Re: Harvard Cancer Expert: Steve Jobs Probably Doomed Himself With Alternative Medicine

[Guest guest]

wrote: I wondered why Mr. Jobs' islet cell tumor, usually not a bad actor, killed him. Seems he delayed any treatment, eating herbs and berries, for nine months before opting for conventional treatments.First, thanks for bringing this up. Here is the original blog.http://www.quora.com/Steve-Jobs/Why-did-Steve-Jobs-choose-not-to-effectively-treat-his-cancer Note, first, that this opinion is not written by Jobs's physician. Thus, we are operating on a theoretical level.He asserts, probably accurately, that Jobs had a Gastroenteropancreatic Neuroendocrine Tumor, of an uncertain subtype. If so, it appears this is a rare type, as he notes, not the adenocarcinoma form found generally and for which I actually cited statistics.Finally, your statement that he ate herbs and berries is of course unfounded, since we don't know what if any treatment plan Jobs pursued, except some kind of dietary intervention. I have learned not to trust your flip opinions, unfortunately, , because you never cite the literature and just expect people to believe you.However, I readily concede that Jobs may have had a better outcome had he undergone early surgery as this physician speculates, given the information provided. But we don't really know because we don't know what his physician(s) said about his condition, diagnosis or prognosis. And indeed, as the abstract below underscores, there are forms of this rarer subtype of cancer that are aggressive--and again, the five-year prognosis ain't exactly great. The physician's opinion is based on a presumption that the tumor was well-differentiated; it may have been. One of the comments from above notes:"If he underwent a Whipple nine months later (again, speculation, but

plausible based on changes in Mr. Jobs' appearance) it might be evidence of a particularly virulent tumor, but also seems consistent with a relatively advanced tumor at diagnosis that did not respond to (conventional) pre-surgical therapies."In this case, you may be correct. CAM may have been a poorer choice--but it may also have provided him with a better quality of life in the interim--also a speculation. Finally, one case does not render all CAM ineffective--which is of course what you appear to believe. However, the virulent opposition to CAM by some in the medical community renders genuine clinical evaluation extraordinarily difficult.What I'd like to see is that interventions be viewed on their own right, risks, benefits and costs under consideration--and that includes medicine which should NOT be a "for-profit" venture that has destroyed a lot of mainstream medicine's credibility (and often does the same for supplements, too).This doesn't help us make valid, wise, best treatment choices. M. ***Cancer Treat Rev. 2011 Aug;37(5):358-65. Epub 2011 Apr 9.Neuroendocrine carcinoma of unknown primary: a systematic review of the literature and a comparative study with other neuroendocrine tumors.Stoyianni A, Pentheroudakis G, Pavlidis N.SourceDepartment of Medical Oncology, Ioannina University Hospital, Greece. aik_stoyianni@...AbstractINTRODUCTION: Neuroendocrine

carcinomas of unknown primary (NCUP) represent a specific subset with relatively favorable prognosis. Data on biology, management and outcome of NCUP patients have not been systematically reviewed neither compared to those of neuroendocrine tumors of known primary.PATIENTS AND METHODS: We systematically reviewed all publications studying neuroendocrine

CUP patients and presented a single center retrospective patient series. In addition, we analyzed and specified the similarities and/or differences between NCUP and other neuroendocrine malignancies.RESULTS: Five hundred patients with NCUP constituted a heterogeneous cohort in terms of histology, grade, anatomic site and tumor

biology in published series and were managed mostly with platinum-based

regimens. Among 294 patients with available outcome data, a median survival of 15.5 months (range 11.6-40) was observed. Comparative analysis with neuroendocrine solid tumors

(NET) revealed that poorly-differentiated NCUP share an aggressive natural history and a dismal prognosis similar to high grade pulmonary and extrapulmonary neuroendocrine carcinomas (Large Cell Neuroendocrine bronchial Carcinomas, LCNEC and poorly differentiated gastroenteropancreatic tumors,

GEP-NET). Well differentiated NCUP reveal a more indolent course with a

survival range resembling that of typical and atypical pulmonary carcinoids, well differentiated gastrointestinal NETs and limited small cell lung carcinomas.CONCLUSION: No evidence for distinct biology or outcome of NCUP patients emerged when histological grade was matched for known primary NETs. The high heterogeneity of the NCUP subgroup limits the potential for identification of reliable prognosticators and hinders development of novel targeted therapies.Copyright © 2011 Elsevier Ltd. All rights reserved.PMID: 21481536