Not a radiotherapist but a radiologist (reading CT, MRI and PET scans). But I know many and do some research in that area as well.
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Steve Jobs Regretted Early Decision to Delay Cancer Surgery
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Not a radiotherapist but a radiologist (reading CT, MRI and PET scans). But I know many and do some research in that area as well.
Actually, that is likely correct. He outlived the median survival of his disease by a few years.
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His decision likely made no difference in his case.
Apparently, his tumor DNA was sequenced (one of the first of his kind of tumors ever). Maybe that will help others by giving insights into this disease. So don't be disappointed.
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Not quite true.
There are a few cancers that need immediate surgery, but for the vast majority of solid cancers (unlike some leukemias and lymphomas) it is better to take some time and do things right. It is better to be right than fast. Not sure I would have waited 9 months for most cancers, but again, in this case I'm not sure it would have made a difference.
It wasn't even a question. When this all first started they said things like remove intestines and things of that nature but in the end the only thing I could think about was my family. At first it bothered me about the side effects but in the end life itself is just to special to throw away.
I pre-ordered this book on iBooks and plan to read it as soon as I can. I am fascinated by his life. It's interesting, because Jobs has many of the traits people despise in a leader-- an unwillingness to compromise, vindictiveness, a singular vision, and being very critical. However, most people do this and produce crap. The thing that saves Jobs form his own abrasiveness is that, at the end of the day, he produced the best products the world has seen.
Life is complicated. So many inter-related processes... sometimes it's not easy to face one's one mortality, especially when it's so imminent... That being said, I would have done that operation as soon as possible... But humans are not always rational. We are also emotional beings... In the end, Steve jobs chose his fate.
My understanding is that one big thing that differentiates cancers from benign tumors is that cancers tend to break apart and spread to other parts of the body. The amount and speed with which this happens varies with the type of cancer. If you catch them early, certain types of cancer have a decent chance that they haven't broken up and spread yet, so there can be a reasonable chance of cure by surgically removing the primary tumor.
But other cancer types may spread like wildfire. If you go in to surgically remove them, you may find dozens of secondary tumors throughout all tissues in the body. It simply isn't feasible to remove them all; if you don't get every last one, chances are good that whatever's left will grow and spread again, damaging any tissues that are invaded. Additionally, chances are very high in this case that there are many more microscopic tumors or bunches of cells that would never be found surgically. In that case, chemotherapy (cancer killing chemicals injected into the bloodstream) or radiation are the primary options, but only if the type of cancer responds well to those treatments.
I'm not a doctor, so anyone feel free to correct any of the above.
As an example, I had a type of cancer called seminoma. It doesn't grow as quickly or spread as readily as many other cancers, so surgery can often be curative when caught early. I had the surgery, but 6 months later a new tumor showed up in one of my abdominal lymph nodes. That means a microscopic clump of cancer cells was left behind after the surgery, and eventually migrated to the lymph node where it attached and grew. We didn't know this until the lump became large enough to be observed on a CT scan.
Since there were likely to be other microscopic bits of cancer floating around besides this one, we did radiation in that area of the body to get them all. Seminoma spreads in a slow, stepwise fashion, going first to the abdominal lymph nodes, then later the lungs, and finally maybe the brain. Because it doesn't do this quickly, we a had very statistically high chance that radiation to the abdomen only would get everything. If that weren't the case, and there were a significant chance of cancer cells existing outside the abdomen, then chemo would have been the only real option. It would have gotten everything since it goes throughout the entire body via the bloodstream.
Hope that helps.
Tks a lot for your reply, that seems very clear.
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Perhaps his point was that (mind you, I am a lawyer, not at all a medical doctor) even when using the latest chemo and radio techniques, you are still dealing with a "shot in the dark" - I've never heard of any MD stating that he WILL guarantee cure to a certain type of cancer (exactly in the same way that no lawyer in his sane mind would formally and absolutely guarantee victory in a certain lawsuit)...instead, it's more like a "we're gonna try this and hope it works" approach.
Don't you agree?
Tks a lot for your reply, that seems very clear.
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Perhaps his point was that (mind you, I am a lawyer, not at all a medical doctor) even when using the latest chemo and radio techniques, you are still dealing with a "shot in the dark" - I've never heard of any MD stating that he WILL guarantee cure to a certain type of cancer (exactly in the same way that no lawyer in his sane mind would formally and absolutely guarantee victory in a certain lawsuit)...instead, it's more like a "we're gonna try this and hope it works" approach.
Don't you agree?
I said, "the only curative approach is surgery" and not that surgery would have absolutely and certainly cured him. IF (big if, I don't know his case in the details, only as much as anybody else here) it was a confined and local tumor upon diagnosis with no detectable disease upon staging (including an Octreotide scan, which scans for neuroendocrine tumors in the body with radioactivity) than surgery would have been the way to a potential cure. And, in that respect I agree, nothing is certain in Medicine. It's not physics, it is biology, and psychology and things beyond we probably don't even know.
I never called him "stupid", nor would I think to. I think you are reading a bit too much into my original post, so perhaps you should re-read it without any predisposition.
As far as "disbeliev[ing] in something bigger and longer lasting than corporeal life", you are again barking up the wrong tree. I rely on faith and prayer more than I rely on the "wisdom of man". That is why I said that any such decision is a personal one. No matter what any of us may think, we do not know what impressions or guidance or personal revelation Steve and his wife may have received through introspection and prayer regarding the surgery. Nor can we know what might have happened had he gone through with surgery at an earlier stage. Certainly Steve was accustomed to being correct when following his heart or a gut feeling.
All any of us can do is comment on the irony of having access to the very best medical care (something many would hope to have in such a situation), but making the personal choice to try alternative remedies. Certainly such a decision does not fit the stereotype of what a billionaire would do. Then again, Steve Jobs rarely fit any stereotypes. And again, given Steve's track record in life you would almost expect for him to have been right about this as well. People always told him he was going the wrong way, but he almost always turned out to be right and the naysayers eventually followed. It is too bad that he was unable to beat this illness -- and that is not to say that an earlier surgery would have guaranteed that -- it may have made things worse and led to an earlier death for all we know.
We will never know for sure. But we do know that he will be missed by those he left behind.
It is sad but Steve marched to the tune of his own drummer...always.
The 2005 Stanford Commencement speech was probably self recognition that he wasn't omnipotent. The establishment of Apple University, the almost carved in stone positions of Cook, Ive and Forstall are very positive consequences of Steve's knowledge that he was going to die. In fact, I would go so far as to say that Apple is a better company for this. He had just been back 5 years and the iMac and iPod and iTunes were fantastic successes but I can't help but wonder if perhaps his attention wasn't sharpened. If the idea of his legacy wasn't even more pronounced.
How many of us get so many years to prepare for our demise? Where would Apple be or even his relationships with his family and closest friends? Steve not only was granted the opportunity, but seized it by its horns and did a darned good job. All of us should be so lucky. Honestly.
I think the extract above sums it all...as much as medicine provides the clearest path to a cure, don't rule out alternative approaches.
Don't rule them out - but don't let them exclude/overrule the conventional and scientifically verified approach! If you want to suplement conventional therapy with special (healthy, not crazy) diet, herbs (certain only, some are toxic) - fine, but only if as supplement.
This is really sad. Anyone who has been cured by cancer knows early detection and intervention is the only hope you have. But I guess even the best of people can be in denial, until it's too late.
As they say, hindsight is 20/20. I'm confident Steve made the best decision (for himself) at the time, as he explored alternate treatments. There's absolutely no certainty that convention treatment would have been the perfect choice.
Despite his ability to seek the finest health care of anyone on earth, one does the best in the decision making process. As we know Steve was a very brilliant man, one with great foresight. That it turned out this way is just one more reminder that cancer can take anyone at anytime.
May He Rest In Peace.
Despite his ability to seek the finest health care of anyone on earth, one does the best in the decision making process. As we know Steve was a very brilliant man, one with great foresight. That it turned out this way is just one more reminder that cancer can take anyone at anytime.
May He Rest In Peace.
Steve, by his own admission, regretted waiting to have the surgery. Why defend that bad decision of his?
You're right, there's no absolute certainty that conventional treatment would have been the "perfect choice," but it certainly would have been the better choice (by which I mean conventional treatment always increases your odds over no treatment). i.e. It doesn't always change the outcome, but it increases the likelihood of a favorable outcome.
Steve, tragically, provided the perfect example of what not to do. He realized it to late, but we need to learn from his mistake, not defend it.
Interpreting what YOU think someone meant by a statement, what YOU think someone was feeling etc is not accurate. It is you shoving your bias into the story.
All the if's in the world don't change one very important fact. Steve Jobs is dead. Pay your respects and move on. Out of respect for his family if not for him.
He wanted the public to know the facts. Not someone else's personal spin on them. Thus I want to hear what Steve said, not what Isaacson thinks Steve was saying.
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That is something a lot of folks don't realize. Even with immediate surgery the survival rate is only like 2-3 years on the outside. And only like 5% of folks are part of that group.
Jobs delayed for 9 months and outlived the statistics but about 2 years.
You're posting in the 'Discuss Steve's Cancer' thread. If you don't want to discuss Steve's cancer, then go post in the 'Steve has died' thread.
No, this was a different sort of pancreatic cancer, with a much better survivability - if operated on promptly.