Image via CrunchBase
Apple CEO Steve Jobs had a neuroendocrine tumor removed from his pancreas in July, 2004. At the time, it was not known what type of tumor this was, though last year, when he underwent a liver transplant, it seemed likely that what Jobs had was in fact an Islet Cell tumor, which often spread to the liver. More than 50% are malignant.
Islet cell tumors are rare, with only 2500 new cases per year in the U.S. They tend to be much slower growing than the more common pancreatic cancer (adenocarcinoma), and 60% of these tumors are non-functioning, meaning that they don’t produce hormones.
Given that Jobs had a liver transplant in 2009, the malignant islet cell scenario seems likely. Liver transplant greatly improves prognosis. In Jobs’ case, he returned to work following the transplant, before announcing this past week that he would again be taking medical leave.
So what is happening now? If Jobs’ medical leave ends up being related to his neuroendocrine tumor, in my opinion three scenarios are most likely.
First, and most dreaded, would be a recurrence or spread of the tumor itself. Treatment options include chemotherapy, but long-term survival estimates are not optimistic despite continued treatment.
Second would be a failure of the transplanted liver. Livers actually have a high level of transplant failures — close to 60% — and if Jobs is experiencing this now, it would be a chronic rejection, since the transplant itself took place over a year ago. It is conceivable that transplant rejection could be handled with stronger immune-suppressive drugs, or perhaps a second liver transplant could be considered.
The third possibility would be the most benign, namely a problem with the immunosuppressive drugs (which likely include the powerful agent cyclosporine), which can lead to infections, bleeding, blood clots and liver or kidney failure. Most likely these side effects could be reversed by altering the treatment, and if this is the current scenario, Jobs could return to work.
Whatever the cause of Jobs’ medical leave, we wish him the very best, and as a practicing physician I would prefer that he keep his privacy regarding the exact cause of concern, rather than provide us in the media with more details.
's Categories: Op/Ed, The World's Billionaires, byline=Marc Siegel
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Hope Steve gets better. Having said that, no matter how “healthy” you eat or try to be, there are things that can get you in the end. All of the vegetarianism and anti tobacco activism etc. didn’t keep this from happening. Better to worry about more important things in life than worshipping one’s own body which many have been doing since the 60’s US gen turned to the ME generation.
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