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Steve Jobs’ use of alternative medicine: Did it kill him?

Dr. David Gorski says it's very unlikely that Steve Jobs' detour into alternative medicine had much of an effect on the ultimate course of his cancer.
REUTERS/Kimberly White
Dr. David Gorski says it’s very unlikely that Steve Jobs’ detour into alternative medicine had much of an effect on the ultimate course of his cancer.

There’s been a lot of debate on the Web about whether or not Steve Jobs signed his own death certificate, as it were, when he postponed surgery for his pancreatic cancer for nine months in order to pursue “alternative” medical care.

Most of the speculation on this topic has been based on personal biases rather than on facts. And some of it has been downright bizarre (such as an oncologist’s suggestion that eating turmeric might have prolonged Jobs’ life).

One of the more rational and detailed discussions about Jobs’ battle with cancer appears on the Science-based Medicine blog. It’s written by Dr. David Gorski, a surgical oncologist, cancer researcher and associate professor of surgery at Wayne State University, who is well known (and heavily disliked) by many alternative-medicine practitioners for his evidence-based criticisms of their therapies and treatments.

Yet, despite being irritated by the “quackery apologists and quacks [who] have been coming out of the woodwork, each claiming that if only Steve Jobs had subjected himself to this woo or taken this supplement, he’d still be alive today,” Gorski says it’s very unlikely that Jobs’ nine-month detour into alternative medicine had much of an effect on the ultimate course of his cancer.

Dr. David Gorski
bcrfcure.org
Dr. David Gorski

He bases that conclusion on his professional knowledge and on the facts of Jobs’ illness as outlined in the new Walter Isaacson biography of the computer entrepreneur.

Of course, we’ll never really know, he adds. And the reason we’ll never know has to do with a truth about cancer that confuses and angers many people recently: early detection does not always save lives.

Writes Gorski:

[S]urgery was [Jobs’] only hope for long-term survival. However, … chances are that surgery right after his diagnosis probably wouldn’t have saved Jobs, but there was no way to be able to come to that conclusion except in retrospect, and even then the conclusion is uncertain.
Although it’s no doubt counterintuitive to most readers, … finding liver metastases at the time of Jobs’ first operation strongly suggests this conclusion because it indicates that those metastases were almost certainly present nine months before. Had he been operated on then, [what] most likely would have happened is that Jobs’ apparent survival would have been nine months longer but the end result would probably have been the same.
None of this absolves the alternative medicine that Jobs tried or suggests that waiting to undergo surgery wasn’t harmful, only that in hindsight we can conclude that it probably didn’t make a difference. At the time of his diagnosis and during the nine months afterward during which he tried woo instead of medicine, it was entirely reasonable to be concerned that the delay was endangering his life, because it might have been. It was impossible to know until later — and, quite frankly, not even then — whether Jobs’ delaying surgery contributed to his death.
Even though what I have learned [from the Isaacson biography] suggests that this delay probably didn’t contribute to Jobs’ death, it might have. Even though I’m more sure than I was before, I can never be 100% sure. Trust me when I say yet again that I really, really wish I could join with the skeptics and doctors proclaiming that “alternative medicine killed Steve Jobs,” but I can’t, at least not based on the facts as I have been able to learn them.

Gorski also concludes that Jobs did not “jump the queue” to get his liver transplant, although he does question, based on details presented in the Isaacson biography, whether that transplant was a reasonable course of action given that spots (possible tumors) were found on his abdominal lining. He also talks about Isaacson’s interesting revelation that Jobs became one of the first 20 individuals in the world to have all of his DNA and the genes of his cancer sequenced (at a cost of $100,000). The hope was to use that genetic information to find a treatment that would specifically target his cancer.

“Unfortunately,” writes Gorski, “as is all too often the case, the cancer ultimately caught up and passed anything that even the most cutting edge oncologic medicine could do.”

Money goes only so far in the battle against cancer.

You can read Gorski’s very detailed discussion of the progression of Jobs’ cancer here. The New York Times also ran an interesting and reasonable piece on this topic this week, which comes to the same conclusion as Gorski’s article.

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Comments (7)

  1. Submitted by Gavin Sullivan on 11/04/2011 - 12:42 pm.

    If it ‘probably wouldn’t have saved Jobs’, might it have? Would earlier, non-magic-based intervention have marginally improved his odds?

    I respect Jobs’ right to select as much spiritual treatment as he liked–but trust in homeopathy results in much suffering and premature death around the world, including children and mentally-debilitated adults who merit protection from their caregivers’ nonsense.

  2. Submitted by Lance Groth on 11/04/2011 - 03:52 pm.

    With respect to turmeric, the oncologist’s suggestion may be less “bizarre” than the uninformed might think. Laboratory studies have shown that curcumin (the active ingredient in turmeric) kills some cancer cells in vitro, and suppresses the growth of others; primarily cancers of the gut. It also seems to suppress the growth of intestinal polyps.

    From an article on the American Cancer Society site ( http://tinyurl.com/4jgehjr ):

    “Laboratory studies have also shown that curcumin interferes with several important molecular pathways involved in cancer development, growth, and spread.

    A number of studies of curcumin have shown promising results. Curcumin can kill cancer cells in laboratory dishes and also reduces growth of surviving cells. Curcumin also has been found to reduce development of several forms of cancer in laboratory animals and to shrink animal tumors. ”

    The article has a rather lengthy list of referenced source material.

    That’s a little more than “woo”.

    I would suspect turmeric is of more use as a preventative than as a cure, but there is at the least enough evidence to warrant further study. No doubt the oncologist in question is aware of the studies that have been done thus far.

    Western medicine has always kind of had its nose in the air as regards traditional medicines used in other parts of the world. Unpasteurized honey, for example, is an excellent bactericide and is used in wound dressings in various parts of the world – but not in the U.S. A cynical person might wonder if that has something to do with U.S. medicine being largely in the pocket of Big Pharma, and the massive profits to be made there. Which might have something to do with the obscene cost of medical care in this country … but I digress.

  3. Submitted by Rachel Kahler on 11/04/2011 - 04:26 pm.

    I would believe that Jobs might have lived longer with traditional medicine, but as often is the case in the case of pancreatic cancer and metastasizing cancer, in general, it probably would have only prolonged his life for a little while.

    Even if traditional treatment might have “saved” him, he was an adult with no apparent mental dysfunction, so his choice to forgo that option was legitimate and should be respected.

    However, in the case of minors and those of limited mental capacity, it is unethical for a guardian to deny treatment using therapies with known results unless those therapies provide little or no benefit with regard to quality of life.

    All that being said, non-traditional medicine outcomes *in adults* should definitely be more quantitatively studied for both health and quality of life outcomes. After all, a consenting adult should be able to freely choose a treatment that may result in a less favorable length of life outcome but a more favorable quality of life outcome.

  4. Submitted by Susan Perry on 11/04/2011 - 05:21 pm.

    Lance: I’m aware of the studies you mention on curcumin. But it’s a huge, huge leap to take such preliminary laboratory findings and apply them to clinical use in humans. The research is not near that point yet. Not even close. That’s what I found bizarre.

  5. Submitted by Mark Boguski on 11/04/2011 - 08:39 pm.

    There is much about Jobs’ diagnosis and medical treatments that is not covered in Isaacson’s biography (http://bit.ly/vcZi2o), such as the details of Jobs’ tumor genome analyses and what targeted therapies were given as a result. Perhaps some day, a more medically qualified historian will write a definitive account of Jobs’ illness. I think both Dr. Gorski’s account and the NY Times article you cite fail to stress the most modern thinking in oncology research, namely that the goal is no longer to achieve a 100%, universal “cure” but rather to transform cancer into a manageable, chronic illness like type II diabetes or high blood pressure. Catching a cancer early and initiating effective treatment could make all the difference in this scenario.

  6. Submitted by Gregory Lang on 11/05/2011 - 09:57 am.

    Sometimes early intervention works. Other times it doesn’t. I had early stage testicular cancer more than forty years ago. That cancer is dramatic in it’s difference between early stage detection and surgery and late stage.

    Lance Armstrong is one of the very few late stage survivors of this disease. I’m still on a bit of the “educational” “save the males” campaign for early stage testicular cancer awareness.

  7. Submitted by Dr. James Pannozzi AP (Retired) on 11/20/2011 - 09:35 am.

    Regarding the appropriateness or suitability of Dr. David Gorski’s opinion on any aspect of so called alternative medicine:

    “One of the more rational and detailed discussions about Jobs’ battle with cancer appears on the Science-based Medicine blog. It’s written by Dr. David Gorski, a surgical oncologist, cancer researcher and associate professor of surgery at Wayne State University, who is well known (and heavily disliked) by many alternative-medicine practitioners for his evidence-based criticisms of their therapies and treatments.”

    Most unfortunately, despite Gorski’s accomplishments in conventional medicine, I found, after reading his “Orac” blog for some time, that his opinions on alternative medicine, particularly acupuncture and homeoapthy, were biased, uninformed, filled with misrepresentations, distortions, and disinformation and, therefore I have ceased reading them, along with the typical responses of his intellectual goon squad fan club which appear with Pavlovian regularity at his instigation.

    Though some of his blogs were indeed well reasoned and quite good, for example his expose’ of Milgrom’s supposed “Quantum” theories of homeopathy a great number of his comments have fallen into formulaic condescension, condemnations, attempts to portray alternative practitioners as “quacks”, even criticizing fellow MDs like Dr. Nimetzow for his acupuncture work now accepted by the U.S. military, or out to “deceive” the public, though there are indeed some like this, and other anti-scientific, indeed even anti-intellectual tirades which in fact represent the fallacy of what Milgrom termed “scientism”.

    Scientism is an attempt to portray conventional medicine as fully “evidence” based by, in part, narrowing the definition of “evidence” and utilizing a double standard which allows certain types of “evidence” to conventional medicine but denying it to the alternativists. All of this while loudly proclaiming loyalty to “science” and “reason” as if, somehow, the alternativists had abandoned these. Likewise, “scientism” can characteristically include innuendo, bullying, omitting or ignoring arguments that contradict the scientism presumptions and other anti-logical, anti-scientific attitudes which can hardly be considered informed discussion, especially by a Doctor. The article “Beware Scientism’s Onward March” by the same chemist and homeopath, Lionel Milgrom, that Gorski criticizes for his “quantum” theories, is a brilliant examination of the scientism fallacy and the intellectual trojan horse whose tacit acceptance makes it possible. Easily found on the web or at this link:

    http://www.anh-europe.org/news/anh-feature-beware-scientism’s-onward-march

    If you are going to be objective on the topic of alternative medicine treatments, find some real experts on it, there are plenty, not someone whose bias in countless blogs, to the point of apparently losing objectivity, is endemic.

    Dr. James R. Pannozzi D.O.M., LAc.

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