
Steve Jobs Succumbs to Alternative Medicine - exit
http://www.skepticblog.org/2011/10/06/steve-jobs-succumbs-to-alternative-medicine/
======
aculver
First, Steve's family asked us to respect their privacy. They never made his
fight with cancer a public matter and it's terribly rude to speculate like
this. That aside, I did have some thoughts on the alternative treatments this
article is talking about.

With close family members having fought cancer more times than I can count on
one hand, my honest impression is that for several forms of cancer the
_current_ state of "orthodox" treatment (typically chemotherapy and radiation)
is a joke worth skipping in exchange for what quality of life you have left..
which in one case has turned out to be 15 years and counting (following two
surgeries.)

What makes a lot of alternative methods appealing to me is not their anecdotal
evidence. It's that many of them (at least the ones I'm familiar with) don't
have such torturous and long lasting side effects. For folks like my wife and
I who have already come to the conclusion that we would not pursue
chemotherapy and radiation treatments for many forms of cancer, we've got
nothing to lose. We've already decided we'd rather die what we consider
gracefully than suffer the side effects and slow, agonizing death of a long
drawn out battle.

Not trying to convince anyone here, just trying to explain this from the other
side.

~~~
Estragon
It depends on the type of cancer. For some classes of cancer, there are now
treatments which dramatically improve the prognosis, with relatively mild
side-effects. This is summarized well in the book _The Emperor of Maladies_.

Pancreatic cancer is particularly intractable. The survival rate is extremely
low. I don't blame him for trying everything. He had nothing to lose.

~~~
hugh3
As I understand it (and I'm only going by what he said in his Stanford
commencement speech here) he had a rare form of pancreatic cancer which is
treatable:

 _The doctors told me this was almost certainly a type of cancer that is
incurable, and that I should expect to live no longer than three to six
months...

I lived with that diagnosis all day. Later that evening I had a biopsy, where
they stuck an endoscope down my throat, through my stomach and into my
intestines, put a needle into my pancreas and got a few cells from the tumor.
I was sedated, but my wife, who was there, told me that when they viewed the
cells under a microscope the doctors started crying because it turned out to
be a very rare form of pancreatic cancer that is curable with surgery. I had
the surgery and I'm fine now._

Ouch.

~~~
mattgreenrocks
What about the possibility of remission?

~~~
hugh3
Well yeah, that's what happened afaik

Whether the nine month delay before getting surgery increased the likelihood
of remission is a question I'm not qualified to answer. But until contradicted
by an oncologist I'm going to go with "probably".

------
monkeypizza
Here is part of the abstract from "Use of CAM results in delay in seeking
medical advice for breast cancer" (1)

"On average, [Women who discovered a lump] took 8.7 weeks to inform the family
and 17.2 weeks to first physician visit. Fifty three percent delayed seeking
medical advice. Common reasons were;

antecedent use of complimentary/alternative therapies (34%), lack of
significance attached to the lump (23%), fear of surgery (22%), conflicting
personal commitments (7%), fear of cancer (5%), and others (8%).

 _Twenty nine percent practiced CAM before visiting any physician._

Common methods used were

homeopathy (70%),

spiritual therapy (15%) and

Ayurvedic medicine (13%).

CAM use was associated with delay in seeking medical advice (OR: 5.6; 95% CI:
2.3, 13.3) and presentation at an advanced stage of disease (OR: 2.2; 95% CI:
1.01, 4.6). Patients who delayed seeking medical advice more often had
positive axillary nodes and stage III/IV disease. Breast cancer patients in
Pakistan frequently (53%) delay seeking medical advice. _Antecedent practice
of CAM is widespread and a common underlying reason. The delay results in
significant worsening of the disease process._ "

tl;dr - people delay medical treatment, and part of the reason is that they
try alternative treatments, and only go to the doctor when the problem gets
worse. This worsens the progress of their disease.

This is why alternative medicine is bad. Because it kills people. Imagine how
mad you would be if someone you loved delayed treatment for a real problem
because they were following advice to try alternative, "natural" medicine
they'd received from a friend.

We are responsible for the outcomes of what we do, not just the sentiment
behind it.

1) <http://www.springerlink.com/content/k8p0400u2u77242l/>

~~~
mechnik
Those 29% who "practiced CAM before visiting any physician" would be better
served visiting a physician who utilizes CAM as an adjunct to his practice,
who would recognize their concerns, and encourage those patients not to delay
any required treatments.

~~~
monkeypizza
Unfortunately, though, few homeopaths would give this type of advice. Most
homeopaths actively recommend people not use scientific medicine.

The following quotes are from an investigation of what type of advice real
homeopaths give when asked to recommend treatment for someone planning to
visit areas exposed to malaria.

"... I tried to find out what homeopaths would offer to a young traveller
seeking protection against malaria. Working with Alice Tuff and the charity
Sense About Science, we developed a storyline in which Tuff would be making a
ten week overland trip through West Africa, where there is a high prevalence
of the most dangerous strain of malaria, which can result in death within
three days. Tuff, a young graduate, would explain to homeopaths that she had
previously suffered side-effects from conventional malaria tablets and
wondered if there was a homeopathic alternative."

...

"Next Tuff found a variety of homeopaths by searching on the internet, just as
any young student might do. She then visited or phoned ten of them, mainly
based in and around London. In each case, Tuff secretly recorded the
conversations in order to document the consultation. The results were
shocking. Seven out of the ten homeopaths failed to ask about the patient's
medical background and also failed to offer any general advice about bite
prevention. Worse still, ten out of ten homeopaths were willing to advise
homeopathic protection against malaria instead of conventional treatment,
which would have put our pretend traveller's life at risk."

<http://www.1023.org.uk/whats-the-harm-in-homeopathy.php>

------
kstenerud
So how exactly does this article square up with Steve's 2005 Stanford
Commencement address?

[http://www.roj.com.np/life-inspiration/steve-jobs-how-to-
liv...](http://www.roj.com.np/life-inspiration/steve-jobs-how-to-live-before-
you-die/)

"About a year ago I was diagnosed with cancer. I had a scan at 7:30 in the
morning, and it clearly showed a tumor on my pancreas. I didn’t even know what
a pancreas was. The doctors told me this was almost certainly a type of cancer
that is incurable, and that I should expect to live no longer than three to
six months. My doctor advised me to go home and get my affairs in order, which
is doctor’s code for prepare to die. It means to try to tell your kids
everything you thought you’d have the next 10 years to tell them in just a few
months. It means to make sure everything is buttoned up so that it will be as
easy as possible for your family. It means to say your goodbyes."

"I lived with that diagnosis all day. Later that evening I had a biopsy, where
they stuck an endoscope down my throat, through my stomach and into my
intestines, put a needle into my pancreas and got a few cells from the tumor.
I was sedated, but my wife, who was there, told me that when they viewed the
cells under a microscope the doctors started crying because it turned out to
be a very rare form of pancreatic cancer that is curable with surgery. I had
the surgery and I’m fine now."

He had the surgery. Successfully, as far as the doctors were concerned. And he
lived the median number of years for those diagnosed with pancreatic cancer.
This information was not hard to dig up.

Stay classy, exit.

~~~
hugh3
* And he lived the median number of years for those diagnosed with pancreatic cancer *

The median number of years for those diagnosed with pancreatic cancer, or the
median number of years for those diagnosed with this particular type of rare,
operable pancreatic cancer?

~~~
kstenerud
The median number of years for those diagnosed with islet cell carcinoma. For
the regular kind it's 3-6 months.

------
exit
A more in depth discussion:

[http://www.thedailybeast.com/articles/2011/10/05/steve-
jobs-...](http://www.thedailybeast.com/articles/2011/10/05/steve-jobs-dies-
his-unorthodox-treatment-for-neuroendocrine-cancer.html#)

------
Tyrannosaurs
And taking a contrary position, here's the editor of Natural News saying that
Chemotherapy and Radiotherapy killed him:

[http://www.naturalnews.com/033793_Steve_Jobs_chemotherapy.ht...](http://www.naturalnews.com/033793_Steve_Jobs_chemotherapy.html)

(For clarification, I think the article is bullshit, I just put it out there
as part of the discussion about Steve's medical treatment and about people
jumping on his death to further some view or other).

------
thwest
The reports of Jobs' treatment elections are conjecture.

"although neither Apple nor those close to Jobs were willing to discuss the
treatments he elected or the course of his disease," the community continues
to assume that rumors about Job's health coming out of financial publications
(Forbes) are somehow accurate.

This post is trite and condescending no matter how long it came after Jobs’
death. Dealing with death is a personal matter. You have no right to demand
that anyone submit themselves to the cold, alienated approach of aggressive
medical treatment. Let people pass with dignity, however they choose.

The purpose of life is not to be a mobile mass of cells for as long as
technologically possible. In fact, the statistics show that people who skip
the N+1th round of chemo and switch to hospice care have better outcomes.
[http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_...](http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande)

~~~
mechnik
Great reply. I thought the OP toxic enough to make one ill.

~~~
burgerbrain
The thought of bullshit fake medicine taking another life should be enough to
make anyone feel ill.

~~~
mechnik
Speak for yourself.

~~~
burgerbrain
I am. "Should be enough" is _very clearly_ an opinion.

My _opinion_ is that it _should_ be enough to make _anyone_ fill ill, because
_everyone_ should approach the matter rationally.

The _fact_ is that alternative 'medicine' is not rational.

~~~
hugh3
"By definition, alternative medicine has either not been proved to work or has
been proved not to work. You know what they call alternative medicine that has
been proved to work? Medicine."

\- Tim Minchin

~~~
pella
see this journal:

 _"Evidence-Based Complementary and Alternative Medicine (eCAM) is an
international, peer-reviewed journal that seeks to understand the sources and
to encourage rigorous research in this new, yet ancient world of complementary
and alternative medicine."_

<http://www.hindawi.com/journals/ecam/>

~~~
burgerbrain
The point being made here is that if something has been proven to work, it is
no longer _alternative_ medicine. "Evidence based alternative" is a
contradiction.

~~~
pella
Alternative medicine is any healing practice: "that does not fall within the
realm of conventional medicine."
<http://en.wikipedia.org/wiki/Alternative_medicine>

~~~
burgerbrain
"Conventional medicine" being "medicine for which there actually exists
evidence of it working."

~~~
pella
source ?

don't forget : 51% Unknown effectiveness ..

<http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp>

one example "Unknown effectiveness"

"Pancreatic cancer New option(s) added for: Chemoradiotherapy for resected
pancreatic cancer One long-term follow-up study added. It found no significant
difference between adjuvant chemoradiotherapy and surgery alone for overall
survival or progression-free survival at 11.7 years' follow-up. Categorisation
unchanged (Unknown effectiveness), as the evidence is not strong enough to
draw definitive conclusion."

------
lsparrish
I suspect in a few more decades it will be revealed that the true cause of
death was failure to cryopreserve. Pretty much all our current medicine can do
is buy a few decades at the most. With his wealth, Jobs could have hired his
own team of superbly qualified surgeons and perfusionists, and started an
apple-themed cryonics vault that would (supported by his fame) last hundreds
of years. He would have inspired thousands, perhaps millions of Apple fans to
come along for the ride. What a wasted opportunity.

~~~
VMG
Harsh words, but valid point. The first cryoperservations could be
billionaires in the hight-tech industry.

------
jcarden
All I can say is that I hope we did not lose a visionary due to a reliance on
alternative medicine.

~~~
pyre
... because conventional medicine has cured pancreatic cancer.

~~~
tmhedberg
It very likely would have cured his particular form of it.

~~~
objclxt
...he had a liver transplant. I hardly think you can say he 'avoided'
conventional medicine...

~~~
tmhedberg
No, he didn't avoid it, but according to the article, he also didn't avail
himself of it until it was clear to him that his "alternative therapy" was not
having an appreciable effect. The delay in effective treatment incurred by
this poor judgment could easily have cost him his life, or at least prevented
him from enjoying several more years of relative comfort.

------
vectorpush
I wasn't aware that Steve favored alternative medicine, sad to hear that, but
I wouldn't judge him for it. The reality is, despite its proven efficacy,
western medicine's answer to cancer is still painful/debilitating and
sometimes borders on humiliating, especially for someone with such a
ubiquitous public image. For many, alternative medicine finds its appeal as an
escape from the grim and down right scary inevitability of chemo and surgery,
it's a way to feel like you're doing something without having to sacrifice
your hair, lunch, and dignity. It's a self delusion that I can't blame anyone
for indulging in.

~~~
burgerbrain
The proper term for 'western medicine' is 'evidence based medicine'. The term
'western medicine' can incorrectly imply an equal footing for so called
'eastern medicine'.

(I did not downvote you)

~~~
pella
not true .. 'western medicine' is NOT 'evidence based medicine'

 _"What percentage of the around 3000 treatments included in Clinical Evidence
fall into each category:

\- 11% Beneficial

\- 23% Likely to be beneficial

\- 7% Trade off between benefits and harm

\- 51% Unknown effectiveness

\- 5% Unlikely to be beneficial

\- 3% Likely to be ineffective or harmful"_

<http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp>

=============

and _"Evidence-Based Complementary and Alternative Medicine (eCAM) is an
international, peer-reviewed journal that seeks to understand the sources and
to encourage rigorous research in this new, yet ancient world of complementary
and alternative medicine."_

<http://www.hindawi.com/journals/ecam/>

Evidence-Based Complementary and Alternative Medicine (ECAM) and Pancreatic
Cancer:

[http://www.hindawi.com/search.aspx?startindex=1&field0=9...](http://www.hindawi.com/search.aspx?startindex=1&field0=9&q0=Pancreatic%20Cancer)

~~~
burgerbrain
I understood vectorpush to be mistakenly using the term 'western medicine'
when he in fact meant 'evidence based medicine'.

My understanding was correct.

So your comment is a non sequitur.

~~~
pella
>when he in fact meant 'evidence based medicine'.

Are you an evidence based mind-reader?

and again:

'western medicine' is NOT 'evidence based medicine'

~~~
burgerbrain
_"Are you an evidence based mind-reader?"_

I made a guess, he confirmed I was correct.

I suggest you read the entire conversation tree when you consider responding.

------
brown9-2
I don't understand. This post claims that the median survival period for this
form of cancer is 10 years.

So therefore, his survival (7-8 years), whether or not alternative medicine
was used, lasted close to the average one could expect.

So what is unexpected here?

~~~
bryanlarsen
Given how young Steve Jobs was when he was initially diagnosed in 2003, how
good his health was, his ability to pay for the best treatment, his large
support network and his insatiable drive, I would have expected better than
median survival.

~~~
eru
Yes, though there's still a lot of chance involved.

Young age does not necessarily help with fighting cancer. Younger people have
a faster metabolism, and that often allows the tumour to grow faster than in
older people.

------
bitsweet
It would be one thing if we were talking about rubbing crystals all over your
body. I would not consider a modified diet "alternative" medicine. There is
legitimate science around diets and how it affects cancer growth (see TED
video):

<http://www.ted.com/talks/lang/eng/william_li.html>

~~~
asr
But going to a naturopathic doctor for a diet prescription _is_ rubbing
crystals all over your body. William Li (the speaker in that talk) is an MD
bringing evidence-based medicine (i.e. science) to bear on the question.

On the other hand, as naturopathic doctors themselves explain, "tradition-
sensitive naturopathic practitioners ... which have tradition-based paradigms
articulating vitalistic and holistic principles, may have significant problems
in relating to the idea of EBM as developed in biomedical contexts."
<http://www.liebertonline.com/doi/abs/10.1089/acm.2006.12.323>

------
toddmorey
Counterpoint: Having been irrevocably harmed by modern medicine, I encourage
everyone to _always_ be a skeptic and a self-advocate when undergoing any
approved or alternative therapy. Do research. Get multiple opinions. Be a
strong, vocal participant in your plan of care.

------
thornad
Confirmed Steve Jobs did Chemo and Rad. Now think.

[http://www.marksmarketanalysis.com/2011/02/steve-jobs-on-
che...](http://www.marksmarketanalysis.com/2011/02/steve-jobs-on-chemo-may-
have-only-weeks.html)

[http://gawker.com/5737092/steve-jobss-cancer-secret-
revealed...](http://gawker.com/5737092/steve-jobss-cancer-secret-revealed-
following-sources-death)

------
marknutter
On the one hand, Steve Job's opinionated and stubborn nature helped craft some
of the most successful consumer products in history, but tragically it may be
that that same stubbornness and free thinking could very well have led to his
early demise.

------
RyanKearney
Nonsense Steve, your diet "just works".

------
nhangen
Way too early for this, and quite frankly, it's none of your business.

------
da5e
Normally a cold lasts 7 days, but with aggressive medical treatment it only
lasts a week.

------
Alex3917
Once again, more intellectually dishonest 'arguments' from the self-labeled
skeptics. How about actually discussing what Steve Jobs did, why he thought it
might be effective, and his logic about the pros and cons.

You know, actually doing some work instead of just trying to rack up some
cheap page views off of the man's death while contributing nothing of value.

~~~
burgerbrain
If awareness of alternative 'medicine' gained from this incident cause _a
single person_ to go to a real doctor and have their life saved, it will be
Steve Jobs' greatest legacy.

Stop thinking about gadgets for one minute and consider _human life_.

~~~
greyish_water
Alex3917 did not say anything about gadgets.

~~~
burgerbrain
It was not my intention to imply that he had.

~~~
greyish_water
What was the point of bringing it up, then?

~~~
burgerbrain
I was anticipating protest, and addressing it before the fact.

~~~
greyish_water
I don't understand what kind of protest you were anticipating. Calling for
deeper discussion of the motives or thought process behind a mistaken action
is in no way an endorsement of gadgets over human life. It sounds more like
you were trying to twist this into something about Apple.

~~~
burgerbrain
I was anticipating this: <http://news.ycombinator.com/item?id=3080812>

