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Steve Jobs First Disclosed Health Problems In 2004, Announcing Pancreatic Cancer Diagnosis

Pancreatic Cancer Steve Jobs

MARILYNN MARCHIONE   10/ 6/11 10:49 PM ET   AP

Pancreatic cancer is notoriously lethal – there are almost as many deaths from it each year as there are new cases. The deaths this week of Apple founder Steve Jobs and Nobelist Ralph Steinman bring unusual attention to this less-well-known type of cancer that has actually been declining despite no big advances in treatment or finding it early.

A decline in smoking, one of the top risk factors for the disease, may be behind the drop in cases.

Jobs lived more than seven years after being diagnosed with a neuroendocrine tumor – a less common, slower-growing and more treatable type of pancreatic cancer than the kind that killed Steinman a week ago and actor Patrick Swayze two years ago.

The Apple chief kept details of his illness behind a firewall and declared he was cured after cancer surgery in 2004. However, five years later, gaunt and having lost a lot of weight, Jobs had a liver transplant. Experts said it was likely because his cancer had returned or spread.

A liver transplant sometimes can cure the type of cancer that Jobs had. But if it comes back, "it's usually in one to two years," said Dr. Michael Pishvaian of Georgetown University's Lombardi Comprehensive Cancer Center.

In January, Jobs announced his third and final leave of absence. He resigned in August and died on Wednesday.

Part of what makes pancreatic cancer so deadly is that the pancreas is as vital as the heart. You can live with just part of a liver or a colon, or only one kidney or lung. But the pancreas is a fish-shaped organ that makes digestive enzymes and insulin and other hormones that enable the body to make energy from food.

In the United States, pancreatic cancer is the fourth leading cause of cancer deaths. About 44,030 people will be diagnosed with it and about 37,660 people will die of it this year in the U.S., the American Cancer Society estimates.

Possible symptoms are fatigue, back pain, abdominal pain, unexplained weight loss, loss of appetite, jaundice and nausea, according to the Lustgarten Foundation, a private group that finances research on the disease.

This cancer often is not found until it is advanced or has spread, and overall survival is dismal: 20 percent after one year and only 4 percent after five years.

However, with a neuroendocrine tumor like the one Jobs had, "people can live a longer time; median survival is five to eight years," said Dr. Alan Venook, a pancreatic cancer specialist at the University of California, San Francisco.

The lifetime risk of developing pancreatic cancer is about 1 in 71, according to the cancer society. Men and blacks account for more cases than women and whites, possibly because of differences in smoking rates. Smokers have two to three times more risk of developing the disease. Use of smokeless tobacco also raises the risk.

Obese people, those who don't exercise much and diabetics also have more risk for pancreatic cancer. Alcohol use might play a role: Most studies haven't tied it to pancreatic cancer, but heavy drinking can lead to diabetes and liver and pancreas problems that pose a cancer risk, the cancer society says.

The best hope for a patient is that the tumor is operable. That was the case in February 2009, when U.S. Supreme Court Justice Ruth Bader Ginsburg had a small, early-stage pancreatic tumor removed at New York's Memorial Sloan-Kettering Cancer Center.

On the horizon are immune system treatments – research that Steinman, the Nobel recipient from Rockefeller University in New York, was studying in the lab and trying on his own pancreatic cancer.

The immune system has a hard time recognizing and fighting cancer because the enemy is not an invading germ but our own cells gone rogue. Treatments called therapeutic cancer vaccines are ways to modify cells to help the immune system recognize the risk.

One such vaccine by NewLink Genetics, a small biotech firm in Ames, Iowa, is in late-stage testing now for pancreatic cancer. The company website says the larger study was initiated after a mid-stage test suggested improvement in survival.

Dr. Roderich Schwarz, chief of surgical oncology at the University of Texas Southwestern Medical Center in Dallas, has enrolled a few patients in some immune therapy studies, which have not paid off in the past.

"Vaccines are coming along," and last year's approval of one for advanced prostate cancer suggests researchers may be learning to overcome some of the drawbacks of the past, he said.

"It's quite possible that vaccines will claim their territory in the treatment of these challenging tumors," Schwarz said. "It's still in the development stage rather than the proven stage."

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Online:

Cancer Institute: http://www.cancer.gov/cancertopics/types/pancreatic

Cancer Society: http://www.cancer.org/Cancer/PancreaticCancer/index

Survival rates: http://bit.ly/oAxKl5

Research and support: and

Links:


Vaccine study: http://www.linkp.com/products/hyperacute-pancreas.html

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Loading Slideshow...
  • Steve Jobs 1955-2011

    In this Jan. 24, 1984, file photo, Steve Jobs, chairman of the board of Apple Computer, leans on the new "Macintosh" personal computer following a shareholder's meeting in Cupertino, Calif. Apple on Wednesday, Oct. 5, 2011 announced the death of its visionary co-founder Steve Jobs from cancer at age 56. (Paul Sakuma, AP)

  • Steve Jobs 1955-2011

    In this April 24, 1984, file photo, from left, Steve Jobs, chairman of Apple Computers, John Sculley, president and CEO, and Steve Wozniak, co-founder of Apple, unveil the new Apple IIc computer in San Francisco. (Sal Veder, AP)

  • Steve Job 1955-2011

    This 1993 file photo shows Steve Jobs, co-founder of Apple Computers. (AP)

  • Steve Job 1955-2011

    In this May 6, 1998, file photo, Jobs unveils the the new iMac computer in Cupertino, Calif. (Paul Sakuma, AP)

  • Steve Jobs 1955-2011

    In this Jan. 15, 2008, file photo, Apple CEO Steve Jobs holds up the new MacBook Air after giving the keynote address at the Apple MacWorld Conference in San Francisco. (Jeff Chiu, AP)

  • Steve Jobs 1955-2011

    In this June 7, 2010, file photo, Apple CEO Steve Jobs holds a new iPhone at the Apple Worldwide Developers Conference in San Francisco. (Paul Sakuma, AP)

  • Steve Jobs 1955-2011

    A statement on the Apple.com website Oct. 5, 2011 announces the passing of Apple's founder and former chief executive Steve Jobs. "We are deeply saddened to announce that Steve Jobs passed away today," the company's board of directors said in a statement. (Robyn Beck, AFP / Getty Images)

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Filed by Catharine Smith  |