23 October 2011
Jobs was a savvy businessman and one of the visionaries of our time. In his famous 2005 commencement address to Stanford University he stressed the importance of taking risks. A trickle has turned into a stream of information that suggests that Jobs may have taken an extraordinary gamble with his own life.
I admit that without Jobs’s full medical history that some of the details herein are speculation and not as scientifically rigorous as I prefer. Also, individual case studies do not meet the standards of rigorous and accurate epidemiology. However, I would like to use the available information as a cautionary tale.
Jobs was very private about his illness, and out of nearly a dozen articles, this one by Sharon Begley of NewsWeek is the most balanced and comprehensive one I could find. Jobs initially decided to forego conventional surgical treatments and using alternate (untested) therapy before undergoing conventional therapies (like surgery) once his cancer spread.
He later took another gamble: a liver transplant. One of the most common (and deadly) sites of pancreatic cancer metastasis is spread to the liver. It’s widely speculated that he swapped a cancer-riddled liver with a fresh one. Now, that’s speculation, but what isn’t speculative is that an organ transplant requires one to take powerful immunosuppressant drugs for the rest of their life. Such a move would theoretically compromise the immune system’s ability to fight the cancer.
A liver transplant in the face of cancer metastasis is like trying to fight fire with gasoline. Once cancer has begun to spread beyond the organ of origin (the pancreas for Jobs) it is likely that tumor cells have been seeded many other places beyond the pancreas and liver. It would only be a matter of time until tumors would become detectable and begin to damage other vital organs. The effect of suppressing the immune system would likely enhance the progression of the seeded tumor cells in other parts of the body by removing a roadblock for tumor growth.
Immune suppression is VERY dangerous for cancer patients. I should also note that radiation and chemotherapy can also weaken the immune system, and this caveat is a major factor in determining the proper dose and application of conventional therapies. Despite these caveats, radiation and chemotherapy have saved many lives and prolonged the lives of many more cancer patients. And, they continue to do so consistently in clinical trials.
Now, don’t get me wrong. The goal of this article is not to take a jab at Steve Jobs. The man did many, many things right in his life. The opportunity presents itself to use his medical history as a lesson for the dangers of relying on treatments that are “alternative” or “complimentary.” I have a problem with those ambiguous labels, as they are often contextually used to try to legitimize medicine that has not been proven to work consistently. If clinical trials demonstrate efficacy, therapies cease to be labeled “alternative” but are instead: medicine.