Was Steve Jobs Really a Difficult Patient?



imagesThe CNN article entitled “Steve Jobs: A Difficult Patient” provoked hundreds to comment online. Here is a sampling of some of the responses:

  • The one man who could get the best possible treatment on earth ultimately did not survive. What point does this prove?
  • What an idiot, he basically killed himself off by his own stupidity.
  • He forgot to try leaches – that is why he died.

The criticism of Mr. Jobs’ decision to delay surgery appears to be unsubstantiated. A recent study shows average survival after surgical treatment of this type of tumor is about 9.5 years, about the survival time achieved by Mr. Jobs.

Mr. Jobs survived by nearly 9 years a slow-growing form of pancreatic cancer first discovered in 2003. He initially shunned surgery (a drastic operation called a Whipple procedure) which is a very trying operation for surgeon and patient. You can get a view of this complicated operation at the Mayo Clinic website here. The operation involves removal of the head of the pancreas where most tumors originate as well as removal of the gall bladder and the first part of the small intestine (duodenum) and reconnection of the digestive organs.

Surgery does not necessarily slow tumor growth. It may or may not buy time. It certainly does de-bulk a tumor and reduce pain and other life-threatening problems as the tumor expands. But contrary to the CNN report, surgery does not inhibit the spread of cancer. In fact, because surgery provokes wound healing responses it promotes new blood vessel formation (angiogenesis) which is how tumors obtain nutrients to grow.

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