Steve Jobs Faces Uphill Battle Against Cancer:
THURSDAY, Aug. 25 (HealthDay News) -- One of the hallmarks of
Steve Jobs' tenure as CEO of Apple Inc. was the secrecy that
shrouded products he was about to unveil -- from the iPod to the
iPhone to the iPad -- creating tremendous consumer interest.
Jobs' announcement Wednesday night that he was stepping down as
the head of the hugely successful technology company he co-founded
in a northern California garage 35 years ago was similarly thin on
details, although speculation immediately turned to his ongoing
In a letter to Apple's board, the 56-year-old Jobs said he
"always said if there ever came a day when I could no longer meet
my duties and expectations as Apple's CEO, I would be the first to
let you know. Unfortunately, that day has come."
This much is known about the health of Jobs, a legendarily
private man: Since 2004, he has been fighting a rare form of
pancreatic cancer called neuroendocrine cancer. In January, he took
his second medical leave from Apple after undergoing a liver
transplant for tumors that had spread to that organ.
Pancreatic cancer expert Dr. Craig Devoe, from the department of
medicine at North Shore-LIJ Health System in New Hyde Park, N.Y.,
said that "neuroendocrine tumors are uncommon, with only a few
thousand cases a year."
For those that affect the pancreas, the numbers are even lower
with fewer than 1,000 cases a year in the United States. In
contrast, there are around 40,000 cases of other pancreatic cancers
a year, Devoe said.
Dr. David M. Levi, a professor of clinical surgery, liver and GI
transplantation at the University of Miami Miller School of
Medicine, said neuroendocrine cancer "is an unusual tumor. It can
arise in a number of places, including the pancreas." Such tumors
can also start in the lungs.
It's one of the few tumors that can benefit -- to some extent --
from a transplant, Levi said. Jobs' cancer started in the pancreas
and then spread to the liver, making the liver transplant an
option, Levi said, adding he has treated patients with this type of
cancer and done liver transplants.
While the prognosis for neuroendocrine cancer is often better
than for the more common type of pancreatic cancer, in which
patients generally live less than a year after diagnosis,
neuroendocrine cancer "can also be bad," Levi said.
Neuroendocrine cancer can return after treatment, Levi
explained. And while a liver transplant can be effective, "it is
not as great a picture as we first thought," he said. "A lot of
these patients who have transplants eventually do recur."
"The vast majority of patients that have recurrent disease will die of their disease. One of the problems with the [liver] transplant is that now you are on immunosuppressant drugs, and while they keep you from rejection or destroying the liver, the immune system also would have helped deal with tumors," he said.
Devoe said a liver transplant is a treatment when "your back's
against the wall," and isn't expected to cure neuroendocrine
cancer, so very few are done. "There is still likely disease in
lungs or bone or other places," he said.
"The fact that the disease came back is not surprising," he said. There are still some treatment options, including chemotherapy and radiation, he added.
These treatments won't cure the disease, but they may slow its
progression, Devoe said. "It may extend the life of patients. But
at this point, your best treatments are behind you and survival may
be under a year or two," he said. "It's clearly incurable."
Doctors don't really know what causes neuroendocrine tumors. In
the past year, the U.S. Food and Drug Administration approved two
new drugs for neuroendocrine tumors -- sunitinib and
In a commencement address in 2005 to Stanford University
graduates, Jobs said: "No one wants to die. Even people who want to
go to heaven don't want to die to get there. And yet death is the
destination we all share. No one has ever escaped it."
To learn more about neuroendocrine pancreatic tumors, visit
Stanford University School of Medicine.
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