Apple CEO Steve Jobs: cause of death
When Apple leader Steve Jobs died, the cause of death was not named. The situation was clarified by the publication of an official document confirming the passing of an outstanding entrepreneur. The certificate indicated the place where Steve Jobs died, the date of death and the cause. According to the document, he died in his home in Palo Alto (California) from respiratory arrest caused by a metastatic neuroendocrine tumor of the pancreas, 10/05/2011 at 3 pm. The cause of the death of Apple CEO Steve Jobs was a rare disease, and its name only hints at the enormous complexity of the disease, to which he finally surrendered to 56 years old. The American entrepreneur joined the Nobel laureate Ralph Steinman, actor Patrick Swayze and Gene Upshaw as the last celebrity who died of this aggressive disease, which even he with his enormous wealth and with the available immunological experimental methods of treatment could not resist.
Most of the cases of pancreatic malignant neoplasms (53%) are diagnosed after their spread, and the survival rate is extremely low - only 1.8% of patients live more than 5 years after the diagnosis is confirmed. For all types of cancer, this indicator is only slightly higher - only 3.3%. So how did Jobs, whose disease was identified in the fall of 2003, which was publicly announced in 2004, survive for 8 years?
Steve Jobs: Biography
The personal life of an American entrepreneur has been marked by a long hard struggle with this disease. In 2004, he underwent an operation to remove the neoplasm. In 2009, Apple’s manager traveled to Switzerland to receive radiation hormonal treatment that was not available in the US, and in the same year he underwent a liver transplant. In January 2011, he took his last vacation, before resigning from his post as head of the company in August and retire from life in October.
Two types of disease
The illness and cause of death of Steve Jobs was a rare form of tumor, known as neuroendocrine cancer, which grows more slowly and is easier to treat. Survival for many years or even decades with this disease is not surprising.Neuroendocrine tumor is significantly different from the common form of pancreatic cancer, because the patient's life expectancy is measured in years, not months. Unlike Steve Jobs, Steinman’s death was caused by a disease that usually ends in death within a year after the diagnosis is confirmed. Given the extremely unfavorable prognosis for both of these forms, scientists are working hard to develop more effective methods of treatment and diagnosis, as well as trying to find out why one patient can live for 8 years, and the other for 8 months.
Steve Jobs: the cause of death
Pancreatic cancer is not a very common disease. In the United States, about 44,000 new cases are diagnosed each year, and the risk of getting sick is 1.4%. The overwhelming majority of diseases (about 95%) are adenocarcinomas, similar to the one that Steinman had, but which Steve Jobs did not have. The cause of death of the latter, known as neuroendocrine cancer, accounts for a small proportion of patients with pancreatic malignant neoplasms.Iron itself consists essentially of two different organs. This means the presence of 2 different types of tissue and, accordingly, 2 very different types of tumors. The most common of these, adenocarcinoma, affects the exocrine portion. It occupies the main volume of the pancreas and produces digestive enzymes that are displayed in the gastrointestinal tract through special channels. Thousands of tiny islands of endocrine tissues that produce hormones released into the blood are scattered in this organ. The cancer of these islet cells caused Steve Jobs to die.
Malignant neoplasms of the pancreas are so deadly largely because it is often detected at a very late stage. Unlike colon or lung cancer, it does not have many early symptoms. Doctors even find it difficult to list its manifestations, which include pain in the upper abdomen, weight loss, loss of appetite and the presence of blood clots, because these are common complaints that almost everyone can suspect of pancreatic cancer.Most cases are detected after some symptoms persist or more serious symptoms appear, such as jaundice.
New diagnostic methods
Some groups of researchers are looking for the best way to screen for pancreatic malignant tumors for early detection. Significant efforts are being made for this, including the company Neogenix Oncology, which is developing diagnostics and treatment of two types of pancreatic cancer. Employees of the company discovered several genetic markers that are present in this disease, but not in normal tissues. The goal of research is to develop something similar to a test for prostate cancer.
There is evidence that what Steve Jobs died from is not a disease that, as it may seem, begins suddenly. According to a study published in October 2016, after studying the accumulation of genetic mutations in pancreatic neoplasms, the researchers concluded that it takes an average of 7 years for the main tumor to form, and 10 years for it to spread to neighboring organs.Armed with this knowledge, as well as other research results of precancerous lesions, scientists hope that a non-invasive screening method will eventually be developed.
The problem of misdiagnosis
Widespread screening for more common types of malignant neoplasms, such as colon, prostate and breast cancer, has recently come under fire because they led to too many false diagnoses followed by treatment. With even rarer diseases, the situation is even more complicated, therefore an extremely low level of false test results is required. Pancreatic cancer is a terrible disease, but, fortunately, rare.
At the early stage of pancreatic cancer, doctors usually try to remove it surgically. However, the likelihood that he will return in a year or two is still relatively high. And the operation itself is risky. The pancreas is deep in the abdominal cavity, it is surrounded and connected to other major organs. This operation, known as the Whipple procedure, is considered an element of aerobatics in surgery.
If the cancer has already spread, as was the case with Steinman, then the most common approach is chemotherapy, which is not very effective for conventional pancreatic cancer. Gemcitabine (Gemzar) is mainly used, which among other things was received by Steinman. During the trials of the drug, some patients did not get better, but for some it extended the life for several years, indicating a significant molecular difference in the tumors.
Despite the initial positive effects of chemotherapy, even when Steinman got better, he felt that he was living with a Damocles sword over his neck — he did not know when the symptoms would return. Therefore, he turned to the area that he knew - immunology. He deeply felt that stimulation of the immune system to such a level that it could fight a tumor was the key to healing. But to achieve this is not so easy. This method has long been studied. The only currently approved immunotherapy for cancer treatment is a remedy for metastatic melanoma (Ipilimumab or Yervoy, approved in March 2017).His approval was good evidence that it was important to study this area in order to apply it in the fight against other forms of the disease.
Chemotherapy and liver transplantation
Steve Jobs, whose cause of death was neuroendocrine pancreatic cancer, was treated with various chemotherapeutic drugs. Two new drugs for the treatment of this disease have recently been approved by the US Control Department. The drug approved in May, Everolimus (Afinitor), acts by blocking mTOR kinase to alter cellular communication. Sunitinib (Sutent) blocks vascular endothelial growth factor. None of them is a panacea, but gives a modest improvement in the condition of patients.
A form of treatment that is not recommended for most types of pancreatic cancer is liver transplantation. It is assumed that the transplantation that Steve Jobs underwent before his death was necessary, since metastases had time to spread to this organ. And although liver failure is a fairly common cause of death in patients with pancreatic cancer, since the liver is close to it and is often affected by malignant neoplasms, transplantation is not a generally accepted standard of treatment.since there is no evidence that it works.
Even if a new liver prevents failure, the immunosuppressants needed to prevent organ rejection may reduce the body’s ability to fight the remaining cancer cells. Given the many other factors of real life, it is ultimately not possible to conclude whether the transplantation extended life or became another cause of death for Steve Jobs.
Keys to treatment
Stainman, however, presents another case. By exposing himself to a whole range of therapies, he increased the average chance of survival for his type of cancer by several years. But what treatment was the most effective is unknown. He was probably helped by a combination of different therapies. Stainman himself was confident in dendritic cells, believing that they play a crucial role, although before they were used only to treat HIV.
To truly unleash the inner workings of the pancreas, more basic human research is needed. Current efforts to improve the understanding of the molecular and genetic differences of each tumor,which give hope to find patterns in growth rate and response to treatment can help find the best objects for therapy. But much of what determines why one patient can live for 8 years, and another 8 months, seems to depend on the biology of these types of cancer. In other words, scientists simply do not know the answer to this question.