Steve Jobs: A difficult patient
October 25th, 2011
12:27 PM ET

Steve Jobs: A difficult patient

All those vague statements about his health that Steve Jobs put out in the last few years caused endless speculation, as the world tried to read into what could really be going on.

But now, with the biography "Steve Jobs" with Walter Isaacson, we know that behind many of those optimistic statements was a cancer that was spreading from pancreas to liver, and finally to bones and elsewhere in the body. One of the biggest surprises is that while he received state of the art medical care, he went against doctors' orders many times.

When his pancreatic neuroendocrine tumor was first discovered in October 2003, doctors said he was lucky that it had been detected so early, and it could be removed before definitely spreading. But, in Jobs' own words, "I really didn't want them to open up my body, so I tried to see if a few other things would work." Those "other things" included a strict vegan diet, acupuncture, herbal remedies, and other alternative techniques -  even consulting a psychic.

His family pleaded with him, but it wasn't until June 2004, when a CAT scan revealed that the tumor had grown and perhaps spread, that he had to realize he couldn't successfully will his own cancer treatment.

The surgery in July 2004 involved a modified Whipple procedure, removing part of the pancreas. But it wasn't a cure: Doctors found cancer spread to three spots on his liver during the operation. It's impossible to know whether having the surgery sooner would have removed the cancer before it had spread. Yet Jobs told everyone he had been "cured." In his famous 2005 Stanford Commencement speech, a rare moment of being forthcoming about his cancer to the public, he said "I had the surgery and I'm fine now."

Jobs also went against doctors' orders with his eating habits.

Since he was a teenager, Jobs had practiced strange routines involving fasting, and would go on obsessive diets.

That's a problem because, the stomach needs enzymes to digest food and absorb nutrients, making it harder for patients who've had pancreas surgery to get enough protein. The standard of care is to have frequent meals and a diet with a variety of proteins from meats, fish and milk. But, as Isaacson points out, "Jobs had never done this, and he never would."

Flash forward to 2008, when Jobs and his doctors knew the cancer was spreading. Besides being in pain, Jobs was losing a lot of weight. This was partly a result of the partial Whipple procedure, partly because his appetite was reduced because of cancer and morphine, and also because he insisted on the same restrictive diets and fasts he'd practiced since his teenage years. Sometimes he would spend weeks only eating something like apples, or a carrot salad with lemon, and then abruptly denounce that food.

Isaacson writes:

Beginning in early 2008 Jobs' eating disorders got worse. On some nights he would stare at the floor and ignore all of the dishes set out on the long kitchen table. When others were halfway through their meal, he would abruptly get up and leave, saying nothing. It was stressful for his family. They watched him lose forty pounds during the spring of 2008.

In a public statement he attributed his weight loss to "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."

We all had speculations, but what that actually meant was: Jobs had a hormone imbalance because his cancer had spread to his liver.

He underwent a liver transplant in 2009, when his health was declining rapidly. It was successful, but doctors found that there were tumors throughout the organ, meaning the cancer had probably spread elsewhere. They also found spots on the thin membrane surrounding internal organs.

Jobs again went against doctors when he insisted that they not pump out his stomach when they needed to perform a routine procedure. That led to pneumonia, and he might have died. But he survived, and didn't lose his stubbornness, even while deeply sedated. He thought the oxygen monitor on his finger was "ugly and too complex," and offered ideas for making the design simpler.

His health and spirits appeared to improve after the transplant, but in November 2010 he experienced another downturn. He was a mere 115 pounds at Christmas. Doctors saw evidence of new tumors. "Every inch of his body felt like it had been punched, he told friends," Isaacson writes.

And his dietary finickiness continued. The family had a part-time cook who made him a variety of healthy options, but he would refuse them after merely touching one or two to his tongue. Cancer curbs appetite, but Isaacson suggests Jobs had a deeper complication from his psychological attitude toward food. He took a third medical leave in January 2011.

Jobs was among the first 20 people in the world to have a complete sequencing of all of the genes of his cancer tumor, and of his normal DNA. In this way, his medical team could choose specific drugs targeted at the molecular pathways that were promoting the abnormal growth of cancer cells. "I'm either going to be one of the first to be able to outrun a cancer like this, or I'm going to be one of the last to die from it," Jobs told Isaacson.

In July 2011, however, doctors had trouble pushing back against the cancer even with targeted drugs. Jobs had stopped going to work; he was in pain, couldn't eat most solid food, and passed many days watching TV.

When Jobs announced his resignation as Apple's CEO at the board meeting on August 24, the cancer had spread to his bones and other body parts.

"I've had a very lucky career, a very lucky life," he told Isaacson. "I've done all that I can do."

soundoff (1,566 Responses)
  1. E

    How very disrespectful you all are. None of us knew him....he was not a saint and he was not all bad...none of us are....we are just human..let him rest in peace

    October 28, 2011 at 19:20 | Report abuse | Reply
  2. Alfred

    Pre-Job's Apple vs. Post-Job's Apple will tell whether Job was as good as they say he was.

    October 29, 2011 at 12:22 | Report abuse | Reply
  3. Van

    If I am diagnosed with Cancer I'm sure I will be classified as a difficult patient too. If there's one time that I will be sure to make my own choices it is when my life is at stake. There's a reason doctors are called 'practicing' physicians.

    November 1, 2011 at 13:15 | Report abuse | Reply
  4. justice4world

    This article reads more like mainstream medicine propaganda than it does unbiased, objective reporting. What a perfect death for pharma to exploit – an extremely high profile person who kept details of his illness hidden from public view.

    To those individuals who felt the need to leave comments of intolerance and hate: You're kidding, right? You never even knew the man, yet somehow you feel qualified to pass judgement on him? Even worse, this judgement is based on information acquired 100% by hearsay.

    You're talking about a man who, in his lifetime, achieved something so significant so as to alter the course of humanity. Which of us will achieve the same in our lifetime? Of course he didn't do it alone – no one exists in a vacuum. But none of those surrounding him were of the caliber to do so on their own, or else they would have.

    Why not learn to have respect for another human being – no matter who they are? What the man went through deserves compassion, not persecution. We are not separate in this world, we are all one – whether we realize it or not. As long as we continue to choose hate over love, we – humanity – will continue to suffer. Don't you get it?

    A little something about the medical-industrial complex one should know before voicing an opinion on such matters:

    Under corporate law, the primary responsibility/number one priority corporations have is to the interests of their shareholders. What this means is that corps must always strive to maximize profits, above all else. Also under corporate law, shareholders can sue executives of the corporation in which they have stock if that corp is setting policies/making decisions/etc that appear to run contrary to this primary objective.

    Mainstream medicine is a for-profit industry, has shareholders, and must abide by corporate law. Shareholders in this industry can sue any corporate executive who willfully sacrifices profits to patients' interests.

    This simple fact should be enough for anyone to make a proper assessment of mainstream medicine's real intentions. There is no profit to be procured from a healthy populace. Don't expect them to ever find a cure for cancer, or anything else for that matter. Instead, pharma suppresses known cures (yes, there are many and they would fall under the realm of "alternative medicine"), using their strong-arm gestapo – the FDA – to do so. Of course the FDA complies, pharma pays their salaries along with giving them cushy, high-paying jobs once they leave the FDA.

    Chemotherapy is poison. When you poison the body, health and vitality diminish. If you poison it to a significant degree – as chemotherapy does – you die.

    Jobs was highly intelligent. Of course he was smart enough to question poisoning his body. That he finally resorted to such measures is sad, really. The act deserves empathy because it is indicative of a person who has reached a state of desperation in wanting to live.

    November 3, 2011 at 16:25 | Report abuse | Reply
  5. seo

    People seems to forget the ones who live long. Steve chose to give us lesson and go away quickly so that we all will remember him and never forget what we are all here for, to create . Mission accomplished Steve!

    December 8, 2011 at 14:00 | Report abuse | Reply
  6. Ena Bodary

    Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique, therapeutic practice and in their relationship to the medical mainstream.

    June 7, 2013 at 05:15 | Report abuse | Reply
  7. Richard

    May God Steve's soul. He created something wonderful for us, thank you. I saw Steve Wozniak in person, gave me goosebumps when I made eye contact. I don't know if Steve Jobs knew about the benefits of high dose vitamin C, orally and intravenously, hell, even rectally; as was done with Australian aboriginals. IVC is usually sodium ascorbate in a lactated Ringer's solution. It can be a push, drip, given both in the vein and muscle. Ascorbic acid orally is determined by bowel tolerance. Taken C until you have laxative effect. RDA is 60 mg that's great if you don't wanna die of scurvy. But it doesn't cut it for cancer patients. Try 100,000 mg IV daily, or half hourly oral doses to bowel tolerance. No sugar. Oh and maybe those crazy organic coffee enemas. (Sarcasm) Thank you! God bless us, everyone. Thy will be done. Amen, and Amen.

    September 20, 2014 at 00:52 | Report abuse | Reply
  8. John

    Yeah, IVC and the Gerson Therapy, would've save his life. Errythang happens for a reason.

    September 20, 2014 at 00:58 | Report abuse | Reply
  9. Dwight Carroll

    I, too, had the Whipple procedure and feel fortunate and blessed to have gone through Whipple and chemo/radiation/chemo, and now am 1/4th of the way through two years of chemo pills, I am fine, in excellent health, and plan to stay fine until it's my time to go. I had/have pancreatic challenges but no big deal for me...so many folks suffer lots more pain than I have had. Steve was a fighter but, unfortunately, a little too stubborn for his own good.

    March 17, 2017 at 14:33 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.