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Why You Shouldn't Judge Steve Jobs' Cancer Choices

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By Lori Hope

The new Steve Jobs biography reveals that the genius' formidable intellect may not have served him well when he made the decision to delay surgery for his cancer, opting instead for alternative treatments. His choice reportedly enraged many who loved him, and I can imagine their frustration because I have faced similar situations with loved ones battling cancer who have made choices I disagreed with.

A cancer survivor myself, I am currently deciding on a course of action that could extend or shorten my life. And it brings to mind a statement that, based on a survey of more than 600 survivors, people with cancer want others to know: "I want you to respect my judgment and treatment decisions." I'll take the liberty of adding a corollary: "I don't want to feel judged."

Who does, really? But who among us can resist judging others? Remember the famous line from the classic 1989 comedy, "Steel Magnolias," spoken in Southern treacle by Clairee (Olivia Dukakis) to Truvy (Dolly Parton)? "As somebody always said, if you can't say anything nice about anybody, come sit by me!"

But when it come something like cancer, please try to resist gossip or judgment. If you feel you absolutely must share your opinion with the patient because it's a matter of life and death, then go ahead. But then let it be. Decisions such as Jobs' do not come easily, nor do decisions like the one I face: whether to have my tumor tissue tested for genetic mutations or wait and conserve the tissue until more extensive mapping is available. Jobs apparently paid $100,000 to have all the genes of his tumor and normal DNA sequenced. Not in my budget, but I am eager to learn whether I have one of several mutations that might render new treatments effective.

In making crucial health care decisions, most of us weigh our options very carefully, relying on our intellect, the opinions of others we respect, and hopefully, our intuition, that je ne se quoi of inner knowing. Although it's easy to "tsk-tsk" someone who forgoes chemo for herbal therapy, you never truly know what you will do until you find yourself in that situation.

There's something even deeper, however, that may underlie our judgment of Jobs. We may unknowingly want to believe that he did something to cause his own demise -- something that we wouldn't do.

I had lung cancer, and the first question that may come to your mind is, "Did she smoke?" You may ask that because you smoke or used to, and want to gauge your risk. If you didn't smoke, you may seek reassurance that you won't get lung cancer -- except that, as you may not know, 80 percent of lung cancer patients diagnosed today are former or never-smokers. Up to one-fifth of women and one-tenth of men with lung cancer have never smoked.

When you hear my answer, "Yes, I smoked, but quit almost 20 years before my diagnosis, and had the kind of lung cancer called 'epidemic' among never-smoking women," you may feel confused. "So, did she bring it on herself (or even 'deserve it') because she was a smoker?" Do you get to feel exonerated or "holier than thou" because you didn't smoke? Or do you feel frightened because it could be you?

Not to scare you, but it could be you.

• It could be you who dies from a heart attack, maybe in part because you often choose to go out for a cheese plate or a steak after work instead of heading to the gym.

• It could be you who develops breast cancer, maybe in part because you have more than three drinks a week or delayed having children.

• It could be you who gets AIDS, maybe in part because you didn't don a condom, just that one time.

• It could be you who gets melanoma, maybe in part because you worshiped the sun more than the temple of your body.

But I'm not judging here, and I hope you won't either. Let he or she who has not made a poor lifestyle choice throw the first stone. And by lifestyle choice I include compulsively checking email or indulging in stressful behaviors to the exclusion of meditation, family time, or self-care.

Yes, I made choices I regret. And Steve Jobs made treatment choices he regretted. But what his family needs now -- and what I need now -- is compassion, literally a "feeling-with." The acknowledgment that it could be you or me or anyone.

Why do some vegetarians die of colon cancer? Why do some lifelong heavy smokers or drinkers live to 100? How do some octogenarians with sun-damaged skin manage to avoid skin cancer?

No one can answer such questions definitively. So if you want to judge anyone, judge those in the political arena who neglect or refuse to commit research dollars to determine why cancer claims legions of lives every year -- lives of people like Steve Jobs, who are guilty of nothing more than being human. We make the best choices and decisions we can. I hope I make the right decision, but if I don't, please don't judge me once I'm gone.

A cancer survivor, Lori Hope has written and spoken about cancer support for almost a decade. Her best-selling cancer support book, "Help Me Live: 20 Things People with Cancer Want You to Know," was released this September in a new, expanded second edition that includes a foreword by Rachel Naomi Remen, M.D., a survey of more than 600 survivors, new sections on gender and cultural differences and childhood and adult cancers, and a "Quick Guide to Cancerquette." Hope's essays and articles have appeared in publications including "Newsweek," and cancer-related and college English textbook anthologies. Her work has been featured on "Oprah" the "Today Show" and in "Time" magazine. She has spoken before staff and leadership of the American Cancer Society, the Oncology Nursing Society, and dozens of other groups. To order her book and to read her blog, visit Lori on www.LoriHope.com and Red Room.

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