WEDNESDAY, Oct. 5 (HealthDay News) -- Steve Jobs, the visionary
leader of Apple Inc. who introduced the world to personal
computers, then the iPod, the iPhone and the iPad, died on
Wednesday following a long battle with cancer.
He was 56.
"Apple has lost a visionary and creative genius, and the world has lost an amazing human being," the company said in a statement it posted on its website Wednesday night. The statement did not cite a specific cause of death.
Jobs announced in August that he was stepping down as head of
the hugely successful technology company he co-founded in a
northern California garage 35 years ago. The announcement was thin
on details, although speculation immediately turned to his ongoing
He first had surgery for a rare form of pancreatic cancer back
in 2004, received a liver transplant in 2009 and took three medical
leaves at Apple before turning over the helm to Timothy D. Cook,
then chief operating officer, in August. But, even after he left,
Jobs was still engaged in the company's affairs,
The New York Times reported Wednesday night.
In a letter to Apple's board of directors in August, Jobs said
he "always said if there ever came a day when I could no longer
meet my duties and expectations as Apple's CEO, I would be the
first to let you know. Unfortunately, that day has come."
This much was known about the health of Jobs, a legendarily
private man: Since 2004, he had been fighting a rare form of
pancreatic cancer called neuroendocrine cancer.
Although neither Apple nor Jobs' family has given a cause of
death, a cancer expert speculated that Jobs' death was due to the
"I have never treated him or seen his medical records, but it certainly fits with the treatments that have been acknowledged," said Dr. Steven Libutti, director of the Montefiore Einstein Center for Cancer Care in New York City.
Patients who have had surgery to remove the tumor, but have had
the cancer return, often have the cancer come back in the liver.
That is probably why Jobs had a liver transplant, Libutti said.
"My speculation is that the tumor returned after the liver transplant and he succumbed to recurrent disease, that would be my bet," he said.
Pancreatic cancer expert Dr. Craig Devoe, from the department of
medicine at North Shore-LIJ Health System in New Hyde Park, N.Y.,
said that "neuroendocrine tumors are uncommon, with only a few
thousand cases a year."
For those that affect the pancreas, the numbers are even lower
with fewer than 1,000 cases a year in the United States. In
contrast, there are around 40,000 cases of other pancreatic cancers
a year, Devoe said.
Dr. David M. Levi, a professor of clinical surgery, liver and GI
transplantation at the University of Miami Miller School of
Medicine, said neuroendocrine cancer "is an unusual tumor. It can
arise in a number of places, including the pancreas." Such tumors
can also start in the lungs.
It's one of the few tumors that can benefit -- to some extent --
from a transplant, Levi said. Jobs' cancer started in the pancreas
and then spread to the liver, making the liver transplant an
option, Levi said, adding he has treated patients with this type of
cancer and done liver transplants.
While the prognosis for neuroendocrine cancer is often better
than for the more common type of pancreatic cancer, in which
patients generally live less than a year after diagnosis,
neuroendocrine cancer "can also be bad," Levi said.
Neuroendocrine cancer can return after treatment, Levi
explained. And while a liver transplant can be effective, "it is
not as great a picture as we first thought," he said. "A lot of
these patients who have transplants eventually do recur."
"The vast majority of patients that have recurrent disease will die of their disease. One of the problems with the [liver] transplant is that now you are on immunosuppressant drugs, and while they keep you from rejection or destroying the liver, the immune system also would have helped deal with tumors," he explained.
Devoe said a liver transplant is a treatment when "your back's
against the wall," and isn't expected to cure neuroendocrine
cancer, so very few are done.
"The fact that the disease came back [was] not surprising," he said.
These treatments won't cure the disease, but they may slow its
progression, Devoe said. "It may extend the life of patients. But
at this point, your best treatments are behind you and survival may
be under a year or two," he said. "It's clearly incurable."
Doctors don't really know what causes neuroendocrine tumors. In
the past year, the U.S. Food and Drug Administration approved two
new drugs for neuroendocrine tumors -- sunitinib and
In a commencement address in 2005 to Stanford University
graduates, Jobs said: "No one wants to die. Even people who want to
go to heaven don't want to die to get there. And yet death is the
destination we all share. No one has ever escaped it."
To learn more about neuroendocrine pancreatic tumors, visit
Stanford University School of Medicine.
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