to the US? Because their life was too easy and they wanted to have more of a challenge?

They come the US because the quality live in the US is superior ... I didn't say it wasn't.


Puberty coming on ever earlier is my pet theory for what's causing this.

It might come in a way that's uneven. An adult set of sexual characteristics and drives without the corresponding development in executive function must be difficult.

Add to that the sudden arrival of sexual characteristics and attention at an age where our culture has no scripts and rituals with which to handle them. Kids must feel like adrift aliens, within the world and within their own bodies.


More likely it’s the endocrine disruptor chemicals in the environment that are causing earlier puberty AND increased cancer rates.


What about constant stimuli fighting for our attention by exploiting our lizard-brain emotions every waking hour?


We know for a fact that social media causes these issues, thanks to the leaking of internal Facebook documents to the WSJ[1]. Whether or not it's the only source of the rise of mental illness isn't clear, but it's a huge factor for sure.

[1] https://www.wsj.com/articles/the-facebook-files-11631713039


Yeah, especially young people do have it bad. One interesting thing is that as society becomes more and more feminist, it's the young women who fare the worst, and especially the demographics most likely to be intersectional activists.

Maybe not all ideologies are good for us? At a quick glance, a lot of the intersectional feminist/activist modes of thought seem to be the polar opposites of what eg. cognitive behavioral therapy and the stoicism it's inspired by advocate (eg. others are responsible for your emotional reactions/state, so to control your mood you have to control others vs. you are responsible for and in control of your own emotional reactions and mental state and you can improve your mood by honing yourself).

We know CBT is effective for getting rid of dysfunctional thought patterns and lessening mental health symptoms. In that light, these numbers seem unfortunate but entirely predictable.

https://i.imgur.com/uRX0A9u.png


CBT is not effective for lessening mental health symptoms. See e.g. https://doi.org/10.1192/bjp.bp.116.187773

>the difference between CBT and pill placebo was a standardised mean difference of –0.22

The effect measured in this meta-analysis is a less than two point drop on a 52 point scale (Hamilton Rating Scale for Depression). That is not clinically significant.


From the study you linked:

> Our study has limitations. First, detection of an interaction effect requires a large sample size. The present findings require replication with a larger sample of trials designed to test the interaction. The trials from which the data were extracted were not designed to test this hypothesis, but do provide a ‘first look’ into this question using all available data. Given the wide confidence interval around zero for the interaction coefficient in the present study, it is possible that our finding represents a type II error. Although none of the sensitivity analyses were suggestive of possible interaction effects, future studies may nonetheless still reveal an interaction that we failed to detect in the data available to us...

I'd be very cautious about saying "CBT is not effective for lessening mental health symptoms" due to a single study. From the American Psychological Association [1]:

> Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.

From the NHS [2]:

> Cognitive behavioural therapy (CBT) can be as effective as medicine in treating some mental health problems, but it may not be successful or suitable for everyone.

From the Cleveland Clinic [3]:

> Cognitive behavioral therapy (CBT) is a structured, goal-oriented type of psychotherapy (talk therapy). Mental health professionals, including psychologists, therapists and counselors, use it to treat or manage mental health conditions and emotional concerns. It’s one of the most common and best-studied forms of psychotherapy.

I'm not at all suggesting that we blindly trust those organizations, rather just cautioning saying it is no more effective than a pill placebo due to one study.

A different study that reviewed meta-analyses came to quite a different conclusion [4]:

> In our review of meta-analyses, CBT tailored to children showed robust support for treating internalizing disorders, with benefits outweighing pharmacological approaches in mood and anxiety symptoms. The evidence was more mixed for externalizing disorders, chronic pain, or problems following abuse. Moreover, there remains a need for a greater number of high-quality trials in demographically diverse samples. Similarly, CBT was moderately efficacious for the treatment of emotional symptoms in the elderly, but no conclusions about long-term outcomes of CBT or combination therapies consisting of CBT, and medication could be made.

>

> Finally, our review identified 11 studies that compared response rates between CBT and other treatments or control conditions. In 7 of these reviews, CBT showed higher response rates than the comparison conditions, and in only one review (Leichsenring & Leibig, 2003), which was conducted by authors with a psychodynamic orientation, reported that CBT had lower response rates than comparison treatments.

>

> In sum, our review of meta-analytic studies examining the efficacy of CBT demonstrated that this treatment has been used for a wide range of psychological problems. In general, the evidence-base of CBT is very strong, and especially for treating anxiety disorders. However, despite the enormous literature base, there is still a clear need for high-quality studies examining the efficacy of CBT. Furthermore, the efficacy of CBT is questionable for some problems, which suggests that further improvements in CBT strategies are still needed. In addition, many of the meta-analytic studies included studies with small sample sizes or inadequate control groups. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on particular subgroups, such as ethnic minorities and low income samples.

>

> Despite these weaknesses in some areas, it is clear that the evidence-base of CBT is enormous. Given the high cost-effectiveness of the intervention, it is surprising that many countries, including many developed nations, have not yet adopted CBT as the first-line intervention for mental disorders. A notable exception is the Improving Access to Psychological Therapies initiative by the National Health Commissioning in the United Kingdom (Rachman & Wilson, 2008). We believe that it is time that others follow suit.

1. https://www.apa.org/ptsd-guideline/patients-and-families/cog...

2. https://www.nhs.uk/mental-health/talking-therapies-medicine-...

3. https://my.clevelandclinic.org/health/treatments/21208-cogni...

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/

edit: formatting


>rather just cautioning saying it is no more effective than a pill placebo due to one study.

It is not one study, it is a meta-analysis.

The quotes from the meta-analysis you mention do not show mention anything concrete; there are words and phrases like "robust", "evidence-base is very strong", "higher response rate". They barely tell you anything. One needs to see the numbers, not the researchers interpretation of them.


Interesting. Will take a look, thanks.


> At a quick glance, a lot of the intersectional feminist/activist modes of thought seem to be the polar opposites of what eg. cognitive behavioral therapy

What a non sequitur. Why would feminism and stoicism have any incompatibilities?


For me, they're absolutely complementary. If I'm the only thing I can really control, how can I do so without the right to make my own decisions beyond whether or not to accept a marriage proposal? Before feminism, married women were legally children, at least in the parts of the world I've lived in (US and Germany). In the state I live in, Bavaria, my husband could have prevented me from getting a driver's license or working up until about 1970.

A woman fighting against feminism is a woman fighting against responsibility for herself.


I literally gave one example in the post you quoted. The intersectional types are vehemently against owning your emotional responses in the way stoicism advocates, and instead actively encourage finding more and more ever more minute things that might be rationalized to be a slight against themselves. On a deeper level, stoicism acknowledges and is built on the idea that not everything in the world is changeable, while the intersectional mode of thought is exactly the opposite.


Oh, I guess to be honest I thought your example was so stupid I didn't feel the need to respond. Now that you reply this way, I admit maybe I am just totally confused as to what you mean.

Why would there be any conflict between "I should try to not let shit get to me" and "Also, I should campaign for there to be less shit around to get to me"?

Those are just two different ways to deal with having shit, and one in no way impedes the other.

Am I misunderstanding your claim?

> The intersectional types are vehemently against owning your emotional responses in the way stoicism advocates


Activisim is a more masculine way of thinking. Stoicism more feminine. As society changes these different modes of thinking get more and more mixed up and seperated from preassigned roles. That could be quite a positive thing. I think we benefit from both. Sometimes passion and anger is needed to change your life and the situation. And sometimes you need to just accept the world as it is. And in something like race/sexism we need a little bit of both. Prejudice is bad, but not all prejudiced people are bad. We should be able to identify it, address it and move on without it being a big taboo that gets people in lots of trouble.


Uh, have you looked at the demographics of intersectional activists and of people preaching stoicism lately?


Stoicism makes no sense in that case? How can you own your emotions if you are unchangeable? A stoic would consider the world as perfect as it is if it is unchangeable. Everyone is a stoic in that case, including the intersectionist types


1. Toxic social media

2. Toxic mass media

3. Devisive, polarizing politicians

4. Being constantly threatened with nuclear death from a madman half a world away

Humans have to be able to visualize a better tomorrow to be propelled toward it. Do you see a better tomorrow? Maybe people are depressed and anxious because deep down, in the recesses of our collective consciousness, we already know how all of this ends.


This is easily solved: quit social media (it does nothing for you, it’s just a massive advertising machine), and quit the news (why worry about things you have no influence over?)


Perhaps knowing that we aren't going to do anything significant about the climate crisis, and thus devastate our environment and the carrying capacity of the planet, might be what's making them a bit touchy.


The smartphone era directly seems to coincide with elevated mental health problems.

I think porn and social media are responsible. Those two things, heavily changing neurotransmitter and hormone patterns, are significantly amplified when everyone has a smartphone.


I think video games, TV, rock’n’roll music and the bicycle are responsible.


I think bicycles are only responsible for the drop in birthdate. All that rattling around is damaging women’s reproductive facilities!


There seems to be an empty space that people rush to fill with a newest iPhone and installing FB and Instagram instantly, I guess in 90s you would use McDonalds for that


If we're going to throw out random theories for the cause like diet and pollution, what about all the volatile chemicals off-gassing from freshly manufactured goods?


Getting an air quality monitor was enlightening and terrifying. My child’s room (which unfortunately doesn’t have great ventilation) would sometimes hit 4000 ppb VOCs, which I tracked down to some of her stuffed animals…


Ventilation got worse in the 70s as there was a big push to eliminate leaks in houses to improve HVAC efficiency.


Still not sure how post-Covid, we haven't concluded that improving indoor ventilation should be a massive public health priority.


Seems like there'd be a lot of tension between that goal, and reducing energy use.


It's not 100% solvable, but it's possible to recover a lot of the thermal energy of the air you exhaust and put back into the air you're intaking: https://en.wikipedia.org/wiki/Energy_recovery_ventilation


Because it's difficult. How do you solve for this problem in a house without internal ducting in temperature extremes throughout the year?


I'm curious, how long has ventilation ducting been part of housing codes, in other words how old are houses that have that problem?


Many (most?) houses in the north/north-east do not have ducts. It's very rare for me personally to come across central air in the NY area.


Can you recommend a product?


I have an older generation Awair. It’s a little expensive but I like it.

I also have a couple different Austin Air purifier models. Also expensive but seems to work well.


You could try running a cycle in the dryer with those stuffed animals. Maybe the dryer filter would pick up something.


Which monitor do you use?


This is known issue, at least of late. There was a recent article posted here (can’t find it right now on mobile) about how that New Car Smell is caused, to some degree, by known carcinogens.


Well, what isn’t a carcinogen? That word gets thrown around way too much — most food items we regularly eat contains several carcinogens, but besides increasing the statistical chance of cancer they are not imminently dangerous without further clarification on the metric of the effect.


Yep, I recently found out that drinking very hot tea or coffee can be carcinogenic. This is the only way that I like to drink these beverages.


Due to the containers


And due to the heat


Sad, that smell is amazing


To be fair, I don't think those are random theories. There's plenty of research on the ill effects of (bad) diet, pollution, etc.

But yeah, volatile chemicals are a form of hyper-local pollution. Perhaps less proof ATM, but close enough to regular (?) pollution to want to avoid it. Err to the side of caution, not to the side of cancer.


I actually wonder if viral epidemics are to blame? Increased air travel means rare viruses can become widespread.


I also wonder about exposure in youth to nuclear weapons testing fallout. That might show an identifiable spatial or temporal pattern, maybe falling off in more recent years and clustered among downwinders worldwide.


I don’t know, radiation is very easy to measure, has a very well-understood effect (the previous century was pretty much about getting to learn every interaction of radiation and the human body), and I don’t think that those fallouts even measurably increase radiation level compared to the usual background one.

In short, radiation either has an immediate, very apparent and deadly effect, or a simple stochastic one that basically linearly increases with radiation exposure.


It's not the environmental radiation that's the problem, it's ingested isotopes. See e.g. strontium and leukaemia.


My pet theory is plastics/microplastics. We're seeing now just how prevalent they are (and how inside of us they are, too).


Or long-term side-effects of medication, food-trends, or lack of exercise?


[flagged]


Impossible. It is safe and effective.


It is telling that people are unwilling to even talk about that. Telling that people fall off science for their political ideologies.


It's telling that people can't help but bring up some very-recent thing they're upset about for dubious reasons, when commenting on an article discussing a trend going back decades. People are "unwilling", in this thread, because it's irrelevant.

Unless we're going for "all vaccines cause cancer", but from the context ("that vaccine", "It is safe and effective.") it seems we're talking about the Covid-19 vaccines. So, irrelevant. Whether they do or don't increase cancer risk (or even if they decrease it, which is also possible) has no bearing on the topic at hand.


This vaccine is special, as we all know.

And it's a possible cause that I offered. The parent was proposing a list. I added to it.

And now I have been censored. Insane.


The article being discussed starts with these words "Over the past several decades", and you suggest as a cause a vaccine that the general public wasn't exposed to just two years ago. You're not being censored, you're receiving feedback that you did a dumb.


It's announced today though.

Fuck it. It isn't because "I did a dumb". You know it, I know it, the microbes on my keyboard know it. Let's not pretend.


What is announced today?


The most disturbing part, to me, is this:

> The early-onset cancer epidemic might be one manifestation of increasing trends in the development of many chronic diseases in young and future generations.

Why are chronic diseases trending upwards? Is it the obvious things (pollution, microplastics, obesity, massive drain on mental health from the modern lifestyle, etc.), or is there something else going on?


Just adding a bit about the subject at hand: I am convinced the cancer epidemic is due to us grossly misusing our biological equipment: we are meant to feast & fast, and not have insulin's anabolic effects constantly activated. Fasting is crucial for "system maintenance", via autophagy (self-eating of damaged cells). Average person constantly stimulates insulin with following the advice of eating small meals often, without even going into the content of those meals.


I've done fasting for a while. It's not the panacea that it's touted as. I was a pretty religious (figuratively) 16 hour fast person. I have several years of bloodwork to show marginal if any changes to baseline. In some cases, for example with blood sugar, there's a small window where insulin actually spikes during a fast. I had several unusual blood sugar readings if I took them around the 15 hour mark along with other numbers that were raised temporarily with no other cause.

I've switched over the last 6 months to eating 3 meals and 2 snacks a day of varying size. I climb often (vigorously, 4 times a week if not more) and found that fasting was simply insufficient to provide the energy I needed. IF caused notable performance decreases at the level I work at leading to more injuries due to poorer recovery. Changing my diet in this way fixed most of it. Of course, I try to eat relatively clean (but chips are a weakness). I don't have a 6 pack but I am also not overweight and carry enough muscle for my uses.

This isn't to say I am giving a license to eat what you want. But what you do with your fuel is probably just as important as what that fuel is. The "average person" you mention is a couch potato. Of course these people not only benefit from IF but literally any change in exercise! IF works great for people who are not intensely active. Hence why it has become popular in tech. Proper sleep (whatever that means to your body) and relatively hard exercise are even better predictors of all-cause mortality than any of this. To me, after having done it, IF feels mostly like new age woo-woo "science" and it dances around people saying it flat out cures cancer. In some cases, for example prediabetes and chemotherapy, "deloading" the system has evidence of being effective. For the rest of us, it's a wash.


> I climb often (vigorously, 4 times a week if not more)

You're very active! Even so, I wouldn't think the IF itself was the problem, probably you were having trouble eating enough for your level of activity with such a regimen.

About bloodwork, I believe you're mistakingly conflating insulin and blood sugar. Blood sugar may vary in such a way, but it's just a proxy because insulin is so hard to measure.

But more to the point, I wasn't referring to intermittent fasting solely, I believe even longer fasting periods are required. Regardless, even IF is a far cry from what the average person does.

I also disagree that fasting is not a panacea. It's a close to one as we have. I don't think this is a subject I'm likely to convince skeptics in a comment, so I will simply say interested people will find reputable resources on the subject, including striking anecdotes published by fasting clinics (of which, for some reason, Germany has a few that publish material on YouTube).


I don't really agree with the parent's assessment that lack of fasting-induced autophagy is the reason for the increase in cancer, but your anecdote about 16 hour fasts is sorta irrelevant.

Autophagy doesn't really kick in until 2-3 days of fasting.


There are some military studies that showed autophagy didn't kick in until they dropped below 6% body fat. But that was with 600kcal and no change in duties. So it's not necessarily relevant. I do IF but I'm a couch potato. If I really stick to 20hrs, it seems to work very well. If I slip to even 19 I have to skip food for a day or even two to get back to feeling good (clear head functioning gut etc.). I am overweight still, but not obese. I lose about 2lbs a week when I stick with it. I am nervous about resuming excercise. I hope I can still recover well. I just do strength training 3 days a week for an hour, or two once I'm back to needing more warmup sets.


I know it's technically true but it's seemed weird to me to lump skipping breakfast in with what I'd consider actual fasting, ever since I first encountered people using it that way in the context of diet fads.

Someone tells me they're fasting, I don't expect they mean 8 non-contiguous waking hours without eating (with sleep in the middle). That's, like... pretty close to a normal day. It's easy to have 16 hour "fasts" just by accident. "I only ate two meals yesterday because I was fasting". LOL WUT? Again, I know, technically true, but not a useful way to refer to it, IMO.


Fasting and IF are not always the same thing - personally I find a bigger benefit from occasionally totally fasting (for longer than one day). If anything it may be the mental benefits that it brings with regards to how you view your relationship with food and what foods specifically make you feel good or bad.


Yes. Every time fasting comes up (because it ALWAYS come up) there's a ton of claims made but it almost always reduces down to the same effects that reducing your calories would have. Eat less, eat better, and get active.


Are you sure you weren't just under-eating calories when you fasted? Just checking.


Autophagy keeps getting brought up with such pseudoscientific bullshit explanations that I can't help but see it as snake oil. Furthermore, depending on who is describing it, the window for autophagy to kick in is anywhere from 8-48+ hours.


There is a lot of "bro-science" out there concerning autophagy for sure, but it is definitely a thing. Yoshinori Ohsumi won the Nobel Prize in Physiology or Medicine in 2016 for "his discoveries of mechanisms for autophagy" (https://www.nobelprize.org/prizes/medicine/2016/summary/).


Ohsumi's research into the mechanics of autophagy doesn't seem to have much to do with the broscience around autophagy.

In other words, the question isn't whether autophagy exists. The question is over whether fanatical "one-weird-trick" claims about autophagy are true and, further, what the impact actually is and compared to what.

For example, autophagy is happening all the time, not just during during starvation. And it hasn't been demonstrated that fasting for 3 days to increase autophagy levels has a net benefit versus eating a nutrient-rich diet during that timeframe.

Instead we just get vague but lofty claims in forum posts.


I don't know what science you need to understand a system that is constantly active and is never fully allowed to rest will develop dysfunction. Anyway, as the sibling reply says, there is plenty of reputable research available to satisfy your curiosity if you wish.


This is not necessarily a given, depending on the nature of the system, it absolutely requires evidence.

Does my circulatory system need to fully rest so as not to develop dysfunction?


Explain heartbeats?


Relatively very frequent rest and activation, I think is a charitably agreeable analogy. A heart muscle that never released would not be healthy.


Honestly the behavioral lifestyle of modern humans is so far off from what we developed that diet is probably a drop in the bucket relative to many other factors. Consider how much movement a persistent hunter in a tribe still engaging in these practices does compared to the modern human, who sits for 95% of the day. The elders in these tribes look lean and still might engage in hunts. The elders in our tribes frequently can hardly walk or access the second floor of their house without difficulty. We went from a species that has to go out and forage or hunt for resources, into one that basically sits in a cave all day and poof there is a couple thousand calories in front of them that they didn’t have to get; no species operates like this. The things that made us humans and improved our fitness to allow us to survive and colonize the globe, our intelligence and endurance or strength, are no longer being selected for in modern life.

Then consider the arbitrary stress that society puts on us. How you dress should not matter, what you love, how you work, where you work, what you do for fun, etc, but we make people hand wring about it all. We have a cruel society in many ways that stifles unorthodox thought and behavior that doesn't ultimately further someone else's dollar. The daily stress of sitting in traffic or waiting for the bus to finally show up on a hot day definitely triggers stress responses. How about the fact that social media has sapped many peoples attention span? The mind is no longer allowed to be bored or to rest or dwell inwardly if you are constantly using every available second to check a website on your cellphone. You see it in kids an adults everywhere: elevator door shuts and out go the phones along with any chance of serendipitous organic thought that doesn't come from an advertising network.

Experiment with your diet, sure, but don’t neglect the other ills of modern life if you want to be truly heathy in body and mind.


Western lifestyles differ markedly from those of our hunter-gatherer ancestors, and these differences in diet and activity level are often implicated in the global obesity pandemic. However, few physiological data for hunter-gatherer populations are available to test these models of obesity. In this study, we used the doubly-labeled water method to measure total daily energy expenditure (kCal/day) in Hadza hunter-gatherers to test whether foragers expend more energy each day than their Western counterparts. As expected, physical activity level, PAL, was greater among Hadza foragers than among Westerners. Nonetheless, average daily energy expenditure of traditional Hadza foragers was no different than that of Westerners after controlling for body size.

https://journals.plos.org/plosone/article?id=10.1371/journal...


A 2019 article in Scientific American suggested that the Hadza example shows our bodies are adapted to require lots of exercise without paying a metabolic cost for it:

> Our bodies are evolved to require daily physical activity, and consequently exercise does not make our bodies work more so much as it makes them work better. Research from my lab and others has shown that physical activity has little effect on daily energy expenditure (Hadza hunter-gatherers burn the same number of calories every day as sedentary Westerners), which is one reason exercise is a poor tool for weight loss. Instead exercise regulates the way the body spends energy and coordinates vital tasks.

They compare the human need for exercise to the evolution of ram ventilation in sharks. By developing a system based on the assumption of constant movement, you become a more efficient forager. But if you stop moving, you die.

https://www.scientificamerican.com/article/humans-evolved-to...


> following the advice of eating small meals often

This must be an american thing. I've always been told the opposite advice all my life. Interesting.


Eating small meals often is a way people control urge and hunger. I don't think it's American only. For a LONG time bodybuilding touted the 6 meals a day to lose weight strategy.


> For a LONG time bodybuilding touted the 6 meals a day to lose weight strategy.

Pretty sure it's to gain weight. So you're all day eating.

To drop in weight, it's better to eat lowcarb,keto,carnivore. Fat/protein is makes you more full and eat less.


I get that people do it, it's just that I've never gotten the advice to do it (non body building contexts, just normal life). To "småäta" in sweden is a widely talked about thing to avoid (i.e. adviced against).


I just want to add a thought about how human biology evolved: australophitecus already was hunting, and subsequent evolution selected for the best hunters. Humans became such successful hunters that we hunted megafauna to extinction. Obviously that environment doesn't exist anymore but biologically speaking, we have simply not evolved for abundance. On the contrary, we are able to go for very long without eating. Even people at their ideal weight have about 100k calories stored. That's 30 days of high energetic expenditure. Interestingly, anyone who has done a long (3-5+ days) fast knows one drops in a mental and physical state that feels very much tailored to better hunting. Reduced need for sleep, antidepressive and procognitive effects, etc.

[edit]: I guess the part about humans evolving with scarcity is not entirely accurate, what we can see for sure is there is some adaptation to surviving without eating; this is not a common trait, other species have much inferior ability to store fat.


This is interesting. Does elevated insulin / anabolic rates mean there’s no breakdown though? At least with muscles, most increases in synthesis rates are accompanied by a proportional increase in breakdown too.

I don’t have papers on hand to cite so take it with a grain of salt, but I believe that just eating is enough to increase both synthesis and breakdown. I think this is actually healthier since you have higher turnover this way


Interesting, what are your thoughts on the anti-CD47 investigational therapeutics being tested for cancer indications? How do you think that antagonizing CD47 will impact this 'system maintenance'. Do you think that modulating autophagy is part of the problem of enhanced autoimmunity, since its clear that is involved in immune surveillance? There is a lot of science out there around this area.


I'm convinced that it's a mistake to be convinced that there's one simple single cause for a society-level issue.


The result of misguidance from health professionals, big food & big pharma marketing.

Not acknowledging that health is largely a result of lifestyle choices, and that pharmaceuticals are mostly ineffective and often harmful.

And now for the specifics:

- lies/bad science about meat (particularly red meat) being unhealthy

- lies/bad science about cholesterol & saturated fat being unhealthy

- not attacking sugar and processed foods at the highest level; should be treated like smoking if not even more harshly

I say this for experience, until I fell ill I had no idea about either of those things. Like many of my peers, grew up with tons of sugar, and many misconceptions about what is healthy (although thankfully to a lesser extent than what's common nowadays)

I'd also add that these things compound over the generations. We are more sensitive than our parents. It checks out for me, every generation has worsening autoimmune symptoms.


> bad science...

> I say this for experience...

> It checks out for me...

Glad you've managed to avoid the pesky allure of bad science with your anecdotal approach!


Those statements of his were both at the end, when he gives his opinion on the general situation. That doesn't mean the main bullet points aren't supported by science


If a doctor says to you ' you have hypertension because you've been eating pizza for dinner last 5 years' .

Do you ask them to provide you with proof directly linking your pizza eating to hypertension? Would you just ignore their advice for lack of proof?

No one will be able to provide you direct link between 'lifestyle choices' and chronic disease at an individual level.


> No one will be able to provide you direct link between 'lifestyle choices' and chronic disease at an individual level.

I wasn't implying I require that for anything. I was just pointing out that someone made broad, speculative claims about the general medical consensus of things like read meat and sugar, and then used an anecdote to support their own claims about those things. Take from that what you will! I just find it funny and worth mentioning.


Are you trying to make the counter point that sugar and highly processed foods are healthy?

There's lots of good science and history (! I guess that's just a bunch of anecdotes though) which demonstrates their ill effects.

Sometimes, a fact has been asserted widely enough that we stop requiring sources, even at HN


> Are you trying to make the counter point that sugar and highly processed foods are healthy?

Nope, I said absolutely nothing to that effect.


More that he's critical of the thought process you've applied. You're conclusions are correct, so no one should be critical of that :)


Wasn't me, but sure


>pharmaceuticals are mostly ineffective

Something tells me you don't understand the vast scale of pharmaceuticals, many of which keep people alive. Mostly "ineffective", come on.

>I say this for experience, until I fell ill I had no idea about either of those things.

Your personal experiences and biology cannot be extrapolated onto the world at large.


> I'd also add that these things compound over the generations. We are more sensitive than our parents. It checks out for me, every generation has worsening autoimmune symptoms.

This may just be a function of increasing pollen overstimulating the immune system. In the last 30 years pollen counts have gone up 20+%[1]. Turns out trees like carbon and warmer air.

Anecdotally both of my kids have seasonal allergies, neither me nor my wife did when we were kids.

https://www.hsph.harvard.edu/news/hsph-in-the-news/pollen-se...


Big Sugar is mostly an American problem due to the industry’s lobbying. If people are not exposed to that level of sweetness they seriously can’t even eat your bread. Also, why allow that level of drug marketing everywhere? That’s also not a thing in other developed countries. So I really don’t think it is fair to call out scientists when these two industries have your politicians in their hands.


plus: high-PUFA oils (seed / vegetable oils) being labelled as "heart-healthy"


This thread makes me wonder how many HNers base their nutrition off a quack like Paul Saladino.

A rebuttal to the seed oil sophistry that seems to have managed to permeate every diet camp: https://www.the-nutrivore.com/post/a-comprehensive-rebuttal-...

Everyone is so desperate to have a counternarrative take on nutrition that they'll believe whatever fad that passes through the internet.

The same goes with saturated fat = healthy broscience and the dismissal of the lipid hypothesis.


Protip: if you're ever looking for some downvotes when bringing up the dangers of PUFAs, recommend that people read the book Deep Nutrition.

There seems to be an animalistic hatred toward a book that really sheds the light on why eating industrial waste is not the healthiest thing in the world.


If people get angry and upset at a topic, I find it usually requires to be brought into the limelight.


Indeed.


I agree sugar is bad, cancer reseracher Lew Cantley has written very clearly scientifically about how High-fructose corn syrup is very bad supported with a lot of mechanistic data.

I also agree health is largely a result of lifestyle choices for most-- it is what we can control.

I can't even begin to contemplating support of many of your other statements. i wish you health and peace of mind.


There might be some unique harms from HFCS but I doubt they're anything but minor over harm from all fructose in refined form (so incl. and perhaps especially fruit juices and other junk often fed to children).

Re: the cholesterol, check out my other comment.

Thank you, wishing you the same.


> lies/bad science about cholesterol & saturated fat being unhealthy

Are you saying cholesterol and saturated fats aren't unhealthy? I'm confused.


Yes, check out this report from Credit Suisse that sums up the state of the art research on the topic: https://research-doc.credit-suisse.com/docView?language=ENG&...

Bottom line is saturated fat is not implicated whatsoever in any negative health outcomes.


From the article: "A proper review of the so called “fat paradoxes” (France, Israel and Japan) suggests that saturated fats are actually healthy and omega-6 fats, at current levels of consumption in the developed world, are not necessarily so"

That probably means a whole ton of marketing material touting Omega oils has to be thrown away.


Just as an aside: This document is interesting. Not saying it isn't valid but I'm just wondering why a bank produced this. It's not just an economic forecast of the health foods market. It's an entire breakdown of the nutrition. Who is the target audience? It looks like the work of some consultants possibly


It turned out eating high cholesterol foods didn’t lead to high cholesterol after all.


I think there is no way to directly link 'lifestyle choices' and chronic diseases. All we have is intuition like yours. There is always going to be aggressive push-back from people who will get you on lack of data linking those two.

I agree about 'big pharma marketing.' part spreading misinformation that all these can be 'treated' with drugs that even educated fall for https://news.ycombinator.com/item?id=32744412


The past 50 years have seen a huge spike in life expectancy averages almost everywhere worldwide, so I’m just guessing that more people than ever with genetic tendencies to have early cancer onset are surviving and passing down those traits. There is also more people being screened for cancer than ever before so more cases are being detected when 70 years ago they would’ve just died and no one would know why


My guess: Environmental toxins, antibiotic use and poor diet leading to loss of microbiome diversity/dysbiosis and consequential disruption to the body’s homeostatic processes.


How to really take care of the microbiome?


Try to be born vaginally rather than c-section (might be too late for that!), avoid antibiotics unless you absolutely need them, polyphenol-rich whole food diet with diverse fruits and vegetables, lots of fibre and resistant starch and fermented foods. Buy organic if possible.


Since I was born via c-section I've tried to make up for the lack of my microbiome diversity by spending many years going down on a lot of different women and it seems to be working.


I suppose you are making fun of it. In case you need arguments to extend your joke: my friend and I were recommended pills made of colostrum of cow -- he took them.


It was a joke but then it made me think there might be some fact to it. The way married peoples start to share biomes and are probably lacking in diversity compared to someone who more frequently changes partners. There’s probably some gut health aspects there that could be studied.


Diverse diet including as many types of food as possible (eg. mushrooms, fermented vegetables, seaweed and other 'unusual' foods), aiming for whole foods (eg. raw rice over white rice).

Your gut bacteria is an expression of the foods that you consume on a daily basis.


Sandor Ellix Katz has some fantastic books about fermentation. Really, really suggest checking them out.

One thing that stuck out to me was when he talked about the relationship between people and their environment. How health is not in a vacuum, but in constant negotiation and collaboration with the world around you. He uses this to suggest fermenting things yourself, to engage in this process with the microbes in your environment. It's easy and fun!

Here's a 6 minute video where Katz talks about fermentation, and walks you through a basic process, in a beautiful and rustic kitchen I still dream about getting to cook in: https://www.youtube.com/watch?v=i77hU3zR-fQ


One other aspect is also soap. Many people say it damages the microbiome in your skin


Eat lots of prebiotic rich vegetables and fruits. Fiber is food for gut bacteria. Also eat plenty of fermented foods. These things increase good gut bacteria and decrease the bad ones.

Avoid alcohol, sugar, and processed foods. These things increase bad gut bacteria and decrease the good ones.


A lot of these chronic diseases are autoimmune ones.

I now know plenty of young people IBD, MS, Psoriasis, and even Rheumatoid Arthritis.

These seem to be caused by less obvious things imo (MS although looks linked to epstein-barr), as otherwise general health doesn't seem to be poor.


Anecdotally, I've found out in recent year about many women having serious thyroid issues. I'm sure more people being open about their health increases this, but the sheer frequency seems absurd.

Whatever industrial chemicals we're ingesting need to be drastically controlled, and this poisoning needs to be branded so that the general population knows about it. I don't want years of my life to be an externality to a slightly cheaper industrial process.


My wife (early 30s) was recently diagnosed with thyroid cancer and it's been absolutely shocking to hear how many other young women just in our social circle have also had it.


I was diagnosed with thyroid cancer 6 years ago. I spontaneously developed hypothyroidism after a tetanus shot, so my thyroid was under supervision for 5 years prior. The main thing I took away from research and from my doctor, was that the imaging has advanced so much because people want to see high quality ultra sounds of their babies that it's simply just diagnosed more. It's also very slow spreading and not uncommon for someone to have thyroid cancer when they die.

There's probably other environmental factors, radiation, diet, etc going on too.


Not just women either.

After going through a profound burnout in 2019 which caused me to develop chronic digestive issues, I worry that I injured my thyroid because I've had chills since even before having COVID. The proteins in gluten are similar to ones in the thyroid, so when the body becomes sensitized to something like wheat, it can also start attacking the thyroid (see autoimmune diseases like Hashimoto's). The problem is that flareups can by cyclical and not get detected by thyroid tests for years, until the damage is permanent.

Also I've been researching how gluten sensitivity can destroy the lining of the small intestine in Crohn's disease. That damage can cause permanent loss of ability to absorb nutrients. It's unclear if the rise of the severe non-Crohn's gluten sensitivity we're seeing causes similar but smaller injuries, lumped into pseudo-science terms like leaky gut. The western high-sugar diet is highly inflammatory, disrupting the endocrine system and eventually leading to metabolic syndrome, neuropathy, possibly even multiple sclerosis (MS). The epidemiological studies aren't there to show that definitively, but I feel that's due to factory farm industry/pharmaceutical lobby suppression of government funding for those studies.

I believe my issues started due to self-medicating my stress and depression with a finger of rye whiskey or cheap beer way too many nights of the week, chronic dehydration from working out, and not knowing how hard casein protein supplements and whole wheat/barley/rye are on the gut. Switching to half a glass of red wine with dinner each night, eating rice/corn instead of wheat, and avoiding all FODMAPs/milk/tree nuts for a year drastically improved my health to the point where I'm back at my old strength in the gym and consider my issues to be in remission as long as I avoid certain triggers.

Anyway, I wasn't sure where to chime in on this, because the corruption of our food supply and rise of severe mental health issues are all connected. When I burned out, I lost the ability to take care of myself for about 6 months as bills started piling up. Burnout from anxiety can be devastating to neurodivergent thinkers like me who already struggle with ADHD and/or autistic symptoms. I didn't truly begin my healing journey until the pandemic. So simple tasks like getting insurance, going to the doctor or seeking counseling feel can feel insurmountable. I'm still trying to get ahead of the curve enough to take more tests and get some definitive answers. But I'm grateful beyond words to have gotten this far and be able to write this now.

If anyone has experienced anything similar to what I'm saying, do you remember what year your symptoms started, or when your friends and family started reporting them?

Edit: deleted my rant about globalization's affect on our food supply/climate/health.


I started having mental health and digestive symptoms similar to yours in mid 2020 and have also had tentatively good results with a gluten-free and inflammation-minimizing diet. I didn't know about the connection between gluten sensitivity and thyroid issues, thanks


For context, looking at UK data:

1. Yes incidence of cancer in 25-49 year olds has increased 22% from 1993 to 2018 - but that is 22% on a very low number which means it is still a very low number. When you account for increased screening, greater awareness, and better testing, the increase is likely even smaller.

https://www.cancerresearchuk.org/health-professional/cancer-...

2. Better treatment (and more effective screening) means mortality rates per 100k from all cancers in 25-49 has dropped c.40% over the same period (despite higher incidence).

https://www.cancerresearchuk.org/health-professional/cancer-...

So whilst this is obviously important to study. At least the UK data doesn't seem too terrifying but I m no expert.


I can't find a source with the full paper at all. And I'm guessing that's why there is no comment here.


This is the source, the full article costs only $99 on a journal subscrption, all expenses paid by a university near you in case you have access


If it isn't on sci-hub, does it even exist? (/s)


Sleep deficient seems to be connected to some cancers.

Daily walking a lot seems to really be a key to longevity. Also to be healthy enough that you can ignore the pharmaceutical companies extensive and endless product line. Often you're just trading one problem for another, or just trading short term risk for long term risk or vice versa. And also have the mental strength to want to go on living with health problems. If you're in Canada and you get to old age, and up in an institution. Be prepared to be offered Euthanasia. 3% of Canadian deaths were that way last year.


My bet is on hormonal changes due to modern living and/or it's impact on the gut microbiome. I'm mid thirties with low body fat and somewhat athletic and got diagnosed with stage 4 colon cancer last year with no history in the family. My support groups regularly get new people around my age.

It's scary to think that in the next few years these cancers will no longer be an old person's illness because chemo is absolutely devastating.


What were your symptoms if I may ask???


Link to full text paper: https://docdro.id/BLOY55z


Could this be related to GMO food? or maybe just the industrialization of food in general?

I also noticed for people born after 1995 there are 18% identify themselves as non-binary these days, I wonder this is also from the same cause, i.e. industrial food related, but I don't have concrete data to back this up.

Longevity is improving slowly, hope one day we can fully catch cancel from onset, I'm aware of quite a few who were taken away by cancers in their 50s or early 60s, sadly.


> I also noticed for people born after 1995 there are 18% identify themselves as non-binary these days, I wonder this is also from the same cause

I wonder about this too. We have a lot more PFAS chemicals in our environments (and bodies) these days and they are known to be endocrine disruptors. It seems plausible that these could be affecting sexual development/identity.


Sauce needed for that percentage. It strains credulity. That’s almost one in five.

Also have to point out that until very recently we had no reliable data. If you stop burning witches and then it seems like everyone is becoming a witch, that is probably not what is happening. What is happening is that people are admitting it.

The best we have from the past are anonymous surveys and those tended to be done by colleges or by people like Kinsey. That is not going to give you a random sample even if we assume everyone on those surveys was fully aware of how they felt and 100% honest.


https://www.axios.com/2022/02/17/lgbtq-generation-z-gallup here is one source, if you google, there are plenty, many are quite authoritative.

I have kids in k-12, and both them and I observed this trend over the years. There might be a biological reason behind it, further boosted by the culture wind these days.


Given that there's no accurate global historical measurements of cancer, anything of this sort is going to be heavily biased by the measurement.

You can only look at this comparative historical thing in certain developed countries with long histories of detecting all cancers.


Since when are we using so many chemicals in soap and deodorants? Since when is soap the mainstream thing for washing the body? I am just curious, I remember an ecotoxicologist detailing the interaction of deodorants with hormons, it was pretty scary.


> Since when is soap the mainstream thing for washing the body?

For soap, it sounds like maybe 3500 years ago? (Which is 1000 years after it was invented.) https://time.com/5831828/soap-origins/


How much is climate change to blame for this epidemic?


Wouldn't it be awful if unbridled capitalism turns out to be mankind's Great Filter?

We'll be licky to become a Type I civilization after poisoning ourselves and the environment through exposure to chemicals and conditions we do not fully comprehend in return of some convenience, cheaper goods and making some a little richer.


Pollution is bad.

Pollution occurs in non-capitalist societies too. It's often much worse. Chernobyl-levels of incompetent and indifference towards environmental protection.

Non-capitalist societies also do things like concentration camps and genocides and world wars and famines which don't seem to emerge as frequently in capitalist societies.

Don't blame capitalism.


Assuming everything you claim on the overall superiority of capitalism is correct, that doesn't still doesn't make it perfect. I am merely pointing out one of the imperfections - an unoriginal one at that: unbridled capitalism[1] does not correctly factor externalized costs, up to, and including mankind's long-term survival.

1. The "unbridled" qualification is deliberate, and very different from what I'm guessing is your idealized version.


That doesnt mean you can't blame capitalism. Capitalism rewards pollution, and that is a bad thing, even if a political/economic system built on nuking the planet every 5 minutes is also bad for different reasons


Does Betteredge's law of headlines apply to academic papers?


I say this as often as I can. We have a vaccine that prevents cervical cancer with ~83% efficacy. Following the "bread-crumbs" seems like a good strategy to me.

We have this little beasty in wild. Human T-lymphotropic virus type 1, but no vaccine. https://www.who.int/news-room/fact-sheets/detail/human-t-lym...

We have correlation with cancer with other viruses. Hep C for example.

How many more clues do we need to expand research in this direction?

Could the implications for the existing cancer "industry" preclude finding prophylactic methods? Asking for a friend.


I used to think this and I don't think so anymore. Consider a company who develops the de-facto cure for a cancer. Let's say a course of normal treatment to remission cost $200,000.

There's no reason this company wouldn't release the cure. They would simple charge <COST_OF_NORMAL_TREATMENT> * <MARGIN> + <OPPORTUNITY_COST> for the drug. People would pay almost any amount for such a cure. The company would have no problem padding it's bottom line sufficiently.


Devil's Advocate:

What if these companies did find a cure, and after running the numbers, determined it was less profitable? Wouldn't 'death by a thousand costs' be more profitable a one-time cure (or limited rounds)? Just because people would be willing to pay almost any amount does not mean they can pay almost any amount.

(Personally, I think they would release a cure if they could find one, but I have heard arguments as to why it would be less profitable, and I am curious about your opinions.

These companies are evil, but it's not entirely their faults. I think they are a manifestation of a sick society -- with each answer to our hopes and prayers the Monkey Paw curls.)


It might be less profitable if you view cancer treatment as MRR. Actuarial tables tell you that this MRR will certainly end unless you produce remission and so I'm not sure if that is a good reason for them to not release it as a single dose. Though, there's no reason they wouldn't divide the dose. Charge say 375,000 instead 200,000 for the treatment using 3 doses instead of 1. But then the question is asked - why wouldn't they just release the treatment at 375,000 then?



Does the vaccine help you if you already have the virus?


People will never accept this theory because it means having more sex is giving us more cancer. Instead they'll say our diet is worse (it isn't) and that we're exposed to worse chemicals (we're not) than 70 years ago. We're definitely having more sex but that's not allowed to be a theory. It's like theorizing that cars are killing flying bug populations-- it's just a non-starter. Come up with something else.


[flagged]


Considering the trend started in the 90s and hasn't shown any particular jump in the past couple years that isn't supported by this research.


dont forget excess deaths.


[flagged]


Source very much needed


[flagged]


Is there a source on this? My understanding is that current trends were lower now than what they were in the past as far as promiscuity goes


Which ones aside from HPV?


Ankylosing Spondylitis is one example, though I believe the area is critically under-researched.


[flagged]


> Cancer is easily explained from an evolutionary optimization perspective

Anything that "easily explains" cancer should be thrown right out as unscientific. Cancer is many diseases, many of which are profoundly different from the others in both mechanisms of action and causes.

I kindly ask that you don't use such confident sounding language, either deluding yourself or others into believing your statements as true, when much of what you state is an untested (and probably unfalsifiable) hypothesis.


> Anything that "easily explains" cancer should be thrown right out as unscientific.

Thank you.

As someone who's recently lost a loved one to cancer, I've lost count of how many times I've wanted to choke people for coming out with these "simple cancer theories".


[flagged]


name checks out :)


I think a young Harvard math professor wrote about this in the 90's.


Sorry, but are we supposed to get this reference, or start Googling for math professor cancer?


Ted Kaczynski


That’s what I thought originally but he wasn’t ever professor at Harvard and he was in his 50s in the 90s so it must be someone else.


Doctor Ted Kaczynski


Berkeley, not Harvard. He was a Harvard graduate, but taught at Berkeley, and in fact was the youngest math professor in Cal history.


U relax the Malthusian selection, u get side effects, simple as.


this. It's because of mutational load of not letting darwin do its thing


Gee wonder what could have caused that.


They're looking at the past several decades...


Free radicals in the water table. Pollution in general. Plastic in the rainwater. Doesn't just affect nature. Backs up up the water table, from ocean to river from the slums to the hills.

Good that we're doing it less and less, in some respects. Pollution is poison.

Although there is always some. Even very primitive societies eg in the Amazon Basin pollute a bit and after like ten years they move to a new place, and the go in circles in the long run, sustainable.


We can scale it to planets. We pollute this planet and then move to another, then another. Come back to Earth in 10 million years.

The only small problem with that is that we are not that advanced to do it.


The problem is that there aren't any other planets. Venus is an inferno, Mars may as well be made of asbestos dust with a side of radiation and drought, those are the most hospitable ones in this solar system and we're not getting anywhere further anytime soon[1]. And the amount of rockets and environmental damage to launch billions of people and enough spaceships for billions of people is ... a lot.

[1] http://www.antipope.org/charlie/blog-static/2007/06/the_high...


No it's not that much, it's water in the atmosphere, hypergolic fuels were before. Steam. It's fine. Although yes when metal vaporizes up in reentry that is pollution.


That's funny because Elon Musk in his capacity as a vehicle entrepreneur has not only advanced the expansion to Mars, by leaps and bounds, hey if before we could get a million people there now we can get 100 million, or if we could get 100 million now we can get everybody out. Leaps and bounds. Costs the same as a college degree to get a rocket into orbit, in fuel terms. Yeah like $200000, well that's only if you get a scholarship and the price of fuel doesn't skyrocket, but similar. Similar.

So what's contradictory is he also yes made good advances with batteries for cars (fixed everything honestly) but really got every other carmaker feeling real threatened right in the business model. A sensitive delicate place, you understand. He got everybody else putting eg 20 billion like Ford into researching electric cars, and partering up, making...making their thing, good cars too, but I would buy no other than a Tesla for a simple reason. Accidents. Fewer accidents is less pollution, yes Tesla allegedly pushes it as self-driving and sometimes it is (Elon gets lied to I saw it once), but really the really cool thing is an incredibly bad driver like me can drive a car while doing his best to pay attention together with the car's safety system. Not instead of. In tandem. Then you don't get all those cadavers filling up the graveyard which takes up land, no joke very expensive South SF...yes the human tragedy yes. But the media overlooks it like nothing so for purely the sake of argument I can focus on the pollution. Well maybe not, pollutes those people with something toxic, there's a debate in medicine eg punches are toxic, blunt force trauma is toxic. Think about that. Well then they're in the hospital for weeks, then the doctors pollute them perhaps [1]. Then, pollution, in the junkyard. Then, you need another car, pollution in the mines to purify the metal...lithium in Chile. So what's the ecological alternative?

Basically horses, the original self-driving car, and very ecological.

Ford said if he asked people they'd say they wanted faster horses, that is what Tesla makes.

.

[1] Change of subject: they did this to me twice, to figure out how to do poison you with no excuses, no loopholes, no fucking consent. Shut you up before you open your mouth. Wait wasn't it going to be just two vaccines and that'd be it? Shut up. Can I assay this vaccine? Shut up. Can I object on religious grounds? Ten years ago yes. Shut the fuck up. Like turns out I haven't met a single Covid death, not personally obviously, you neither, through an acquaintance only one, and he died because he went to a hospital, caught Covid in a hospital with an existing condition.

Yes I do know how to bitch down to social expectations under the threat of being labeled as a stereotype, or like I used to, sorry, I knew too much it was lobotomized.

Dude no excuses nothing don't take no for an answer (violers's slogan), oh there was an exception but you didn't qualify, learn to poison people on the schizos first, then the rest. Nazi playbook, literally. First they came for me man, they're coming for you now. Well didn't poison me twice, hundreds of times meaning two different pills, but second time, mostly dodged it. They provided no benefit and had serious side effects, second one required signatures for consent that were extorted out of 100% of the patients (Clozapine at Clínica Rayencura, full court press, tiered rewards in the Caribbean 10% you get a plane ticket 20% you get a hotel room 30% you get a boat ride to the secret island, shooting for that 100% consent, they got caught in fact biggest suit of its kind, not big enough did it again), doctors say first do no harm. No benefit just harm, poison.

Dude just read the consent form (consent is code for rape), then recognized the name, said Oh that Abbott wants me to take this pill? Fuck that. So second time around I was wise and dodged, only guy in the rehab to dodge obesity and immune compromise, it gives you AIDS ["Te da SIDA" -- Juan Luis Lorca Tobar, like July 2018], Abbott--which I'm dying to take to court. Dying to take that Abbott to court. This close to giving me AIDS? What an Abbott. But due to torture that is their fault in part as well, I by design can't properly communicate with any lawyer within the hour I get for free, who'll take the case and ride to victory fucking them in the Federal Circuit...dude my dream. Someday I will get my day in court, evidently not within 13 years, maybe not even 20 years, someday. Dude combination of the 6th and 13th amendment. I can justify with exact mathematics the shrink industry is treating me like a slave. And you know my code compiles.

Let that be known. That Abbott owes me money.

Hey, Abbott, abbot, cleric right there in the name. Like there's no hot guys studying sixty years to get their degree as a cleric. They get work, or, in the club, get worked, women jumping them nonstop, me too but I think my libido is very damaged again lobotomy. Cleric is a pervy career path basically, come on no partying til 35 and then crazy?

Women don't like doctors anymore, just like...eeegh. Yeah money yeah, literally blood money. And even then always beta. Alpha on the secret island? Yeah. Gray's Anatomy, yeah. Patrick Dempsey is handsome and an actor, as counterfactual as it gets, exact opposite career path, bleached his hair to look gray in fact. American Medicine subsidizes those shows for you to trust them.

There's good doctors too, that's why they call them good doctors, like dumb blondes, why not just say doctors, why not just say blondes? I was blond, still considered blond in the modeling industry I would say dirty blond. But when I was small? Blond. Smart as fuck. [And in general blondes are only dumb insofar as jealousy first, secondly loss of innocence ie sex diminishes their fairness depending on whom it's with chimeric DNA goes everywhere, yellow felt-tip pen. Finally it's a trait indicating youth, apart from that I] Proved it hardcore, under a psychiatric handicap, beat the secretly nationally-ranked shrink at chess. They had to let me out at that point, but it was a bullshit thing it was an illusion to torture their patients, all I have to do is win this game (which is impossible) and I'm free. Even if you win they won't let you out any sooner. Not a good doctor, not a dumb blond. You can see the before and after on http://fgemm.com, my whole history before during and after the torture ward, which had HN access isn't that a nice perk? Another patient who was a lifer said, "cuatro estrellas.". Four star hotel. Lindsay Lohan that's five stars, Hollywood rehab, there's one in Chile nobody said a word about, a rumor among my favorite people. Great food for one, not niggardly with the calories, number one, you'd think if they pretended to understand milligrams they would need to understand calories, nope. Should lose their degrees just for that. Cept for the anorexics.

.

This where it gets interesting.

.

So one killer strategy--you really want the shrinktalk I got for you? First off you will remain inside until either your sponsor runs out of money or you stop insisting you're sane. Dude you want to get out (not always better on the outside though), dude shut the fuck up if you want to get released. Just shut the fuck up. Stop saying you're not insane, never accuse more than one person, play dumb because they won't stop til you are dumb. Amnestic drug lobotomy.

.

I read advice on reddit, Epic Shrinktalk, dude said 1) take shit and 2) ask if you're making progress. Dude playbook for May 12, 2012, right there! That was literally it! I owe him royalties...let me pay them by divulging the following. I took some shit (better than taking on a whole gang) and I asked if I was making progress. And I had signed in myself, that's when they roll out the red carpet if it's legit. Now I know if you're eg a psychiatrist considering treating me reading this you'll be like...the fuck? But bear in mind, lobotomized into divulging compulsively, lost my shit after the final third time of abduction, and second, come on doc you watched One Flew Over the Cuckoo's Nest. You're a doctor, or a good doctor? White horses are not horses, as the Ancient Chinese, School of Names, said. Genius.

I've had much more than my share of good doctors, I'm a lifer. I didn't look under a rock, I did a rock census. I know there's 950-998 psychs in Chile. I know what they can do and what they can't. I know the system. I bought the Law Book and read as far as I could, well like any book if there's five words you don't understand on the first page it's beyond your level. Fifteen laws broken in my gainst. OK, so here is something I did understand:

If you like the medication (depends on the medication, Risperidone you don't have to) but if it's controlled pretend you hate it. Opioid? Say you're constipated. Oh stimulants uh, can I get something for my stomach ache with that? Do I have to take this pill every day, I'm getting sick in my throat...How do I swallow that down, like what yoghurt to mix it with? Research and complain about the side effects...dude literally swapping pills in the rehab, one man's trash is another man's treasure--outside the rehab, because inside there's no private property. Inside? One man's poison is another man's cure. We hated our shit. We were both flushing it. We wanted the other guy's. So trade. But like better than a trade, absolute gift in both directions. No yuck from saliva dude fuck it, did not care. This is coercion, this is Hell, get fat if you're uninformed because you didn't read this post. Dude your gut wis sticking out like a horse.

And this is the right forum to talk about this.

Look it all up, it's on http://fgemm.com


> Doesn't just affect nature

Well it does, we're not outside of nature




Consider applying for YC's W25 batch! Applications are open till Nov 12.

Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: