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Dave W.
Info Junkie
USA
26022 Posts |
 Posted - 03/05/2008 : 18:00:28
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The trouble with Steve Jobs:...A Buddhist and vegetarian, the Apple (AAPL, Fortune 500) CEO was skeptical of mainstream medicine. Jobs decided to employ alternative methods to treat his pancreatic cancer, hoping to avoid the operation through a special diet... No wonder Macs are so wonky... they're built with woo!
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- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too. |
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Zebra
Skeptic Friend
USA
354 Posts |
Posted - 03/08/2008 : 17:17:40 [Permalink]
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Jobs was found on a "routine abdominal scan" (?) to have a pancreatic mass, diagnosed on biopsy as islet cell carcinoma, a rare form of pancreatic cancer & one which has a less bleak outlook than the more common pancreatic cancer.
He may well have read up on this condition & been reassured that he had some time to make his decision, even to try nontraditional approaches first. He waited 9 months before undergoing the surgery, presumably having serial CT scans along the way to monitor the mass & see what it was doing.
This 2007 observational study of islet cell carcinomas reports that more than half of people had metastatic disease at the time of diagnosis; Jobs didn't. That same study reports that the median survival for those diagnosed & treated between 1993 & 2003 with localized disease, as Jobs had, was 124 months = 10.3 yrs (95% confidence interval 80 to 168 months, = 6.7 to 14 yrs). So he probably figured he had some time to treat it nonsurgically first & see whether it responded to that approach. |
I think, you know, freedom means freedom for everyone* -Dick Cheney
*some restrictions may apply |
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Dave W.
Info Junkie
USA
26022 Posts |
Posted - 03/08/2008 : 17:41:11 [Permalink]
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Is there any sort of rational, medical basis to the idea that diet can treat islet cell carcinoma?
If not, I stand by my diagnosis of "woo."
Really, nobody would think of anybody who says, "I've got a fever; it's not going to kill me for a couple of days, so I think I'll try to treat it by watching Apolcalypse Now ten times in a row," as sane. Is there good reason to give any other dreamt-up treatments for disease more consideration? |
- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too. |
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Zebra
Skeptic Friend
USA
354 Posts |
Posted - 03/08/2008 : 23:09:14 [Permalink]
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Well, if the fever is caused by viral conditions, that approach may work just fine! It might help if the person is fatigued from the illness & dozes off on the couch through many of the repeats. But it beats going to work sick.
No, there's no good reason to believe that islet cell carcinoma will remit in the face of dietary approaches (or naturopathic treatment, or prayer, yadda yadda). But there are cancers that do remit spontaneously, or don't act in a malignant fashion.
Our understandable assumption is that a cancer which is found must be eradicated, otherwise it will kill the person. In an individual's case, it's probably better to err on the side of treating the identified cancer rather than sitting back for some watchful waiting, because there's no turning back if it is an aggressive cancer & it spreads. But there's interesting data from a number of different studies, on a number of different cancers, showing that is not always the case.
In the study I linked to earlier on islet cell carcinoma, people with disease which was metastatic in distant locations at diagnosis lived on average 23 months after diagnosis, while people with "regional" metastases lived on average 70 months after diagnosis, while people with localized disease lived on average 124 months after diagnosis. We tend to assume that means that diagnosing the cancer earlier made a big difference in how long someone had to live, but it may well just represent lead time bias, length time bias, and/or overdiagnosis. If it took, on average, 50 months for islet cell carcinomas to progress from localized to regionally advanced to distant metastases, then the survival data would be showing no benefit from treating the disease early. (We don't know that it takes that long. But that would fit with the observed data, and is the case in some other cancers.)
Neuroblastoma (in kids) is the poster child example, so to speak, of a cancer which so often remits spontaneously that screening has been shown not to improve the death rate, & exposes many children diagnosed with neuroblastoma to unnecessary surgery & chemotherapy. And the results on studies in the past few years on screening for lung cancer by spiral CT seem explicable only if small lung cancers which are not destined to grow significantly locally, nor to metastasize, are fairly common (a study published in JAMA last year found many-fold more "early" cancers, but no difference in advanced cancers or in survival, in those screened with chest CT). And ductal carcinoma in situ or DCIS is found on mammograms, and is treated as breast cancer, and is treated as breast cancer in the statistics, but DCIS itself does not metastasize & won't kill anyone. (It's not invasive.)
One researcher who has focused on overdiagnosis & overtreatment of cancer is Gil Welch, MD MPH. Besides his papers in medical journals, he has written a book for the public called Should I Be Tested For Cancer? Maybe Not and Here's Why. It's very interesting & illuminating, and based on sound data, interpreted by a level headed skeptic (Gil Welch).
So, I'm saying that Jobs was found incidentally to have a localized cancer of a rare type, which seems not to be all that aggressive (at least not early on), for which surgery is a pretty big deal. (You should never have anyone mess with your pancreas if you can help it.) Many people his age diagnosed with this cancer, at a localized stage, die of something else. While most people, including you and I, would probably have leaped at surgery to Get That Thing Out Of There, maybe Jobs did his homework & talked with some people who weren't freaked out just because the pathologist said it was "cancer", & he figured he'd give a less invasive treatment a chance.
That, and I like my Mac so don't go dissin' them, you hear!!
Edited to correct links |
I think, you know, freedom means freedom for everyone* -Dick Cheney
*some restrictions may apply |
| Edited by - Zebra on 03/08/2008 23:13:30 |
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Dave W.
Info Junkie
USA
26022 Posts |
Posted - 03/08/2008 : 23:40:55 [Permalink]
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Originally posted by Zebra
Well, if the fever is caused by viral conditions, that approach may work just fine! It might help if the person is fatigued from the illness & dozes off on the couch through many of the repeats. But it beats going to work sick. |
I have a hard time calling an activity which has no actual effect on the course of a disease a "treatment." Tylenol, for example, doesn't treat a viral infection (make the virus go away faster), it just relieves some of the symptoms.| No, there's no good reason to believe that islet cell carcinoma will remit in the face of dietary approaches (or naturopathic treatment, or prayer, yadda yadda). But there are cancers that do remit spontaneously, or don't act in a malignant fashion. |
Indeed.| Our understandable assumption is that a cancer which is found must be eradicated, otherwise it will kill the person. |
But not treating it isn't a treatment. I really do get what you're saying (which I'm snipping) - perhaps I'm just fond of not giving words new meanings without merit.| While most people, including you and I, would probably have leaped at surgery to Get That Thing Out Of There, maybe Jobs did his homework & talked with some people who weren't freaked out just because the pathologist said it was "cancer", & he figured he'd give a less invasive treatment a chance. |
Except it wasn't a treatment. And from what I read, he kept it all hushed up for a long time, and has said nothing about simply trying something "natural" while the disease wasn't critical, which says to me that he was worried about the obvious appearance of woo on sales. The headline "Jobs has cancer" could have increased sales among people who wanted to ensure they own a Jobs-era Mac, instead of whatever might come later.| That, and I like my Mac so don't go dissin' them, you hear!! |
Ah, now the real reason for your defense is apparent.
What can I say, but... Macs are made with woo! Macs are made with woo! Macs are made with woo! Neener-neener!
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- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too. |
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Zebra
Skeptic Friend
USA
354 Posts |
Posted - 03/09/2008 : 09:01:56 [Permalink]
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I get your point, but am going to respond/rebut anyway. Neener neener!
Definitions of "treatment" include:
1. a. The act, manner, or method of handling or dealing with someone or something: “the right to equal treatment in the criminal and juvenile justice system” (Susan C. Ross).
b. Informal. The usual methods of dealing with a given situation: gave the opposing team the treatment.
2. a. Administration or application of remedies to a patient or for a disease or injury; medicinal or surgical management; therapy.
b. The substance or remedy so applied.
You're right, watching DVDs is not active treatment for fever, but allowing time to pass could count as treatment, under definition #1. I'm a physician, & we do informally say in some conditions that "the treatment is time," recognizing of course that's not an active intervention as in meaning #2 above.
| Is there good reason to give any other dreamt-up treatments for disease more consideration? |
Obviously, woo-heads have come up with all sorts of wacky ideas about what "natural" approaches will make their medical conditions melt away magically, and most of those approaches don't work. On the other hand, there's alot we do "medically" which has never been shown to be necessary or beneficial, we all just assume that doing something must be better than doing nothing. And we harm people along the way.
And, there are, of course, some "natural" treatments which have turned out to have merit. Glucosamine has more effect on knee osteoarthritis than any Rx approach currently available. Cinnamon (without the sugar) improves diabetes control & lowers cholesterol, though not enough to substitute for Rx medications. Grapefruit enhances the absorption of many medications and the active substance might, in the future, be mixed in with medication formulations to capture this as a benefit. Rat poison is an anticoagulant. Oh, wait, that last one probably doesn't count as "natural".
An approach which is thought to have merit should be studied against a placebo or against the current standard of care, and while Jobs wasn't doing that formally, he might well have taken a fairly savvy approach if he was having serial scans to follow his tumor & changed his mind about surgery when saw that it wasn't shrinking, & maybe was enlarging, with the "treatment" approach he had taken.
In the original article you linked, there's a line about how people hadn't known Jobs was "sick" before his surgery. Well, he may well not have been "sick", just because he had a small tumor in his pancreas. Again, the assumption is that "cancer" equals "dying" & that is not always the case.
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I think, you know, freedom means freedom for everyone* -Dick Cheney
*some restrictions may apply |
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Kil
Evil Skeptic
USA
13477 Posts |
Posted - 03/09/2008 : 09:25:19 [Permalink]
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Dave:
No wonder Macs are so wonky... |
Define "wonky". |
Uncertainty may make you uncomfortable. Certainty makes you ridiculous.
Why not question something for a change?
Genetic Literacy Project |
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JohnOAS
SFN Regular
Australia
800 Posts |
Posted - 03/09/2008 : 18:10:34 [Permalink]
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Originally posted by Zebra
An approach which is thought to have merit should be studied against a placebo or against the current standard of care, and while Jobs wasn't doing that formally, he might well have taken a fairly savvy approach if he was having serial scans to follow his tumor & changed his mind about surgery when saw that it wasn't shrinking, & maybe was enlarging, with the "treatment" approach he had taken. |
What gets up my nose is that, had Jobs spontaneously recovered, we'd have to deal with a massive explosion of cancer-curing diets. With the number of fan boi's out there, you can bet the iDiettm would've been a huge hit.
Actually, that might not have been so bad, I could make a fortune writing a biorythm plug in for the iPhone. Or maybe I could just sell homepathic battery life extenders outside apple stores...
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John's just this guy, you know. |
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HalfMooner
Dingaling
Philippines
15831 Posts |
Posted - 03/09/2008 : 18:59:40 [Permalink]
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I think Jobs simply has a tendency to deny facts that he doesn't like, a common human failing. When is ex-girlfriend sought child support for her child, Steve denied being the father, and demanded genetic testing. The tests were duly performed, and showed Jobs was the daddy. He paid. (My source: I was told about this by the mother.)
Jobs named the forerunner of the Mac after this child.
In business, such denialism might conceivably be a strength in some cases. But not in disease, nor in fatherhood.
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“Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive. |
| Edited by - HalfMooner on 03/09/2008 19:01:59 |
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@tomic
Administrator
USA
4607 Posts |
Posted - 03/09/2008 : 20:56:20 [Permalink]
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What I loves is that he can distrust medical science, then get the surgery because it's what works, then resume distrusting medical science when it's convenient for him.
I just find it ironic that someone in the technology field is a luddite when it comes to medical technology. I mean, what a hypocrite!
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Gravity, not just a good idea...it's the law!
Sportsbettingacumen.com: The science of sports betting |
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Kil
Evil Skeptic
USA
13477 Posts |
Posted - 03/09/2008 : 21:24:37 [Permalink]
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Originally posted by @tomic
What I loves is that he can distrust medical science, then get the surgery because it's what works, then resume distrusting medical science when it's convenient for him.
I just find it ironic that someone in the technology field is a luddite when it comes to medical technology. I mean, what a hypocrite!
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Actually, this is exactly what we, as skeptics, are up against. Jobs is no different from the average Joe when it comes to critical thinking outside of his area's of expertise. That doesn't make him a hypocrite. Unfortunately, it makes him pretty much normal.
It would be nice if he were better informed. But oh well. The good news is he wasn't stupid enough to keep trying different alternatives until he died of a treatable cancer. That happens, you know.
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Uncertainty may make you uncomfortable. Certainty makes you ridiculous.
Why not question something for a change?
Genetic Literacy Project |
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@tomic
Administrator
USA
4607 Posts |
Posted - 03/09/2008 : 22:30:18 [Permalink]
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You're right. He's not a hypocrite. Even so, there's a lot of irony to be had here. He's lucky he came to his senses in time and that a real solution was available to him despite his distrust of what saved his life.
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Gravity, not just a good idea...it's the law!
Sportsbettingacumen.com: The science of sports betting |
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This explains a lot
