A friend of the family said the cause was complications of pancreatic cancer.
–New York Times
…[In] recent years Jobs had fought a form of pancreatic cancer and had a liver transplant.
In 2004, he announced to his employees that he was being treated for pancreatic cancer.
These quotes are just three of the hundreds, if not thousands, of statements made by news media about the cause of death of Apple founder Steve Jobs.
For a public figure as well-known as Jobs, the media had a responsibility to “get it right” and to explain the medical facts behind the headlines to increase the health literacy of the public. With one exception, the mainstream media had a very poor showing in both regards.
Our mission at Celebrity Diagnosis is to use the unique circumstances surrounding the health and illnesses of those in the public eye as “teachable moments in medicine,” and in so doing, increase your health awareness and medical knowledge.
When people hear the term “pancreatic cancer,” they think of the disease that killed Patrick Swayze, Pernell Roberts, William Saffire and others: One day you’re fine, next you feel a little off and go to the doctor who gives you the horrendous diagnosis, and you’re dead within weeks or months.
This is the most common kind of cancer, that doctors call pancreatic adenocarcinoma. It is NOT the kind of cancer Steve Jobs had – he had a much rarer type of tumor called an neuroendocrine tumor. Although it did arise in the pancreas, it originated from a different pancreatic cell and had a different prognosis and treatment.
So let’s start at the beginning…
The pancreas is a fish-shaped organ (with a head to the right and tail to the left) which lies behind the stomach. It is made up of two types of cells:
1. Exocrine cells: These cells produce a pancreatic juice that includes enzymes which aid in the digestion of food in the small intestine, breaking up proteins,carbohydrates and fats.
2. Endocrine cells: These are clustered in small groups (called the Islets of Langerhans) scattered throughout the pancreas. These cells produce important hormones such as insulin, glucagon, and somatostatin.
An islet cell tumor is a mass of abnormal cells that forms in the endocrine (hormone -producing) tissues of the pancreas. Islet cell tumors may be benign (noncancer) or malignant (cancerous). Islet cell cancer is rare- only about 5% of pancreatic cancers start here.
When islet cells in the pancreas become cancerous, they may make too many hormones. Islet cell cancers that make too many hormones are called functioning tumors. Other islet cell cancers may not make extra hormones and are called nonfunctioning tumors. Seventy-five percent of islet cell tumors are functioning tumors.
Functional Islet Cell Tumors are often named after the hormone they produce:
Surgery is the most common treatment of islet cell cancer. The doctor may take out the cancer and most or part of the pancreas. Sometimes the stomach is taken out (gastrectomy) because of ulcers. Lymph nodes in the area may also be removed and looked at under a microscope to see if they contain cancer.
If malignant cancer cells spread , they tend to go to the liver, and a portion of the liver may also be removed, if possible. Research has suggested that since the tumor is slow growing, even when present in the liver, that liver transplantation is a reasonable option for islet cell cancer patients with spread to the liver. (Steve Jobs underwent a liver transplant in 2009)
If the cancer is widespread, various forms of chemotherapy may be used to try and shrink the tumors.
The prognosis for islet cell tumors is generally better than adenocarcinomas. Average life expectancy has been stated as 5-10 years. They tend to be slower growing tumors. Also, because the hormones they produce cause symptoms, they are often caught at an earlier stage. Surgery may be curative if found before there is any spread elsewhere.
Pancreatic adenocarcinoma is a cancerous overgrowth of exocrine pancreatic cells (see above).
Inherited genetic disorders cause 5-10% of cases of pancreatic cancer and certain genes can inrease the lifetime risk up 80%.
Because pancreatic cancer is often advanced when it is first found, very few pancreatic tumors can be removed by surgery. The standard surgical procedure is called a pancreaticoduodenectomy (Whipple procedure).
When the tumor has not spread out of the pancreas but cannot be removed, radiation therapy and chemotherapy together may be recommended.
When the tumor has spread (metastasized) to other organs such as the liver, chemotherapy alone is usually used. The standard chemotherapy drug is gemcitabine, but other drugs may be used. Gemcitabine can help about 25% of patients.
Managing pain and other symptoms is an important part of treating advanced pancreatic cancer. Palliative care tams and hospice can help with pain and symptom management, and provide psychological support for patients and their families during the illness.
More extensive information is available by visiting these Resounding Health Casebooks:
Neuroendocrine (islet cell) tumor