The big health story of the week, headlining the business news, is that Steve Jobs, Apple’s founder and usual CEO, is taking another medical leave. This is hardly a surprising development, given that the 55 year old corporate leader has had a complex medical course since at least 2003. In August, 2004 he told Apple employees he’d undergone surgery for an islet cell tumor of the pancreas. He received a liver transplant, said Methodist University Hospital in Memphis in the spring of 2009. According to multiple reports, lately he’s been looking tired and gaunt.
There’s a lot to learn from this case without delving into the private details. First, about cancer pathology – that not all cancers of the pancreas (or any organ) are the same. The NCI estimates that approximately 43,000 people (roughly half men, half women) are found to have pancreatic cancer, and over 36,000 adults will die of the disease each year in the U.S.
But Jobs’ case is special: he had a neuroendocrine tumor, a kind of malignancy that can arise from hormone-secreting islet cells in the pancreas. In general, neuroendocrine tumors cause symptoms from the hormones they secrete or from local effects; a slow-growing tumor lump can press on nearby nerves, vessels or ducts. Neuroendocrine tumors, which can be distinguished from other glandular tissues by special stains and molecular tests, usually confer a relatively good prognosis. According to the NCI, islet cell tumors of the pancreas are quite rare, with estimates of between 200 and 1000 new cases per year.
A liver transplant is definitely a complicated matter, with its own sets of long-term issues, needed medications to reduce the likelihood of graft rejection, and potential complications. By all reports Jobs is not interested in going public with specifics now. Still, there’s abundant speculation about his condition; when you hold a high office in a publicly-traded company, your well-being matters.
At another level, some people may simply care how he’s doing. Jobs is a creative, public person who’s delivered Pixar movies and iPods and Macs, and who’s been ill in recent years. Taking a medical leave, when you care about your work and you love what you do, and you’ve invested much of your life in that, is no easy decision. I hope he gets well and feels better soon.