A Lesson in Treating Illness

I'm sad that today I'm adding a slide to one of my live presentations, adding Steve Jobs to the list of famous people who died treating terminal diseases with woo rather than with medicine.

Seven or eight years ago, the news broke that Steve Jobs had been diagnosed with pancreatic cancer, but considering it a private matter, he delayed in informing Apple's board, and Apple's board delayed in informing the shareholders. So what. The only delay that really mattered was that Steve, it turned out, had been treating his pancreatic cancer with a special diet [UPDATE] suggested by the alternative medicine promoter Dr. Dean Ornish.

Most pancreatic cancers are aggressive and always terminal, but Steve was lucky (if you can call it that) and had a rare form called an islet cell neuroendocrine tumor, which is actually quite treatable with excellent survival rates -- if caught soon enough. The median survival is about a decade, but it depends on how soon it's removed surgically. Steve caught his very early, and should have expected to survive much longer than a decade. Unfortunately -- and to his later regret -- Steve relied on a diet instead of early surgery. There is no evidence that diet has any effect on islet cell carcinoma. As he dieted for nine months, the tumor progressed, and took him from the high end to the low end of the survival rate.

Why did he do this? Well, outsiders like us can't know; but many who avoid medical treatment in favor of unproven alternatives do so because they've been given bad information, without the tools or expertise to discriminate good from bad. Steve was exposed to such bad information, as are we all.

Eventually it became clear to all involved that his alternative therapy wasn't working, and from then on, by all accounts, Steve aggressively threw money at the best that medical science could offer. After nine months of dieting from 2003 to 2004, he finally had the surgery to remove the tumor. But it was too late. He later had to have a Whipple procedure. He had a liver transplant. And then he died, all too young.

My whole family loves Apple devices. Steve made our lives better, and I think I can say that pragmatically and without any Apple heroin in my veins. Not only that, he created my profession.

His lifelong friend Bill Gates tweeted:

For those of us lucky enough to get to work with Steve, it’s been an insanely great honor. I will miss Steve immensely. b-gat.es/qHXDsU

I saw another tweet today from @DamonLindelof that I thought was beautifully worded:

Steve Jobs. On behalf of every dreamer sitting in his or her garage who is crazy enough to try to change the world, you will be missed.

We can't say for sure that Steve would still be alive and making lives better were it not for the alternative therapy, but the statistics suggest it very strongly. If you insist on unproven therapies, fine; but also try the proven ones while you're at it. Nobody likes to either write or read a post such as this one.

For a more expert response to this post, see Dr. David Gorski's critique at Science Based Medicine.

For Harvard oncology researcher Ramzi Amri's thoughts, see the Gawker article in which he expressed the same concerns about the likely effects of Steve's delay in surgery.