Good or Bad, celebrities continue to shock and amaze us, and 2011 was no exception.

From Charlie Sheen’s outburst in February, and Harry Potter’s Daniel Radcliff admitting to being an alcoholic, to the tragic losses of Steve Jobs, Ryan Dunn, Amy Winehouse and others, 2011 was a year filled with shocking celebrity health moments that will not soon be forgotten.

Below you’ll find our list of the 2011′s 27 most shocking moments in celebrity health.

1. Charlie Sheen Will Make Your Face Melt Off

How could we forget Charlie Sheen‘s rant back in February?

In what was arguably one of the biggest celebrity meltdowns in since Britney Spears in 2008, Charlie Sheen simultaneously got fired from his role on Two and A Half Men, and became an internet sensation.

His comments in interviews with various media outlets raised questions as to whether or not he was using drugs again, but at the time of the infamous 20/20 interview, he was clean.

Dr. Drew Pinsky argued that Charlie Sheen was showing signs of mania at the time, and we detailed the symptoms of manic and depressive episodes.

In the end, Charlie’s outbursts gave him a huge spike in internet traffic, and spawned several items of Charlie Sheen branded Clothing & Accessories based on his outrageous comments.

And if you ask Mr. Sheen how he was able to come out “Winning” he’d simply say;

I’ve got Tiger Blood, bro.

2. Michael Douglas Beats Throat Cancer

Sheen’s “Wall Street” co-star Michael Douglas was diagnosed with throat cancer in August of 2010, but, in January after 7 weeks of radiation and chemotherapy, he announced  ”The tumor is gone.”

Douglas lost about 35 lbs during his treatment, but regained 12 back by “eating like a pig.”

Perfect timing for Michael Douglas as he began preparing for the Steven Soderbergh directed Behind the Candelabra, an upcoming biopic that tells the story of the “tempestuous relationship” between famed singer Liberace (Douglas) and Scott Thorson (played by Matt Damon), his younger lover.

3. Bret Michaels Survives Heart Surgery

In April 2010, 10 days after undergoing an emergency appendectomy, rocker Bret Michaels of Poison and Rock of Love fame suffered a major brain hemorrhage, which landed him in the intensive care unit.

His recovery was marked by a number of set-backs including suffering a “warning stroke” in May. Despite all this, he went on to win Celebrity Apprentice.

It was during the medical evaluation to determine why he had the stroke that physicians diagnosed Michaels with patent forale ovale, a congenital hole in his heart.

The hole in his heart was real, but it was surgery, not a VH1 reality show that was going to fix it. He underwent a successful repair in January 2011.

Michaels told People Magazine:

It was one thing after another…It has been rough. But I’m feeling pretty damn good. I’m really blessed to be here.

4. Barbara Walters Opens Her Heart to the World

What do Barbara Walters and Brett Michaels have in common?

At first glance, you wouldn’t think much, but on February 4th the 20/20 host aired “A Matter of Life and Death” where she spoke with the likes of Bill Clinton, David Letterman, Regis Philbin, Robin Willams, and Charlie Rose about their open heart surgery.

Walters also used her special to turn the cameras on herself to showcase a teachable moment in medicine and document her own surgical journey.

In the special, she talked to doctors, including her own to educate viewers, especially women, on what they need to know about cardiovascular disease (which kills more than 450,000 women a year)

She used her celebrity to promote public health awareness (something we’re a huge fan of at Cdx) and said,

“I didn’t want people to feel that this was going to be an hour lecture,”  “To have these very famous, and in some cases very funny people, meant that they [the viewers] would watch.”

5. Serena Williams Undergoes Treatment for Pulmonary Embolism

Tennis superstar Serena Williams had a rough year.

First her feet were deeply lacerated by a broken glass in 2010 for which she had two surgeries, then in March she had to undergo emergency surgery for a pulmonary embolism.

At the time of diagnosis, she was experiencing shortness of breath and swelling in her leg. She had also developed a hematoma the size of a grapefruit that had to be surgically removed.

Ultimately though, she did very well in the Wimbledon tournament and the US Open Final.

She was also named UNICEF’s international Goodwill Ambassador where she will use her popularity and personal interest in children’s issues to support UNICEF’s mission.

6. Matthew Morrison’s Sweet Potato Abs

Matthew Morrison (aka Will Schuester on Glee) revealed something very interesting about his diet this year.

Before a photo shoot, Morrison will only eat sweet potatoes and drink very little water.

“My trainer said eat nothing apart from sweet potato and very little water.The potato acts as a sponge and your body literally shrinks and gets ripped and tight.”

Of course, he also cycles 100 miles a week, and runs another 25 and does :08 min. Abs daily. He also works on a different muscle of his body for about 20 minutes every day and does resistance training four times a week, AND follows a strict diet that limits even healthy snacks like nuts, AND he doesn’t eat fruit after dark.

Not to mention all of the dancing he does on the set of Glee.

So, if you want abs like Matthew Morrison, be sure to follow all of the steps in his workout routine.

BTW, sweet potatoes and  little water is considered a semi starvation diet and is by no means sustainable.

Still, his abs aren’t all that bad to look at.

7. Keenan Cahill is Dynamite!

Keenan Cahill may very well be the only “non traditional” celebrity on this list, being that his claim to fame is lip syncing famous songs on YouTube and that he’s created his own celebrity status from a webcam in his bedroom.

Don’t let “lip syncing” fool you though, BeenerKeeKee19952 (as he’s known on YouTube) has 567,068 subscribers on YouTube and his videos have been viewed over 360 million times.  He is the 39th most subscribed musician of all time on YouTube.

Keenan frequently features celebrity guest stars in his videos, such as 50 Cent, Flo Rida, Cobra Starship, and Jennifer Aniston, just to name a few.

Now for the amazing thing, he’s only 16 years old.

He also has a rare genetic disorder called Maroteaux-Lamy Syndrome which prevents his body from breaking down certain complex sugar molecules.

He undergoes weekly enzyme replacement therapy that doctors hope will stabilize his disorder and extend his life. But treatment is expensive which is why Keenan teamed up with members of the San Francisco Giants to start “Dynamite: A Fundraiser for Keenan Cahill”

He’s been involved in several other campaigns, working with NY Knicks, Smartwater, and Wrigley Gum  and he also runs his own clothing line Just Love Apparel.

All this from a kid in his room with a webcam. Amazing!

8.  Missy Elliot with Graves

Wonder why Missy Elliot has been absent from the music scene for the past few years?

In June, Missy Elliot told People Magazine that she had been diagnosed with Graves’ Disease, a thyroid condition, in 2008.

When she was diagnosed, she said the disease had “began affecting her motor skills, followed by a string of symptoms: dizzy spells, lumps in her throat, mood swings, hair loss, a fast heart rate and bulging eyes.”

She was treated with radiation therapy and medication, and is apparently feeling much better.

After being featured on “Behind the Music” she was also voted the second favorite female rapper  by Power99 (though she only lost by .69% margin). She also remixed Last Friday Night by Katy Perry, was featured on Demi Lovato‘s All Night Long, and J. Cole’s Nobody’s Perfect.

It’s good to see the 39 year old rap innovator back in the game, and we hope to hear more from her in 2012.

 9. Harry Potter was an Alcoholic?!

Harry Potter fans may have received a shock when they read in GQ in July  that Daniel Radcliffe was heavily reliant on alcohol while filming Harry Potter in 2009.

“I became so reliant on (alcohol) to enjoy stuff…There were a few years there when I was just so enamored with the idea of living some sort of famous person’s lifestyle that really isn’t suited to me.”“As much as I would love to be a person that goes to parties and has a couple of drinks and has a nice time, that doesn’t work for me. I do that very unsuccessfully. I’m actually enjoying the fact I can have a relationship with my girlfriend where I’m really pleasant and I’m not (expletive) up totally all the time.”

So, it’s good to know that he’s been able to kick the sauce, and Voldemort’s butt in this year’s Harry Potter and the Deathly Hallows Part 2.

10. R. Kelly Has a Bump N’ Grind Removed (From His Throat)

In July, R. Kelly was likely saying “I Believe I Can Fly” not because he was feeling inspired, but from the drugs used during an emergency removal of an abscess in one of his tonsils.

He had been complaining of a sore throat but couldn’t get “The Best of Both Worlds” when it came to treatment. Physicians drained the abscess immediately at the hospital.

Though his publicist said he would be “laid up indefinitely” he was nominated for a Soul Train award for Best Male R&B/Soul Artist and received two Grammy nominations for  Best Traditional R&B Vocal Performance and Best R&B Album for his Album “Love Letter”

Surely, the singer doesn’t feel like he’s “Trapped in the Closet” anymore.

P.S. He sounded in great form last night on The X Factor-  he sand a duet with contestant Melanie Amaro!

11. Angelina Jolie Eats Bugs

That’s right, Angelina Jolie and her children have revealed that they love eating insects.

Specifically crickets. While shooting a Louis Vuitton ad in Cambodia, Jolie said;

“They ate them like Doritos and they wouldn’t stop. But they’re good. They are like a potato chip.”

Angie’s however has really acquired a taste for cockroaches.

“There’s this very pointy bit on their stomach you just can’t eat. You have to kind of pop that off.”

However strange this celebrity diet seems, eating certain insects can actually be good for you. They’re lower in fat, higher in protein, and have a better feed to meat ratio than beef, lamb, pork, or chicken.

They say you are what you eat, now if we could only stop getting stuck in fly traps, this diet would be great.

12. Kim Kardashian Gets a Nasty Rash

After a trip to the dermatologist, Kim discovers that the nasty rash on her legs is psoriasis.

Her doctor let her know that the disease can be influenced by “stress, food, water, diet. Travel has a lot to do with it” and while there’s no “cure” the condition can certainly be controlled and that she should “lead an easier, slower paced life.”

Of course, in an authentic Kim Kardashian moment, she became very flustered, saying;

“My career is doing ad campaigns and swimsuit photo shoots. People don’t understand the pressure on me to look perfect…Imagine what the tabloids would do to me if they saw all these spots”

Two words Kim, Photo. Shop.

Seriously.

13. I’ll take “Kick Ass Game Show Hosts For $100, Alex”

“He refused to let Lucinda Moyers take cash and the bracelet his mother gave him.”

“Who is Alex Trebek?”

“That is correct!”

Before hosting the National Geographic World Championship at the Googleplex, Trebek spotted a 56 year old woman leaving his hotel room.

His first reaction? Chase her down!

Unfortunately for the 71 year old Jeopardy host though, he tore his Achilles tendon while in pursuit .

“My Achilles tendon ruptured and I then fell on carpet, bruising the other leg in process. Surgery on Friday.”

Crazy part is, this story took place on a Wednesday. So Trebek toughed it out for the next three days while walking around on crutches.

Take that Pat Sajak!

14. Dianna Agron Gets a Broken Nose

And no, it’s not because somebody punched her (God, I hate Quinn this season!)

While on the “Glee Live! Tour” Dianna broke her nose for the second time.

The actress broke her nose for the first time at a high school dance when she was 13, causing her to have a deviated septum. She broke her nose again after going dancing with some friends the night before a day off.

”We were in the middle of doing this concert tour and we had gotten into New York and we had a day off the next day. So I met some of my friends out and we were dancing. And there was a collision of sorts – again… It’s fixed now!”

So now that it’s all fixed can Quinn stop being such a mess? Please?

15. Sean Kingston looks at Beautiful Girls – Crashes Jet Ski – Nearly Dies – Twice

After crashing into a bridge, Sean Kingston’s jet ski accident put the 21 year old singer in the ICU with a broken jaw, fractured wrist, and water in his lungs.

After 11 days in the hospital, as he was about to be released, Kingston complained of having a searing pain in his chest which turned out to be a torn aorta and was rushed in resulting in two open heart surgeries.

Now for the good news, Kingston lost 70 pounds, is living a healthier lifestyle, and even played a show with the Black Eyed Peas in September.

16. Steven Tyler Slips in the Tub

Got to hand it to Steven Tyler and the other aging rock stars who made the list.

They spit in the face of getting old. They rock crowds, fill stadiums, and… slip in the tub?

Yup, Steven Tyler, 63, slipped in his Paraguay hotel’s tub and broke two of his teeth and suffered some lacerations to his face.

Of course, everything was repaired within short order, and he was back to his American Idol hosting duties in no time.

17. Tanorexics Everywhere!

Peanut butter and jelly, ice cream and apple pie, celebrities and tanning; all perfect pairs.

But it turns out, being addicted to tanning could be a very real thing.

According to a study by UT Southwestern released this year, Tanorexia is a real condition. The study found that when frequent tanners are exposed to UV light, the reward and addiction centers of the brain light up like a Christmas tree, indicating increased blood flow to these areas.

What about when the UV rays are blocked?You guessed it… these centers become dim as blood flow decreases to these areas.Lead investigator, Dr. Bryon Adinoff, says:

Using tanning beds has rewarding effects in the brain so people may feel compelled to persist in the behavior even though it’s bad for them… The implication is, ‘If it’s rewarding, then could it also be addictive?’ It’s an important question in the field.

18. Bono’s Heart Skips a Beat

You know, Bono has a constitution unlike any other rock star.He’s a humanitarian, a Nobel Peace Prize Nominee, an Honorary Knight, a Grammy winner, and was even once named Person of the Year.

So maybe it’s no surprise that he suffered some heart palpitations after wrapping up the 2 year long  360° Tour.Now let’s think about this for a second, Bono goes on tour for two years, films commercials, attends film festivals, oversees projects he founded like Product Red, DATA, EDUN, and the ONE Campaign…

And all he get’s are some heart palpitations? Heck, smokers who sit around and do nothing get heart palpitations.

In the end,  his doctors gave him a clean bill of health and told him to “Get some rest.”

It’s unlikely though.Knowing Bono, there are still too many issues in the world that haven’t been solved yet.

19. Venus Williams Leaves US Open

2011 was not good to the Williams sisters (remember Serena’s health scare above?)

Venus pulled out after winning one match of the US Open due to her diagnosis of Sjögren’s Syndrome.

Sjögren’s mainly affects the salivary glands and tear ducts along with other moisture-producing glands, and can affect other parts of the body including the skin, thyroid, and  joints and muscles.

“I altered my mind set completely because I was the person who always ate their steak first and their salad second. I changed my diet completely, so lots of vegetables”

But she reports being healthy again, and will resume playing professional tennis.Venus and sister Serena are planning to win their third Olympic gold together in London next year, after wins at the Sydney and Beijing Olympics. As Serena said:

We’re the defending champions and we want to defend our title and I don’t see why we wouldn’t.

20. Don’t Chew Anything Around Kelly Ripa

On a September episode of Live! With Regis and Kelly, Kelly Ripa told guest co-host Seth Meyers that she believes she suffers from misophonia which literally translates to “hatred of sound.”

She says ever since she was a child, the sound of chewing drives her nuts.

The most common reaction of someone with misophonia is extreme rage, meaning if you’re caught chewing gum or something else loudly near Kelly Ripa, she’s likely to haul of and deck you.

Chew on that for a minute.

21. John Mayer Silenced

Fans of John Mayer were saddened when told that Mayer had to cancel two shows, and delay the recording of his next album.

In September, John Mayer’s voice got the best of him when his granuloma became too much for him to handle.

What is a granuloma you ask?

It’s a noncancerous growth that occurs on the vocal cords at the back of the vocal fold. Leading causes of granuloma are excessive use of the voice when talking , smoking, coughing, yelling, or singing.

I wanted to give you an update on the granuloma just above my vocal cord. I had surgery this afternoon to remove it and am now on complete vocal rest for a month or more.

While on vocal rest, John decided that he was going to tour the country, just so he could “look and listen.”

Poetic, no?

22. Demi Lovato Does What Few Actresses Do

Well, actually she went into rehab last year for doing what many actresses do, which is suffer from aneroxia, but what set her apart from the rest of the starlets is that she decided to bring it to the public’s attention.In September, Lovato opened up on Ellen not only about her eating disorder, but about being bullied, being a cutter, and her own drug and alcohol experimentation.

“I would be lying to you , if I said that I never experimented or self-medicated with drugs and alcohol.”

It takes a lot of courage for anyone to admit these types of problems, and it’s especially courageous for someone who’s 19.

Hats off Demi. Hats off.

23. Wanda Sykes says Breast Cancer is No Laughing Matter

What started off as a routine breast reduction resulted in the discovery in a DCIS, which is basically stage zero cancer.

She kept very private about it at first, but in a September interview with Ellen, Wanda Sykes talked about having breast cancer and a bilateral mastectomy.

Sykes, 47, admits she was afraid of coming out about her Breast cancer saying,

How many things can I have? Black, lesbian and I’m like, I can’t be the poster child for everything… at least with the LGBT issues, we get a parade, and a float and all of that, but I was real hesitant about doing this because… I hate walking… and I got a lota walks coming up.

It’s great to see you good spirits Wanda!

24. Did Alternative Medicine Kill Steve Jobs?

Sadly, in 2011 we lost one the most innovative and creative geniuses of our time.

We started covering Steve Job’s story back in March of 2009 and tried to bring to light the major differences between pancreatic neuroendocrine tumors (PNETs) and the much more common, and deadly, pancreatic adenocarcinoma (“pancreatic cancer”).

This story brought major controversy because it explored the idea that while Steve Jobs was seeking alternative treatments for 9 months at the most critical point after diagnosis, his tumor had metasized, and was ultimately able to spread the cancer.

It was a tragic loss not only for the Tech World, but for the world as a whole as Jobs has influenced many aspects of our every day lives.

25. Adele Can’t Sing

Without a doubt, this has been Adele’s breakout year. Her hits “Rolling in the Deep” and “Someone Like You” have been an overwhelming success, being covered on Glee, and getting massive radio play.She was nominated for artist of the year, favorite female artist, favorite adult contemporary artist and favorite album for 21 for the American Music Awards.

Now for the bad news. Adele had to cancel the rest of her 2011 tour due to a vocal cord hemorrhage. But, she is working with Dr. Zeitels, the“Voicebox Hero”, as he has repaired some of the most famous voices in the world— including Steven Tyler, Julie Andrews,and ESPN sportscaster Dick Vitale. Dr. Zeitels is a pioneer when it comes to repairing vocal cords. He’s designed over 20 procedures and an instrument to perform them (and he uses special lasers).

So, fans of the singer, don’t worry Adele’s voice is in good hands.

26. Gabby Giffords learns to speak again

On January 8th,  U.S. Representative Gabrielle Giffords and eighteen other people were shot during a public meeting; six of those shot died, including Arizona Chief Judge John Roll and one of Rep. Giffords’ staffers.

Giffords was critically wounded by a gunshot wound to the head. She survived, but many of her cognitive abilities became severely limited, including her ability to walk, speak, read and write.

With intense physical, occupational, and speech therapy however, Gabby has been showing signs of improvement, regaining the ability to speak through music therapy, where the language centers of her brain are being rebuilt through song.

Her will to recover is inspirational, and her treatment is fascinating.

We wish you a full recovery Gabby!

27. They’re letting Khloe Have a Baby?!

Yup, after hearing that big sister KourtneyKardashian and boyfriend Scott Disick are having their second child, Khloe started to get baby fever. 

Khloe Kardashian, 29, has been married to LA Lakers star Lamar Odom for two years, and she is reportedly desperate to have a child with him, but it seems as though they have been unable.

So they’ve announced they will begin IVF Treatments (which run between $10-15,000 per procedure) and are very hopeful to have a happy announcement soon.

“For two years, people have been wanting me to get pregnant. People keep saying, ‘Why aren’t you pregnant yet?’ That’s what scares me, when people are like, ‘Did you go to the doctor? Do you know if everything is working?… It’s nerve-wracking. Sometimes I feel like I’m letting everyone down.”

Don’t worry Khloe, we’re keeping our fingers crossed for you.

But this sure does give “Keeping up with the Kardashians” a whole new meaning! 

And that’s it, those were 2011′s 27 most shocking moments in Celebrity Health.

Was there one we missed?

What do you think will be in store for 2012?

What celebrity do you think will have a melt down next year?

Leave your thoughts and predictions in the comments below, and one lucky commenter will win a Celebrity Diagnosis Tee Shirt as well as a $25 gift card to Amazon!

You could tell by her eyes, something wasn’t right.

Fans of  Giuliana Rancic know about her very public battle with infertility. They knew that at the end of the most recent season of Giuliana and Bill, that the couple were headed off to Denver, Colorado for a third try of IVF (in vitro fertilization).

They were hoping that her appearance on the Today show this morning would announce that the E! News host and husband, The Appentice winner Bill Rancic, were now expecting their first child.

But there was no glint in those eyes, they looked sad, even fearful.

Before undergoing the IVFprocedure, the physician insisted that the 36 year old undergo a mammogram.

He said, ‘I don’t care if you’re 26 or 36, but I will not get you pregnant if possibly there’s a small risk that you have cancer because the hormones will accelerate the cancer. I never in my wildest dreams expected anything would be wrong.

Although she was very reluctant, Guiliana underwent the procedure, and the results shocked her: She had an early stage of breast cancer!

Guiliana was in the middle of taking medications to stimulate the ovaries to produce eggs for the IVF. Her doctor recommended that she continue this process, harvest the eggs and produce the embryos, but that they do not be implanted at this time. This is what she did.

Rancic will under surgery this week to remove the cancer, followed by 6-1/2 weeks of radiation therapy. She remains optimistic. She’s going to be OK, the cancer was caught early:

I’m not going to give up. I want that baby…. That baby will have saved my life.

But what is more, Rancic wants to use this opportunity to impress the importance of mammograms for women:

A lot of us think we’re invincible … but we have to start putting ourselves on the to-do list,” she said. “I had a friend call me yesterday, and she said, ‘I’m so sorry, can I do anything for you?’ And I said, ‘Just call your doctor tomorrow and make an appointment. That’s what you could do for me.’ … I will be okay because I found it early.

You can see the full video of Guiliana’s interview with Ann Curry here:

Visit msnbc.com for breaking news, world news, and news about the economy

What message do you take away from Guiliana’s story? Does it make you more likely to undergo a mammogram?

When they first discovered the tumor in his pancreas in October 2003, his doctors told him an immediate operation was necessary, and could lead to a cure.

As first reported by Peter Elkind in 2008, Jobs decided to think different, declined surgery, and explored alternative medicine treatments for his disease.

Nine months later, in July 2004, the tumor had grown. Only then would he allow his doctors to operate.

Would Steve Jobs be alive today had he consented to surgery when they first discovered his tumor?

Without knowing more details about his case, such as the grade and stage of the tumor, it is hard to say.

However, Dr. Roderich Schwartz, an experienced cancer surgeon has said waiting more than a few weeks to take action on such a rare diagnosis “makes no sense because you don’t know what the potential for growth or spread is.”

Steve Jobs is not the first public figure to seek answers outside conventional medical science.

• Steve McQueen (1930-1980) was probably the first modern celebrity to attract widespread public attention with his efforts to cure asbestos-related cancer through unorthodox treatments in Mexico, where he died.
• Farrah Fawcett (1947-2009) and Bret Hudson (1953- ) sought unconventional treatments for anal and throat cancers, respectively. They even underwent treatment at the same German cancer clinic. Even after her cancer regressed following alternative treatments, Farrah eventually lost her battle with anal cancer on June 24, 2009. Bret however was declared cancer free after completing a conventional chemotherapy and radiation regimen.
• Beastie Boyz’s Adam Yauch (1964- ) developed, and beat, cancer of the salivary gland. He attributes his success to augmenting his treatments of conventional surgery and radiation therapy, with becoming a vegan at the recommendation of Tibetan doctors (augmenting conventional therapy is technically called complementary medicine). Yauch’s introduction to Tibetan medicine came after converting from Judaism to Buddhism.

Steve Jobs, also a Buddhist, was reportedly skeptical about mainstream medicine.

While his uncompromising personality and dedication to unconventional-ism undoubtedly changed the way interact with technology forever, that same stubbornness may have also lead to his demise.

Arthur D. Levinson, Apple’s Director who is a Ph.D. in Biochemistry and a biotechnology executive at Genentech, along with other board members pleaded with Jobs to have the surgery. ”There was genuine concern on the part of several board members that he may not have been doing the best thing for his health,”says an Apple insider.”But Steve is Steve. He can be pretty stubborn.”

“Surgery is the only treatment modality that can result in cure,” Dr. Jeffrey A. Norton, chief of surgical oncology at Stanford, wrote in a 2006 medical journal article about this kind of pancreatic cancer.

While it was Norton, who is one of the foremost experts in the field, ultimately removed the tumor, Jobs decision to seek alternate forms of treatment, such as a special diet, among other alternative treatments could have been what cost him his life.

Dr. Roderich Schwarz (quoted earlier) says he is unaware of any evidence that a special diet can be helpful. “But the patient decides. If they believe an herbal diet can do miracles, they have to make the decision. Every once in a while you have somebody who decides something you wish they wouldn’t.”

Furthermore, to date, there is no evidence that indicates successful “alternative treatments” for Jobs’ form of tumor.

According to Dr. Edzard Ernst, an international authority on alternative medicine and author of the book Trick or Treatment: The Undeniable Facts about Alternative Medicine

 “There are far too many charlatans who manage to convince desperate patients to abandon effective treatments in favour of ineffective alternative treatments. This often hastens or even causes death. In my view, this behavior is outright criminal.”

Could it be that Steve Jobs was so committed to the concept of “think different” that he was unable to “think clearly” until it was too late?

Is it possible that his need to defy convention left him vulnerable to alternative medicine practitioners in need of a major endorsement to validate their “alternative” treatment? Was their success more important than Job’s health at the most critical moment of his treatment?

Buddhist theories of medicine say the reason people get sick is through one of  “three poisons:” greed, anger and ignorance.

That’s like saying the iPad is made from earth, wind, fire and water.

Why would someone as technologically sophisticated as Jobs base life-and-death decisions about his health on ancient philosophy, especially when there have recently been more breakthroughs in cancer research than at any other point in history?

Perhaps Watler Isaacson’s new biographywill shed more light on the medical history of Jobs’ tumor including details of the alternative medicine treatments he pursued.

Until then, we are left with the conclusion that Steve Jobs died just as he lived — thinking differently.

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.
-ABCNews

In 2004, he announced to his employees that he was being treated for pancreatic cancer.
-CNN

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…

What is the pancreas and what does it do?

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.

Islet Cell (Neuroendocrine) Cancer of the Pancreas

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:

• Gastrinoma -The tumor makes large amounts of a hormone called gastrin, which causes too much acid to be made in the stomach. Ulcers may develop as a result of too much stomach acid.
• Symptoms:  Abdominal pain, diarrhea, ulcers in the stomach and small bowel and occasionally vomiting blood
• Insulinoma -Overproduction of the hormone insulin and causes the body to store sugar instead of burning the sugar for energy. This causes too little sugar in the blood, a condition called hypoglycemia.
• Symptoms: Feeling tired or weak, shakiness, sweating, headache, hunger, nervousness, double or blurry vision, and fast or pounding heartbeat
• If your blood sugar gets too low, you may faint, have a seizure, or even go into a coma.
• Glucagonoma – This tumor makes too much of the hormone glucagon and causes too much sugar in the blood, a condition called hyperglycemia.
• Symptoms: Diabetes (present in most of the patients), inflamed mouth and tongue, and a crusty or scaly skin rash on the face, abdomen, buttocks, or feet – which may be filled with clear fluid or pus

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

Pancreatic adenocarcinoma is a cancerous overgrowth of exocrine pancreatic cells (see above).

Pancreatic cancer is the fourth leading cause of cancer death for both men and women.

• Pancreatic cancer is one of the most deadly of all types of cancer.
• This year 44,030 Americans will be diagnosed with pancreatic cancer and about 37,660 will die from it.
• Despite the high mortality rate, the federal government spends woefully little money on pancreatic cancer research.

Pancreatic cancer is treatable when caught early; the vast majority of cases are not diagnosed until too late.

• Five-year survival rates approach 40% if the cancers are surgically removed while they are still small and have not spread to the lymph nodes.

Pancreatic cancer is difficult to diagnose

• There is no reliable screening test for the early detection of pancreatic cancer.
• Symptoms are often vague and easily confused with other diseases:
• Dark urine and clay-colored stools
• Fatigue and weakness
• Jaundice (a yellow color in the skin, mucus membranes, or eyes)
• Loss of appetite and weight loss
• Nausea and vomiting
• Pain or discomfort in the upper part of the belly or abdomen
•  Back pain
• Blood clots
• Diarrhea
• Indigestion

Who Has the Greatest Risk?

Inherited genetic disorders cause 5-10% of cases of pancreatic cancer and certain genes can inrease the lifetime risk up 80%.

• People with two or more relatives who have had pancreatic cancer
• Cigarette smokers
• People of Ashkenazi Jewish descent
• Have the BRCA2, p16, STK11 gene mutation or chronic pancreatitis (inflammation of the pancreas)
• Are over the age of 50

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:

Resounding Health(tm) Neuroendocrine (islet cell) tumor

RESOUNDING HEALTH(tm) Pancreas Cancer

Apple Founder Steve Jobs has died at the age of 56.

Jobs recently stepped aside as Apple CEO due to poor health. As we have reported on numerous occasions, Jobs suffered from a neuroendocrine tumor of the pancreas, NOT the pancreatic cancer he is frequently reported by the media as having.

He underwent a liver transplant in June 2009, and urged others to become organ donors.

Steve Jobs was a visionary who took technology to a whole new level. The world is a different place because of him.

He will be missed. R.I.P. Steve.

Has Dr. Mehmet Oz gone too far this time?

It’s one thing to urge people to analyze the sound and shape of their poop, or to recommend pepto-bismol as a anti-aging facial.

But when you mess with one of the cornerstones of childhood beverages-namely, apple juice- you may have just gone too far!

This week on The Dr. Oz Show,  Oz aired an “investigative report” revealing that some of the best known brands of apple juice , including Minute Maid, Apple & Eve, Mott’s, Juicy Juice, and Gerber,  may contain arsenic and that parents should be concerned.

The show hired an independent laboratory, EMSL Analytical, to test samples of juice taken from three U.S. cities for arsenic. They then compared this to the Environmental Protection Agency’s EPA) safe standard for drinking water, which is less than 10 parts per billion. According to Oz, several sampled tested higher than this limit.

The FDA has questioned these results, centering primarily on Oz’s testing methods, which provided only the level of total arsenic in the juices. There are two forms of arsenic — organic and inorganic.

According to the FDA: The inorganic forms of arsenic are the harmful forms, while the organic forms of arsenic are essentially harmless. Because both forms of arsenic have been found in soil and ground water, small amounts may be found in certain food and beverage products, including fruit juices and juice concentrates. The reason the organic form of arsenic is not harmful is because it is not absorbed by the body.

Apparently, the FDA warned Dr. Oz’s staff that they questioned his results, even before the show was aired, but he showed it as is anyway.

This lead to a rather heated debate between Dr. Oz and ABC medical correspondent, Dr. Richard Besser on Good Morning America:

Five things to know about Arsenic and Apple Juice

1.  Although arsenic has been banned from pesticides in this country since the 1970, small amounts of arsenic will always be around as it is a natural chemical.

2. Apple juice is a blend of juices from all over the world. Although some areas, such as southeast Asia, may have some areas with higher arsenic levels,the overall level of arsenic in apple juice has remained low over the long period of time that the FDA has been monitoring levels.

3. The FDA is unaware of any data that shows that organic juice tends to have less arsenic than non-organic apple juice. Even organic apples come from trees that grow in soil that may contain arsenic.

4. FDA completed laboratory analysis of the same lot of Gerber apple juice that was tested by the Dr. Oz. Show, as well as several other lots produced in the same facility. The FDA’s testing detected very low levels of total arsenic in all samples tested. These new results were consistent with the FDA’s results obtained in the FDA’s routine monitoring program and are well below the results reported by the Dr. Oz Show.

5. Where can I get more information?

• FDA: Apple Juice is Safe To Drink http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm271394.htm
• Arsenic and Apple Juice: Questions and Answers http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm271595.htm
• Letters from FDA to The Dr. Oz Show Regarding Apple Juice and Arsenic http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm271746.htm

So, do you think Dr. Oz went too far by airing this report?

Will you stop giving your child apple juice?

Don’t it always seem to go that you don’t know what you’ve got ’til it’s gone…

-Joni Mitchell, Big Yellow Taxi

We were ready. I had bought enough bottled water to float a boat in. Every flashlight had spare batteries and our laptops, cell phones, Kindles and iPads were all fully-charged. I had filled up my car’s gas tank and had spare propane tanks for the gas grill. So on Sunday, when the rain came and the winds began to blow, I felt pretty secure, even ready for a zombie apocalypse.

Our power went out about 11 am. “That’s OK,” I thought – it’ll go back on soon. By noon, my husband was driven by curiosity to venture out and investigate. He was back in the driveway 60 seconds later.

“We’re stuck here,” he said. “There’s a tree down blocking the intersection with electrical wires hanging in the street.”

The rain slowed then stopped after an hour or two and we walked around the neighborhood to survey the damage. Our neighbors were out as well. There were  actually three trees down in our neighborhood and several more down on the main street; all had taken sections of telephone poles and power lines down with them. We could tell that it would be days before our electricity was restored.

The first night was kind of special: eating dinner by candle light then settling down with our daughter in front of her laptop watching a DVD with a glass of wine in hand. But when the laptop battery ran out of power half-way through the movie, and it was pitch dark, and it was only 8:30 pm, the novelty of our blackout was starting to wear a little thin.

Although city workers cleared the downed trees pretty quickly the next day and made it possible to drive out of the neighborhood, the power and phone service did not return until a few hours ago and over 50 hours after the lights first went off. Some of our neighbors had gone to stay with friends or relatives and a few went to hotels. They were returning now and starting the clean-up.

Here are some things I learned from this experience.

• I am much more addicted to electronics than I thought I was. I found myself sitting down at my desk, moving the mouse around, expecting the computer to jump to life.
• I think better in brightly lit rooms.
• It can get awfully quiet in a house without functioning TVs, radios, computers
• You need a flashlight to read a Kindle as well as a traditional paper book
• It can be nice when you don’t have to listen to the drone of electronics and 24/7 media — you can hear the birds chirp.
• You can meet new neighbors and talk to those you haven’t seen all summer because we’ve all been ensconced in our air conditioned homes.
• After the dark clouds, driving rains and gushing winds, a blue sunny sky and a gentle breeze feels glorious.

I know that there are many out there who are still without power, have lost homes, other property and even loved ones. I am very grateful that our losses were mostly confined to food in our refrigerator. But it’s times like these when you realize how much the world has changed and just how much we depend on our electronic cocoons. Sometimes you need an event like Irene to put things back into perspective, to pause and enjoy the people and things around you, then to push the reset button and move on in that Big Yellow Taxi called life.

It’s been a strange, strange summer in Massachusetts this year. In June, a tornado hit Springfield, leaving behind severe damage and 4 dead. Last week, we felt shocks of the earthquake centered in Virginia. AND NOW, we are about to be hit by Hurricane Irene in what local weather-casters are calling the first hurricane to hit the area since Hurricane Bob in 1991. So what’s next? A Biblical plague like locusts?  Or maybe…

ZOMBIES!?

We first ran this article in May, but it’s advice on how to be ready for natural disasters is suddenly pertinent again.

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Who says the government doesn’t have a sense of humor? When it came time to come up with an idea for their annual campaign to raise awareness about the upcoming hurricane season, Centers for Disease Control and Prevention (CDC) associate director of communications Dave Daigle and his team got an idea from a tweet the CDC had recently received. It asked about zombies during the Japan nuclear crisis- and it seemed to generate a lot of buzz! Thus the idea of Preparedness 101: Zombie Apocalypse was born. After all, as the slogan for their campaign says:

The post by Ali S. Khan, which was on the CDC Public Health Matters Blog on May 16th, certainly seems to be getting a lot of attention. Normally, the CDC might get around 3,000 page views a week, but after word got out about the blog entry, the CDC Emergency’s Twitter feed went from 12,000 to 1.2 million followers. The volume to their blog site crashed several times because of the increase in traffic.

So what does the government suggest you need to do should the threat of zombies…or hurricanes or pandemics, actually happen?

First- have an emergency kit in your house and/or car. This includes things like water, food, and other supplies to get you through the first couple of days before you can locate a zombie-free refugee camp (or in the event of a natural disaster, it will buy you some time until you are able to make your way to an evacuation shelter or utility lines are restored). Below are a few items you should include in your kit, for a full list visit the CDC Emergency page:

1. Water (1 gallon per person per day)
2. Food (stock up on non-perishable items that you eat regularly) Remember to have a manual can-opener to get into cans if the electricity is out.
3. Medications (this includes prescription and non-prescription meds)
4. Tools and Supplies (utility knife, duct tape, battery powered radio, etc.)
5. Sanitation and Hygiene (household bleach, soap, towels, etc.)
6. Clothing and Bedding (a change of clothes for each family member and blankets)
7. Important documents (copies of your driver’s license, passport, and birth certificate to name a few)
8. First Aid supplies (although you’re a goner if a zombie bites you, you can use these supplies to treat basic cuts and lacerations that you might get during a tornado or hurricane)

Once you’ve made your emergency kit, sit down with your family and come up with an emergency plan. This includes where you would go and who you would call if zombies started appearing outside your door step. You can also implement this plan if there is a flood, earthquake, or other emergency.

• Pick two meeting places, one close to your home (such as your mailbox, or a neighbors front yard) and one farther away.
• Identify possible types of emergencies in your area.  Besides a zombie apocalypse, this may include floods, tornadoes, hurricanes or earthquakes. If you are unsure contact your local Red Cross chapter for more information.
• Pick a meeting place for your family to regroup in case zombies invade your home… or your town evacuates because of a hurricane. Pick one place right outside your home for sudden emergencies and one place outside of your neighborhood in case you are unable to return home right away.
  
• Identify your emergency contacts. Make a list of local contacts like the police, fire department, and your local zombie response team. Also identify an out-of-state contact that you can call during an emergency to let the rest of your family know you are OK.
  
• Plan your evacuation route. When zombies are hungry they won’t stop until they get food (i.e., brains), which means you need to get out of town fast! Plan where you would go and multiple routes you would take ahead of time so that the flesh eaters don’t have a chance! This is also helpful when natural disasters strike and you have to take shelter fast.

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Although we’re not in a flood plane, our house is surrounded by very tall, older trees. I’m glad we had them pruned and some cut down earlier in the summer, so it’s less likely that one will fall on our house. I’ve gotten together the bottled water, flashlights and batteries and got a fresh tank of propane for the gas grill (so we could still boil water and cook food if we are without electricity). I’ll make sure all of our electrical devices (like cell phones, laptop computers, etc) are fully charged and we have full tanks of gas in our cars. Then we’ll just sit and wait, ready for hurricanes, zombies or anything else that comes our way. If we get locusts, we can always just eat them like Angelina Jolie and her kids.
It might be a good time to read the Max Brooks’ book, World War Z, which is being made into a movie starring Brad Pitt and Breaking Bad’s Bryan Cranston.

These are real ads from bygone eras when :

• woman’s sole function was being a housewife and mother
• cigarette smoking was considered to have health benefits
• you tried to get your baby on “grown-up” food as soon as possible
• Coke was “the Real Thing”
• you could sell tapeworms as a diet solution

We’ve come a long way baby…
15 Ads We Hope Never to See Again!

Playboy entrepreneur Hugh Hefner is having a week. First, we found out that his 25-year-old fiancee Crystal Harris called off their wedding and now his 21-year-old twin girlfriends Karissa and Kristina Shannon are moving back into the Playboy Mansion. The Shannon twins, however, reported to the UK’s The Sun, that Hef has gone nearly deaf because of the Viagra he uses.  According to Karissa:

You have to lean down and talk into his good ear for him to understand you… We could sit right next to him and he wouldn’t have a clue what we said.

When asked about whether Hef has stopped taking the Viagra, she said that:

He said he would rather have sex than have his hearing. He has hearing aids now and even then he can only hear out of one ear.

So, is it the Viagra that has caused Hef’s hearing loss? Of course, it is hard to say that the Viagra caused the hearing loss in an 85-year-old man. According to the Institute on Aging, hearing loss is one of the most common conditions affecting older adults. Approximately 17 percent, or 36 million, of American adults say that they have some degree of hearing loss. Roughly one-third of Americans 65 to 74 years of age and 47 percent of those 75 and older have hearing loss. Men are more likely to experience hearing loss than women.

But this doesn’t mean Viagra didn’t contribute to his hearing loss. In 2007 the FDA made changes to the labels of certain erectile dysfunction (ED) drugs  such as Cialis, Levitra, and Viagra. The new labels had to clearly state a potential risk of sudden hearing loss. The FDA had found 29 cases of sudden hearing loss closely related in time to the use of those ED drugs. The hearing loss was sometimes associated with ringing in the ears or dizziness.

A more recent study by the University of Alabama supported the FDA ruling. They looked at the health records of over 11,000 men over 40. Men who reported using those ED drugs were twice as likely to also report hearing loss as were men who had not used the drugs.

For more information about Viagra and ED, look at our story about Tokio Hotel Guitarist Tom Kaulitz.

If you had a choice between sex and your hearing, which would you give up?