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."
Amri went on to say that, even after entering conventional medical care, the Apple CEO seemed to eschew the most practical forms of treatment. Addressing the period when Jobs began to visibly shed weight, Amri wrote, "it seems that even during this recurrent phase, Mr. Jobs opted to dedicate his time to Apple as the disease progressed, instead of opting for chemotherapy or any other conventional treatment."
When we contacted Amri at his Harvard Medical School email address to verify the post was his—he's a researcher in the department of surgery at the medical school and research fellow at Massachusetts General Hospital—Amri emphasized, "I wrote that on a PERSONAL title and it's my PERSONAL opinion." On Quora, Amri expressed his "profoundest respect" for Jobs and that "I do not pretend to know anything about the case on a personal level and I never participated in the care of Mr. Jobs. I base all my cancer figures on my own research or sources from biomedical research known to me... I have done 1.5 years of research on the type of tumor that affected Steve Jobs and have some strong opinions on his case."
According to a 2008 Fortune article, Jobs for nine months pursued "alternative methods to treat his pancreatic cancer, hoping to avoid [an] operation through a special diet." The Buddhist vegetarian took this approach from the time he was diagnosed in October 2003 until at least the end of July 2004, when he underwent surgery at Stanford University Medical Center.
By then the cancer was so far along Jobs had to lose his pancreas and duodenum in a "Whipple procedure." The cancer also spread to all the major parts of his liver. "The only reason he'd have a transplant," wrote Amri, "would be that the tumor invaded all major parts of the liver, which takes a considerable amount of time." Amri said the Whipple procedure and liver transplant were clear signs the cancer was out of control and should have been stopped earlier.
The condition might have been nipped in the bud if Jobs had acted right away. Jobs's cancer manifest in neuroendocrine tumors, which are typically far less lethal than the "pancreatic adenocarcinoma" that make up 95 percent of pancreatic cancer cases. Amri said neuroendocrine tumors are so "mild" that...
"In my series of patients, for many subtypes, the survival rate was as high as 100% over a decade... As many as 10% of autopsied persons in the general population have been reported to have one of these without ever having had any symptoms during their life. Up to 30% of detected GEP-NETs are so well differentiated they're strictly not cancers."
But even "the most innocent cancer" needs to be removed quickly, which is why older men are always being lectured about colon cancer screenings; colon cancer tumors are thought to begin as removable polyps. In Jobs's case, surgical removal may well have saved him if performed early enough, Amri implies. He wrote:
"In many cases, a simple enucleation (just cutting out the tumor with a safe margin around it) is enough and leaves no residual side-effects."
The cancer researcher made his comments about Jobs because he was looking for a lesson in his case. Doctors routinely face the ethical conundrum of being unable to treat patients because they've exercised their freedom to reject sound medical science.
But there is also, thankfully, a much clearer and easier lesson for patients in Jobs's experience: Do not waste time. Don't waste time by ignoring advice to get screened; don't waste time by drowning yourself in research about your condition; and don't waste time by delaying medically recommended treatment in the hops that something else will work.
"We saw the tumor slowly draining the life out him," Amri wrote of Jobs. "It was a horrible thing to see him lose weight and slowly turn into a skin and bones form of himself."
That, in the end, may prove the most compelling reason to forgive the brilliant CEO his many faults: Of all the people who suffered on the dark side of his headstrong, iconoclastic decisionmaking, it was Jobs himself who appears to have paid the biggest price.
[Photos via AP]