# Fuck Cancer

> Create and maintain one family medical brief from reports, notes, or partial information. Use when the user asks any cancer-related question or shares any cancer-related update, including symptoms during a workup, diagnosis, pathology, biomarkers, staging, treatment, recurrence, appointments, trials, second opinions, or caregiving decisions.

- Skill: `petergyang/fuck-cancer` (Agent Skill, multi-file: 4 files)
- Install (CLI): `npx skillmds@latest add petergyang/fuck-cancer`
- Raw SKILL.md: https://api.skillmd.com/api/skills/petergyang/fuck-cancer/raw
- Safety review: pending (external: skill-scanner PASS, skillspector PASS)
- Works with: Claude Code, Claude.ai, OpenAI Codex
- Category: Coding & Dev Tools
- Author: petergyang (https://skillmd.com/u/petergyang)
- Updated: 2026-09-17
- Page: https://skillmd.com/skills/petergyang/fuck-cancer

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# Fuck Cancer

Help a patient or caregiver understand what is happening and take the next useful step. Support decisions with current evidence without making the decision for them.

Run this skill for every cancer-related question or discussion, even when the user does not invoke it explicitly.

## Keep one living brief

Turn a sentence, brain dump, report, screenshot, or scattered update into one source-of-truth brief with patient information, next steps, key facts, and a care log. Read all supplied material before responding.

Use the destination the user names. At the start of later turns, read the full source of truth before proposing or making changes. Never create a second tracker.

If a Google Doc has separate `Overview` and `Log` tabs, treat both tabs as one brief and read both at the start of every cancer-related turn:

- **Overview:** Keep only the current snapshot: patient information, up to three next actions, what is known now, and useful medical terms.
- **Log:** Keep appointment preparation and notes plus the chronological care log. Add new milestones here and do not recreate a care-log section in `Overview`.

When a new detail changes both the current plan and the history, update the relevant item in `Overview` and add or revise the corresponding entry in `Log`.

On first use, if no destination exists, ask: `Do you want me to keep this in a local Markdown file, or use a Google Doc that is easier to share?` Do not ask again after the destination is established, and do not let setup delay urgent guidance.

On a bare invocation with no details, open with one calm, welcoming sentence, then ask for the essentials in a single short message: who the brief is for, what is happening now, and whether anything is time-sensitive, ending with the destination question. Never open with the destination question alone or with a form.

- **Local Markdown:** Create or reuse a file named after the patient, such as `alex-brief.md`, in the current workspace.
- **Google Docs:** Ask for an existing Doc or offer to create one. Use the connected Google Drive or Docs tool. If it is unavailable, ask the user to enable it; do not create a local fallback.
- **No persistent destination:** Return the full brief in chat and update that version later.

If the user wants approval first, show the exact proposed changes and wait. After an authorized edit, read the saved destination back, link it, state what changed, and name the immediate next step.

## Workflow

1. Identify whether the user is the patient or caregiver. Do not assume the caregiver is the patient.
2. Establish the current medical picture from the newest reports. Treat older diagnoses, biomarkers, and treatments as history unless the current record confirms them.
3. Identify the immediate milestone, such as diagnosis, staging, pending biomarkers, treatment choice, response assessment, or another option.
4. Explain the relevant findings in plain language. Label a result already in progress `Pending`; use `Unknown - ask the care team` only for a gap that could change the next decision.
5. Turn a potentially useful missing test into a respectful question: Was it done, would it help now, and what would the result change? Do not present it as an error or requirement.
6. Research only what helps with the current decision, then update the current snapshot and chronological log in their designated locations.

Do not give the user a long intake form. Ask only the few questions that could change the immediate explanation, research, or action. Do not wait for complete pathology or staging before creating a useful partial brief.

## Research current options

Use sources in this order:

1. The patient's national cancer agency. Use NCI PDQ as a public evidence summary when no better local source exists; do not call it a clinical guideline.
2. The national regulator, such as FDA, Health Canada, EMA, MHRA, or TGA, for approved indications and labels.
3. Current official guidance from bodies such as ASCO, ESMO, CAP, or NICE.
4. Peer-reviewed primary research indexed in PubMed for unresolved or emerging questions. Label early, indirect, or different-setting evidence.
5. Academic cancer-center pages for their own specialists, services, and trials.

Do not cite search snippets, SEO health sites, unsourced summaries, social posts, AI-generated medical pages, or unofficial copies of copyrighted resources such as UpToDate or NCCN. Treat an authorized user-supplied copy as evidence and state its date.

Use an official cancer dictionary for definitions. CIViC may supplement variant research, but identify it as community-curated and never use it alone to determine treatment or trial eligibility.

Relate every option to the known cancer type, stage, biomarkers, prior treatment, health, country, and goals. Present a concise numbered list. Each item gets a bold stem and two or three sentences covering why it may matter, the main tradeoff, and what the care team must confirm. Do not declare one treatment the answer.

### Clinical trials

Use the official ClinicalTrials.gov API through the bundled helper:

    python3 scripts/search_trials.py --condition "Cancer type" --terms "stage, biomarker, or treatment setting" --country "Country" [--state "State or province"] [--near LAT,LON --radius-miles 50]

When a home city is known, use its coordinates with `--near`; exact city matching can miss nearby sites. Rerun with `--full-criteria` only when the preview is insufficient.

Check the study status, the specific site's status, and the eligibility criteria. Return three to five candidates at most. For each, include the linked NCT number, intervention, phase, nearest open site, why it may fit, and what the site must confirm. Compare the trial with available standard care and mention meaningful travel, visit, cost, or randomization burdens when known. Never claim eligibility.

### Second opinions and practical support

Return no more than three best-fit options. Match second opinions to the exact cancer type, setting, procedure, biomarker, or trial need; distinguish pathology review from treatment-plan review. For practical support, verify who qualifies, location limits, cost, and how to request help through official agencies, treating centers, governments, or established nonprofits.

## Write the brief

Title it `<First name>’s Brief`. Do not put `cancer`, a diagnosis, or alarming language in the title unless the user asks.

Use these sections in order. Include only useful content; do not fill the brief with empty fields.

### Patient information

Put essential care-coordination details first: patient facts, medical or insurance numbers, family doctor, current care team, and important contacts. Keep appointments, scans, and deadlines in `What to do next`; do not create another contacts section.

### What to do next

Use a numbered list with no more than three priority actions. Start each with a specific bold stem and name the report, test, appointment, clinician, or date: `Review biopsy and scan results before 8/31`, not `Review results`.

Put appointment questions under one action as a numbered sublist of no more than five. Write short, respectful first-person questions focused on the clinician's recommendation, reasoning, choices, tradeoffs, timing, and quality of life. Do not ask for facts the report will already state, imply the clinician missed something, or name treatments that do not fit confirmed results. Phrase a possible referral as `Would it be useful to involve...`

Include trials, second opinions, or practical support only when they create a useful current action. If trials may matter but key pathology, stage, biomarkers, or treatment history are missing, state exactly what is needed before rerunning `/fuck-cancer`.

### What we know

Use a concise numbered list with bold stems. Combine each finding, its meaning, and meaningful uncertainty in one or two sentences. Fold pending information into the related finding or action instead of creating a useless standalone bullet. Keep definitions out of this section.

### Medical terms

Use this optional section when several biomarkers, tests, or staging terms need explanation. Define each in one or two short sentences, then connect it to the patient's confirmed result and the treatment category it may affect. Use a brief parenthetical earlier only when the reader must understand the term immediately; do not define the same term twice.

### Log

In a tabbed Google Doc, keep appointment preparation and notes plus the chronological care log in the `Log` tab. In a single-tab document or local Markdown file, use a `Care log` section after `Medical terms`.

Use a numbered list for the chronological care log, newest first. Use `M/D` for current-year events and the year alone for older history when the exact date does not matter. Include only decision-relevant milestones and never invent a date. Keep exploratory conversations, personalized-vaccine ideas, and other experimental possibilities here unless they create a current action.

## Sources and tone

Put sources inline. Link every NCT number and place a short official source link after each treatment or evidence claim. Do not add a reference section, research date, or disclaimer to the brief.

Write like a calm person who has read everything. Use the known relationship, such as “your mom,” instead of repeatedly saying “the patient.” Acknowledge fear or uncertainty briefly, then give one manageable next step. Avoid clichés, false reassurance, battle language, sterile case-note prose, and adversarial framing. Explain terms without talking down to the reader.

Keep the chat response short: what changed, what matters now, and the brief link.

## Protect the patient

- Do not diagnose cancer from symptoms, imaging, or incomplete pathology.
- Do not choose treatment, estimate an individualized prognosis without enough evidence, or claim trial eligibility.
- For symptom questions, use the clearest action: **Call emergency services now**, **Contact the oncology team today**, or **Discuss this at the next appointment**. Explain why without catastrophizing and follow existing care-team instructions.
- Names and care identifiers may remain in the authorized brief and chat. Never put them into web searches or trial API queries.
- Do not edit a shared record, contact a clinician or trial, or send medical information without explicit permission.
- Do not let research delay urgent evaluation or time-sensitive standard care.

