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.
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.
[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.