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Ed Steve Jobs cancer story/alternative medicine

Susan Gerbic

Graduate Poster
Joined
Jan 23, 2007
Messages
1,527
Can't find this mentioned anywhere on the forum.

During a routine abdominal scan, doctors had discovered a tumor growing in his pancreas. While a diagnosis of pancreatic cancer is often tantamount to a swiftly executed death sentence, a biopsy revealed that Jobs had a rare--and treatable--form of the disease. If the tumor were surgically removed, Jobs' prognosis would be promising: The vast majority of those who underwent the operation survived at least ten years.

Yet to the horror of the tiny circle of intimates in whom he'd confided, Jobs was considering not having the surgery at all. A Buddhist and vegetarian, the Apple CEO was skeptical of mainstream medicine. Jobs decided to employ alternative methods to treat his pancreatic cancer, hoping to avoid the operation through a special diet--a course of action that hasn't been disclosed until now.
http://valleywag.com/363816/fortunes-cover-story-steve-jobs-hid-cancer-for-nine-months

Apparently the "alternative methods" didn't work because he ended up having the surgery after all.

Does anyone know what he was trying?

Susan
 
Doesn't the juxtaposition of "routine abdominal scan" and "skeptical of mainstream medicine" seem a bit ironic?

-Dr. Imago
 
Hadn't thought of that. Maybe Apple makes its leaders get routine exams? What do Buddhists and Vegetarians have against modern medicine? Don't Buddhists believe in just letting things happen? Not killing anything? Was he afraid that he would be killing his tumor?

These stories of famous people seeking out A.M. and it not working should be more out there in the news. The more discussion on these topics the better.

How many people remember M.L.K's widow went to Mexico to have treatments on her cancer, but died before she could receive it. Actually they would not touch her she was so far gone. But she made it to the clinic and died there.

Susan
 
Megan McArdle speculates

I am not a doctor, nor do I play one on the internet. But what seems more likely? That Steve Jobs is suffering from a "hormone imbalance" that has sent his weight plummeting and requires a leave of absence, or that his delay in treating his pancreatic cancer while he messed around with woo "alternative therapies" for nine months gave it time to metastize? Pancreatic cancer is nasty, nasty stuff. I don't think we're going to see another comeback this time.

Somehow I missed this story when it came up the first time. Cancer is not something to put off treating, IMHO.

While vegetarianism and Buddhism aren't necessarily woo in and of themselves, they do suggest a certain kind of New Age mindset that is also liable to buy into CAM quackery.
 
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Megan McArdle speculates



Somehow I missed this story when it came up the first time. Cancer is not something to put off treating, IMHO.

While vegetarianism and Buddhism aren't necessarily woo in and of themselves, they do suggest a certain kind of New Age mindset that is also liable to buy into CAM quackery.

As far as I know, the Buddha never said anything about avoiding evidence-based medicine. While some "new-agers" might be attracted to Buddhism, there's nothing "new age-ish" about living the Buddhist lifestyle. If anything, it will make you a healthier, more rational person.

The following site has some good information about one of the strands of Buddhism.

http://www.accesstoinsight.org/lib/authors/bullitt/theravada.html


M.
 
These stories of famous people seeking out A.M. and it not working should be more out there in the news. The more discussion on these topics the better.


Susan

This bears repeating.
 
I think Apple and Jobs did a very good job at keeping his disease and alternative treatment a secret. But I would guess that he was following the macrobiotic diet. From what I can tell it's a diet (among others) that is well established to lower various risk factors for pancreatic cancer (insulin resistance in particular) but has lots of lots of outlandish woo around it also. Maybe someone with more medical knowledge will come along but it looks to me like it also has a limited amount of evidence for it extending the survival time in pancreatic cancer cases. But for the particular kind of cancer Jobs had, surgery is well proven.
 
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Hm...

A Buddhist and vegetarian, the Apple CEO was skeptical of mainstream medicine.

It makes it seems like the first part is an explanation for the second. But neither of those things includes or leads to being skeptical of mainstream medicine.
 
Hm...



It makes it seems like the first part is an explanation for the second. But neither of those things includes or leads to being skeptical of mainstream medicine.

Certain things just seem to go together. Actually, the sentence sort of suggests that, but leaves out "therefore," because there isn't a direct causal link there. I'm sure that there are skeptical vegetarians and skeptical Buddhists, but there is also a certain type of person attracted to "New Age" fads and alternative medicine, and, for whatever reason, these people also seem to be into things like Eastern religions and vegetarianism.
 
Harvard Cancer Expert: Steve Jobs Probably Doomed Himself With Alternative Medicine

It seems pretty much anybody can be taken in by woo:

Steve Jobs had a mild form of cancer that is not usually fatal, but seems to have ushered along his own death by delaying conventional treatment in favor of alternative remedies, a Harvard Medical School researcher and faculty member says. Jobs's intractability, so often his greatest asset, may have been his undoing.

"Let me cut to the chase: Mr. Jobs allegedly chose to undergo all sorts of alternative treatment options before opting for conventional medicine," Ramzi Amri wrote in an extraordinarily detailed post to Quora, an online Q&A forum popular among Silicon Valley executives. "Given the circumstances, it seems sound to assume that Mr. Jobs' choice for alternative medicine has eventually led to an unnecessarily early death."

It's a shame that it took such a talented individual from us. This story needs to be spread far and wide in order to demonstrate the dangers of delaying any conventional cancer treatment.

http://gawker.com/5849543/harvard-c...imself-with-alternative-medicine?popular=true
 
Here is the primary source.

www.quora.com/Steve-Jobs/Why-did-Steve-Jobs-choose-not-to-effectively-treat-his-cancer

Note that the author is very clear that he is indulging in informed speculation, not dealing in absolute facts. I have to say this is the first time I realised Jobs had an insulinoma, rather than a pancreatic carcinoma. This puts a very different perspective on the case.

ETA: Here is a different, and very detailed, article on the topic. www.sciencebasedmedicine.org/index.php/the-death-of-steve-jobs/

For as much as the quacks are trying to claim that they could have cured Jobs if only they had given them the chance, there is, however, the chance of taking the opposite argument, namely that Jobs might have died because of his embrace of non-science-based treatments, too far in the other direction. Unfortunately, there is a skeptic who should really know better who did just that, using Steve Jobs’ death as evidence of the harm that alternative medicine can do. Now, given my reputation as someone who relentlessly applies the cudgel of reason, science, and critical thinking squarely to the back of the head of woo on a regular basis, you just might think that I would heartily approve of this line of argument. You’d be wrong, and not because I have any qualms whatsoever about appropriately blaming alternative medicine when someone pursues alternative medicine and ultimately dies. (I have, after all, done it myself on several occasions.) The key word is “appropriately,” and the reason that I’m not so hot on using Jobs’ death as a “negative anecdote” against “alternative” medicine is because I’m not so sure how appropriate doing so is in Jobs’ case. While Jobs certainly didn’t do himself any favors by waiting nine months to undergo definitive surgical therapy of his tumor, it’s very easy to overstate the potential harm that he did to himself by not immediately letting surgeons resect his tumor shortly after it was diagnosed eight years ago.


Rolfe.
 
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Also note the rebuttal to the author in the first comment:
Mitchell Berger

In any discussion of Steve Jobs' illness it's vital to be clear about one thing - he did not have pancreatic cancer he "had what is called a neuroendocrine tumor, more specifically an insulinoma." Not just my opinion, but that of University of Chicago Medical Center Transplant Center, J. Michael Millis, who was quoted in an article about Jobs in Scientific American. That the tumor was located in his pancreas does not make it pancreatic cancer. Mr. Amri got at least that part correct. It is not an ad-hominem to note that Mr. Amri is not recognized as an expert in neuroendocrine tumors. He betrays his lack of expertise in the disease when he makes bold headed statements like "Neuroendocrine tumors are relatively mild forms of cancer" and "Neuroendocrine tumors caught in time can be treated just by surgically removing the tumor." Both are broad outdated generalities subscribed to by so many members of the medical establishment, that they, much more than Mr. Jobs' early misguided reliance on "alternative remedies" may have played the major role in a death that might otherwise have been forestalled for many more years.

While Jobs probably did not help himself by waiting nine months between diagnosis and surgery, it can often take years before neuroendocrine tumors are diagnosed even when symptoms of "active" tumors are present, (see the Journal of the National Cancer Institute 9/17 2008) so the ultimate effect of the delay in treatment on his survival is academic. The one thing that is absolutely clear about his case is that when his surgeons told him that they "got it all" in 2004, they were wrong. This monumentally bad advice is not unusual among those with neuroendocrine tumors. I know dozens of others who have been given the same erroneous post-surgical assessment.

The first thing I noticed in the article is this mis-information:
...Jobs waited so long before seeking normal treatment that he had to undergo a Whipple procedure, losing his pancreas and whole duodenum in 2004. This was the first alarming sign that his disease had progressed beyond a compact primary to at least a tumor so large his Pancreas and duodenum could not be saved.
A Whipple only removes the head of the Pancreas. You cannot live if the whole pancreas is removed. It's one reason pancreatic cancer is so deadly. You can't just take the organ out. A lay person might not know that, but someone claiming to be a medically knowledgeable cancer expert should have.


I think the topic deserves a closer look. I'm interested in finding out whether Jobs delayed treatment against medical advice, whether he delayed that treatment because he was in denial or whether some alt med seemed more inviting, or whether he simply added alt med to conventional treatment as many people do. I'll see what else I can find.
 
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Here's another take on it at Skepticblog by Brian Dunning:

STEVE JOBS SUCCUMBS TO ALTERNATIVE MEDICINE
Seven or eight years ago, the news broke that Steve Jobs had been diagnosed with pancreatic cancer, but considering it a private matter, he delayed in informing Apple’s board, and Apple’s board delayed in informing the shareholders. So what. The only delay that really mattered was that Steve, it turned out, had been treating his pancreatic cancer with a special diet [UPDATE] prescribed by the alternative medicine promoter Dr. Dean Ornish.

I'm sure more info will be forthcoming the near future.

It is a discussion that is sorely needed.
 
The link I added to my above post is very critical of Dunning's position, and this criticism is well argued. I would recommend reading the entirety of this article before rushing to judgement.

www.sciencebasedmedicine.org/index.php/the-death-of-steve-jobs/

Dunning is massively overstating the case in his eagerness to attack alternative medicine. This is a mistake. Again, I would certainly agree that Jobs did himself no favors by waiting. If I were his physician or the surgeon to whom he was referred, I would have done my best to talk him out of such a course of action, but I would do so more out of the uncertainty of not knowing how fast his tumor would progress. So, is it possible, even likely, that Jobs compromised his chances of survival? Yes. Is it definite that he did? No, it’s not, at least it’s not anywhere as definite as Dunning makes it sound. In fact, based on statistics alone, it’s unlikely that a mere nine months took Jobs “from the high end to the low end of the survival rate,” as Dunning puts it. That’s just not how insulinomas usually behave from a biological standpoint.


Rolfe.
 
Wow, looks like we need to think this one through and not jump to any quick conclusions. It's easy to want to believe the Skepticblog discussion, the authors are trustworthy. Then you find all sorts of different and important aspects in the SBM blog entries. I find it to be a more thorough approach. Things are rarely black and white. I've seen the hesitation people go through when faced with difficult cancer treatment. I don't think it's just the allure of a magic alt med bullet. There are people who delay treatment without substituting alt med. Cancer treatment itself is often a difficult pill to swallow. Delay is a common occurrence.
 
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Yes - There is a tendency to understand pancreatic cancer as one disease.The so called ductal adenocarcinoma is the most frequent type. and it is quite often diagnosed as stage 4 (ie metastasised). The one Steve Jobs had originated in the insulin producing cells located in the "islets of Langerhans". They are quite rare, and they behave less aggressively. And at the time of primary surgery, no residual cancer was detectable. So we really can't know if his delay of proper treatment had any influence on the outcome.

A few studies have been done to see what happens to patients who chose alternative therapy instead of conventional treatment for breast cancer. These studies show that the risk of progression/death significantly increases - most notably in those who refuse surgery, but also in those who refuse additional radio-chemotherapy:

http://www.ncbi.nlm.nih.gov/pubmed/16978951
http://www.ncbi.nlm.nih.gov/pubmed/21225354
 
What's the sequence of events here: did he only try the "alternative" crap before the surgery several years ago and stick to the real thing ever since, or did he have the surgery first, then switch to "alternative" crap after it (and apparently back to the real thing more recently, shortly before dying)?
 

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