Steve Jobs looks terrible. He has for months. After losing a reported 30 pounds last year, the Apple CEO has been the subject of constant scrutiny concerning his health, sparking media coverage that’s bordered on the morbid—including a mistaken obituary and a false report that he’d had a heart attack
The speculation reached a frenzy when Jobs announced he wouldn’t give the keynote speech at this month’s Macworld Expo. While Apple originally denied that the cancellation was due to their CEO’s poor health, they later conceded that Jobs had pulled out because he was ill. Exactly what this illness could be, however, remains the subject of mass conjecture.
In August 2004, Jobs announced he had had surgery to remove an islet cell tumor in his pancreas—a form of cancer that’s far rarer and less deadly than regular pancreatic cancer. It was later reported that he’d delayed the surgery 9 months after his diagnosis in order to pursue holistic treatments—a dangerous move that likely gave his doctors, and Apple’s board members, at least one ulcer apiece.
According to the New York Times, Jobs underwent another surgical procedure in 2008, the “details of which remain unclear.” Off the record, Jobs told Times reporter Joe Nocera that the CEO’s health problems “weren’t life-threatening, and he doesn’t have a recurrence of cancer.”
Still, Jobs’s current illness has reached a point where no one—not even the notoriously secretive Apple and its even more secretive CEO—can deny it.
In a somewhat unprecedented move, Jobs posted an open letter on Jan. 5 stating the following:
As many of you know, I have been losing weight throughout 2008. The reason has been a mystery to me and my doctors….
Fortunately, after further testing, my doctors think they have found the cause—a hormone imbalance that has been “robbing” me of the proteins my body needs to be healthy. Sophisticated blood tests have confirmed this diagnosis.
The remedy for this nutritional problem is relatively simple and straightforward, and I’ve already begun treatment. But, just like I didn’t lose this much weight and body mass in a week or a month, my doctors expect it will take me until late this Spring to regain it.
So could the mysterious ailment really be nothing but hormones? And is treatment simply a matter of nutrition?
“If a patient came to me with [Jobs's] history, the two big questions that would come to mind are: 1) is this a [recurrent] tumor, and 2) was there sufficient pancreas removed with the original surgery that he’s gradually lost his ability to digest and absorb food,” says Michael Jensen, an endocrinologist and nutrition specialist at the Mayo Clinic College of Medicine.
“The third option, when you take out the pancreas and see weight loss like this, is that it’s diabetes,” Jensen says. “But this would be something so well-known and treatable, we would have heard about it. Just the fact that they didn’t say it was diabetes means it probably isn’t.”
Jensen estimates that the chances of tumor recurrence versus impeded digestion are 50-50. But Jobs’s claim that the problem is a “hormone imbalance” that can be treated through “nutritional” means (both terms that rank high on the obfuscation and vagueness scales) raises some questions. If the second option on Jensen’s list is true, and the CEO’s pancreas is no longer making the enzymes he needs to digest food, the problem is in fact dietary—but not hormonal.
“The kind of hormonal imbalances [that are possible] in his case cannot be treated by simple nutritional intervention. If he’s undergoing simple nutritional treatment, then it wouldn’t be a hormone problem,” says Jensen.
While the contradiction remains unexplained, other physicians have raised plenty of possibilities, such as the tumor removal upsetting the balance of hormones like insulin and glucagon, which help control blood sugar levels, or somatostatin and gastrin, which aid digestion and other functions. But there’s a very real possibility that Jobs may once again have cancer.
If this worst-case scenario is true, it might not be devastating for Jobs. In all likelihood, the recurrence would be of the same islet tumor removed in 2004. A malignant islet tumor that recurs still isn’t as deadly as normal pancreatic cancer, and while it could eventually be fatal, an islet tumor recurrence “does not typically cause a rapid, severe [decline] if you can control the hormonal problems, which you usually can,” says Jensen.
Just how important is the truth? After the rumors of Job’s growing illness flamed in the blogosphere last summer, Apple’s stock plummeted 11 percent. At one point, an analyst estimated that the loss of Jobs could mean a 20 percent drop of Apple stock overnight. Then, of course, there’s the matter of a 53-year-old father and creative genius battling a potentially fatal disease—which, depending on your perspective, is the biggest risk at issue.
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