In a recent Binding of Isaac playthrough I encountered an item which I had not seen before. It was called "Cancer", and it seemed to increase my DPS considerably. However, since then I have only gotten cancer rarely.

Is there any technique or method I can use to increase my chances of getting cancer?


2 Answers 2


Honestly, it's all down to luck. The factors that define what you get and where are completely random. First off, when you start, the computer "rolls a dice", and depending on what you get between 1 and 7 defines your luck (item find, possibility of getting curses etc.). 1 being "Curse of the dark" every time, 7 being amazing items in every gold room, arcades on every floor, etc.

Also there are items that certain characters start with like the 6-sided die, that allow you to re-roll gold room and shop items.

However, the best place to get Cancer with the highest drop chance is Mystic Slots. Other than that, cross your fingers and pray to Pinocchio.

  • Sounds like scumming for an awesome first floor will increase your odds of getting other awesome floors.
    – Brilliand
    Commented Oct 10, 2014 at 21:56
  • @Brilliand yep, that's generally how it's done
    – Ben
    Commented Jan 5, 2016 at 23:50
  • I'm late to the party but I remade my account to make a correction: this answer is almost completely wrong. The luck stat is not random between 1-7 (it starts at 0), it does not influence whether you get "good" or "bad" items in rooms, and it also does NOT influence the chance of getting a curse. This holds true even for the original Flash version. We already knew this back in 2014.
    – Hugo
    Commented Feb 12 at 17:27

Cancer is a trinket slot item like The Tick, or Cain's Eye, or The Polaroid.

The effect it has is to reduce the delay between shots - this is independent of the "Tears" statistic that governs fire speed, so as you get faster tear shots this static reduction in delay is a greater % of the remaining time and your DPS increases geometrically.

Trinket slot items are gotten from room drops, chests and the Fortune Telling machine.

The best way is then to play as Cain - the Luck Foot increases your chance of getting items from room drops and chests, but most importantly it removes the "Fortune" part of the fortune telling machine (the messages across the top that say things like "Steven Lives!"). This means that every time you put a coin into the machine you'll be getting a) a tarot card b) a soul heart or c) a trinket. Given that the chances of winning the fortune slots is fairly low for other characters this is a huge huge bonus.

Fortune Telling machines spawn most often as parts of Arcades. Arcades only spawn on even numbered floors/XL floors, and only if you have 5 or more coins.

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