It’s often argued that alternative medicine is safe because most of the remedies considered to be “alternative” are in and of themselves harmless. This is certainly true of things like homeopathy, which, if prepared properly, contains absolutely nothing other than the solvent the preparation was based on, which is usually water. However, it does kill by another means: it displaces real, useful and scientifically valid medicine and leads to people harboring the belief that something will cure them when it won’t, directing them down the wrong road for treatment. It does not need to completely stop someone from getting real treatment to kill; just delaying real treatment can be enough.
Such would appear to be the case with Steve Jobs. I do not mean to make light of his death. While I do think his legacy has become extremely inflated, especially in light of his death, he was, by all accounts a nice guy and certainly a good manager. He was a great motivator, he had a pretty good sense of industrial design and he helped provide direction for Apple in the mid to late 1990’s when the company was faltering.
Without diminishing the grief his family and friends are surely feeling, we can still look at this death as an example of why alternative medicine is dangerous. Hopefully it can even save lives.
In 2003, Steve Jobs was diagnosed with pancreatic cancer. Pancreatic cancer happens to be one of the most deadly forms of cancer, because it tends to be asymptomatic until it reaches very late stages of development. By the time most pancreatic cancers are discovered, the prognosis is very very poor. Once the cancer has metastasize, it becomes very difficult to treat. Pancreatic cancer is often aggressive and will quickly invade the liver and other organs. Once this happens, simply removing the tumor does little to stop the spread of the cancer and even the most aggressive treatment with chemotherapy and radiation only results in a long term survival rate of a few percent.
Steve Jobs, however, was lucky. His form of cancer was slower in progression and less aggressive than most forms of pancreatic cancer. Even more importantly, it was caught relatively early on in the progression of the disease. The cancer was discovered entirely by chance. Steve Jobs had a history of gastric problems and therefore had been receiving periodic abdominal scans. In October 2003, doctors noticed a growth that was confirmed to be pancreatic cancer.
It’s impossible to know with absolute certainty whether the cancer had begun to spread when it was detected, but based on the early stage it was in and the type of cancer, it probably had not. With any form of cancer, delaying treatment can be deadly, but with a form of cancer like pancreatic cancer, it’s all the more vital. As long as the cancer is confined to the pancreas, it can be operated on and the survival rates are very good. Yet the longer the cancer remains, the greater the odds that it has begun to spread to other organs. In 2003, the time bomb had probably not yet gone off, but it was definitely ticking.
Steve Jobs’ doctors recommended an immediate Pancreaticoduodenectomy, also known as a “Whipple Procedure”. The procedure would have removed a large portion of the pancreas, including the entire tumor along with some of the other structures around the pancreas, such as the duodenum and possibly part of the stomach. Overall, for a person in Steve Job’s stage of the disease in 2003, the prognosis for completely overcoming cancer is excellent for the procedure.
The procedure is fairly drastic, and while most who undergo it successfully are able to lead relatively normal lives, it can include complications like digestive issues and an elevated risk for diabetes. The fact of the matter is that the cancer was not going anywhere and was only going to get worse unless it was operated on. Doctors urged Jobs to have the procedure immediately, but he was understandably apprehensive. Jobs instead perused a course of so-called “alternative” treatments. While these treatments may have been a lot less invasive than major surgery, there’s absolutely no evidence that they actually work.
By some reports, Jobs was “skeptical of mainstream medicine.” His preferred course of treatment was a special diet and various supplements prescribed by a naturopathic practitioner. There was concern by some of Jobs friends as well as board members at Apple, but Jobs stuck with the special diet and herbal remedies for more than nine months.
Unfortunately, scans showed that the tumor was growing at an alarming rate, with the herbal and dietary measures having no apparent effect on the progression of the disease. Finally at the end of July 2004, Jobs had the procedure to remove the cancerous tissue from his pancreas.
It’s not entirely clear from published reports exactly how far the cancer may have progressed, but what is known is that the procedure that was preformed on Jobs did not simply remove the part of the pancreas. Instead, doctors had to remove much the pancreas, gal bladder, bile duct and parts of the stomach and intestines. It therefore appears that by the time the procedure was preformed the cancer had begun to spread at least to the organs closest to the original tumor. None the less, Jobs and his doctors were hopeful that they had gotten every trace of the cancer, although this is impossible to be certain of.
After recuperating from his operation, Jobs began to resume his role at Apple and appeared to be in reasonably good health. However, over the following months and years, he would show additional signs of troubled health. In 2006, Jobs provided the keynote speech at a major apple event. Many observers were surprised by his appearance, which was described as thin, listless and unhealthy. By 2008, his health had apparently deteriorated further, resulting in Jobs taking medical leave for several months.
It was later revealed that Jobs had received a liver transplant. The exact reason for the transplant has not been made public, but it is overwhelmingly likely that it is because the cancer had returned and spread to the liver. In most cases, the standard course of treatment for such liver tumors would be to surgically remove only the parts of the liver where the tumors are located. However, it seems that the cancer was too far progressed for anything less than complete liver transplantation. Such surgery can cure the type of cancer Jobs had, provided it has not spread beyond the liver, but cancer does often return, often within about two years. A liver transplant tends to be the last resort for such situations. Not only is it very major surgery, but it also involves the use of powerful immunosuppressive drugs, which introduce their own risks and reduce the ability of the body to fight both infections and cancer.
In the end, it seems the cancer returned again. Jobs began to show signs of illness again this year, resulting in his taking medical leave in January and finally stepping down last month. His death, though sooner than most had expected, is not shocking given his deteriorating health.
We’ll never be able to know for sure whether it was those nine months of inaction that killed him, but the time lost took him from having an excellent prognosis to having only a mediocre one. If you are lucky enough to catch cancer early, do not squander your opportunity to treat it early. Do what your doctor tells you gives you the best chance of survival, not what some naturepath or yogi tells you will work.
This entry was posted on Sunday, October 9th, 2011 at 6:47 pm and is filed under Bad Science, Misc, Quackery. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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