Why Did Steve Jobs Die -McDougall Newsletter_ 11 2011 — drmcdougall_com.pdf

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McDougall Newsletter: November 2011
Why Did Steve Jobs Die?
Steve Jobs gave tacit permission and encouragement for me to write this
newsletter article about the medical and nutritional aspects of his life when he
commissioned his biographer to tell a true account. “I wanted my kids to know
about me…” “Also, when I got sick, I realized other people would write about me if
I died, and they wouldn’t know anything. They’d get it all wrong. So I wanted to
make sure someone heard what I had to say.”(556) Jobs
would have been pleased to hear my challenging second
opinions about his pancreatic cancer and his diet, because
my thoughts are in agreement with what he intuitively and
factually knew to be correct. Hopefully, my account will
bring some peace of mind to his family and friends after his
untimely death.
This article is not meant as a critique of his doctors and
their medical care. I am certain these professionals
performed their best for him. In hindsight, everything is
clearer. The purpose of this article is to set the record
Jobs’ Cancer Began as a Teenager and
Metastasized When He Was a Young Man
“In October 2003 he happened to run into his urologist
who had treated him, and she asked him to get a CAT scan
of his kidneys and ureter.(453) It had been 5 years since
his last scan. The new scan revealed nothing wrong with
his kidneys, but it did show a shadow on his pancreas.” By
the time a tumor is large enough to be seen on a CAT scan
it has grown to a size of at least 2 millimeters (mm) (half
the size of a BB, twice the size of a period on this page). My
guess is that the shadow seen on his pancreas was at least
one centimeter (cm) in diameter (the size of an eraser on a
pencil). This size mass contains 1 billion cells and has been
growing on average for 10 years. Death usually occurs when
the size of individual tumors reaches ten centimeters in
diameter (4 inches). Pancreatic neuro-endocrine (islet cell) tumors, the kind that Jobs had, fit this
pattern of growth.
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The natural history of the growth of Steve Jobs’ pancreatic cancer can be determined by mathematical
calculations. The interval between his diagnosis at age 48 and his death at age 56 was approximately 8
years (October of 2003 and October 5, 2011). From these dates it can be determined that the tumor mass
in his pancreas doubled in size every 10 months. (Commonly, solid tumors of various organs double in
size every 3 to 9 months.) His was a very slow growing tumor.
By knowing this stable rate of doubling (every 10 months), the date when Jobs’ cancer began can be
calculated. His cancer started when he was a teenager or a young adult, possibly as young as 16 years old.
Similar calculations show that his cancer spread from his pancreas to his liver (and other parts of his
body) three decades before his surgery on July 31, 2004. (Exact methods for doing these calculations are
found at the end of this article.)
One of Jobs’ greatest regrets when he found out he had incurable cancer was that he had refused to have
surgery for 9 months after being diagnosed. He believed he might have been cured if he had acted earlier.
Since he was about 20 years old when the cancer spread throughout his body, removing his CAT-scan-
detected cancer in October of 2003 would never have cured him.
How Cancer Grows
People unfamiliar with the manner in which cancer grows are easily fooled into thinking it spreads like
wildfire, almost overnight, because one moment the person appears to be in good health, and then the
next moment the patient has a body full of disease. When the cancer is first diagnosed people believe
that this is “early disease,” that can be “caught in time and cured” if removed. This fairytale view is,
unfortunately, untrue.
Cancer grows at a steady rate (referred to as the doubling time ). Early growth is invisible because the
cancer is microscopic in size. This increase in size of the cancer is hidden from view as one cancer cell
divides into two cells, two into four, and so on. The doublings remain undetectable until the cancer
reaches a size of 1 mm (period-size), which now contains a million cells, after about 6 years of growth.
After 10 years of growth, the tumor is 1 cm in diameter (eraser-size) and contains one billion cells. At
this point in its natural history the doublings become very apparent: one billion cancer cells divide into a
mass containing two billion cells, and with the next doubling there are 4 billion cancer cells inside the
patient’s body. Thus, cancer is undetectable by the patient and his physician for the first two-thirds of its
natural history, and this leads to confusion.
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Cancer Caused Steve Jobs Troubles in His Thirties and Forties
A report about Jobs’ mannerisms during meetings in 1987 said, “His hands, which are slightly and
inexplicably yellow, are in constant motion.”(223). Yellow discoloration of the skin is a classic sign of
jaundice. Cancer in the head of the pancreas commonly causes blockage of the flow of bile, resulting in
jaundice. Likely, the tumor was 1 cm in size (nearly one-half inch) or greater at this time (1987), and
causing partial and intermittent obstruction.
His cancer also caused him abdominal and back pains at least 5 years before his diagnosis in October of
2003. “I was driving up to Pixar and down to Apple in my black Porsche convertible, and I started to get
kidney stones. I would rush to the hospital and the hospital would give me a shot of Demerol in the butt
and eventually I would pass it.”(334) The CAT scan obtained in October of 2003 (which showed the
shadow on his pancreas) revealed nothing wrong with his kidneys.(453)
Kidney stones are caused by a diet high in animal protein. As a strict vegan, it is unlikely that Jobs had
kidney stones. I do not have his medical reports, however, I believe some or all of these episodes of pain
were misdiagnosed and mistreated as pain from kidney stones. Jobs was actually suffering from the
cancer growing in his pancreas.
Proof that the cancer had been present for at least 10 years before the time of diagnosis came at the time
of his surgery on July 31, 2004. “Unfortunately, the cancer had spread. During the operation the doctors
had found three liver metastases.”(456) For his surgeons to see these tumors on the surface of his liver
with the naked eye, each cancer would likely have been at least 1 cm in size. As I explained above, these
metastasizes began three decades before when Jobs was in his early twenties. Finding tumors on the
liver means the cancer has also spread to other organs of the body many years before.
Jobs considered himself to be a very intuitive person, who relied on his own gut feelings. At some level of
consciousness he may have known that he had disease twenty or more years before his diagnosis. In
1983, “Jobs confided in John Sculley (Apple’s CEO) that he believed he would die young.”(155) Jobs was
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only 28 years old when he spoke this prophecy.
Lead (Pb) and Other Carcinogens from Computers Caused Jobs’ Cancer
Jobs would speculate that his cancer was caused by the grueling year that he spent, starting in 1997,
running both Apple and Pixar.(452, 333) He guessed, “That’s probably when this cancer started growing,
because my immune system was pretty weak at that time.”(452) However, based on reliable calculations,
his cancer likely started decades earlier, as a teenager, when he was building computers and other
electronics by his own hands without adequate safety precautions.
The summer after his freshman year at Homestead High School in Los Altos, California, Jobs called Bill
Hewlett of HP on the phone, “And he answered and chatted with me for about twenty minutes. He got
me the parts, but he also got me a job in the plant where they made frequency counters.”(17) Here he was
exposed to toxic chemicals, known to cause cancer of the pancreas. Another example; Jobs soldered
circuit boards in the early days of Apple.(67) This compound (solder) is typically an alloy containing lead,
tin, and other metals. Lead is classified as a probable human carcinogen, a class of substances that are
directly responsible for damaging DNA, and promoting or aiding cancer. Lead is suspected of causing
cancer of the pancreas.
Steve Jobs may be the best-known example of the high risk of cancer for people working in the
electronics industries from occupational exposure to carcinogens. The metals contained in personal
computers include aluminum, antimony, arsenic, barium, beryllium, cadmium, chromium, cobalt, copper,
gallium, gold, iron, lead, manganese, mercury, palladium, platinum, selenium, silver, and zinc.
Steve Jobs getting cancer was an unfortunate accident—like being struck by lightening or hit by a car.
The carcinogen(s) entered his body and due to genetics, “bad luck,” or other unknown and uncontrollable
factors his body was susceptible. The cause of his cancer was not due to his vegan diet. In fact, his
healthy diet likely slowed the growth of his tumor, delayed the time of diagnosis, and prolonged his
useful life.
Jobs Suffered with Unfounded Regret, Believing He Had Hastened His Own Death
Jobs lived the final 8 years of his life with regret, guilt, and remorse over delaying his surgery for 9
months after the initial diagnosis of cancer. With one honest sentence his doctors could have relieved
him of this heavy burden. This simple fact could have been told: “Mr. Jobs, you had a body full of cancer
long before October of 2003, when you were diagnosed by a needle biopsy.” Apparently, not one of his
doctors—not James Eason, who had operated on his pancreas in 2004, nor Jeffrey Norton, who had
performed his liver transplant in 2009—told Jobs this indisputable truth.
In October of 2003, after confirming he had a mass in his pancreas, one of his doctors “suggested that he
should make sure his affairs were in order, a polite way of saying that he might have only months to live.
That evening they performed a biopsy by sticking an endoscope down his throat and into his intestines
so they could put a needle into his pancreas and get a few cells from his tumor…It turned out to be an
islet cell or pancreatic neuro-endocrine tumor…”(453)
Jobs initially refused surgery to remove the cancer. “I really didn’t want them to open my body, so I tried
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to see if a few other things would work.”(454) Nine months later, “In July 2004 a CAT scan showed that
the tumor had grown and possibly spread.”(455) Jobs underwent surgery on Saturday, July 31, 2004, at
Stanford Medical Center. He had a modified Whipple’s procedure, which took part of his pancreas.(455)
He reassured his Apple employees the next day when he wrote in an e-mail that the type of cancer he
had, “represents about 1% of the total cases of pancreatic cancer diagnosed each year, and can be cured
by surgical removal if diagnosed in time (mine was).”(455) In retrospect, all would agree this statement
was untrue.
Unfortunately, he spent the remainder of his life believing he could have been cured if he had not delayed
his surgery for nine months. “According to Steve Jobs’ biographer, Walter Isaacson, the Apple
mastermind eventually came to regret the decision he had made years earlier to reject potentially
life-saving surgery in favor of alternative treatments like acupuncture, dietary supplements and juices.
His early resistance to surgery was apparently incomprehensible to his wife and close friends, who
continually urged him to do it.” “We talked about this a lot,” says his biographer. “He wanted to talk
about it, how he regretted it. … I think he felt he should have been operated on sooner.” This falsehood
was repeated to the world shortly after Jobs death in a 60-minutes interview with Mr. Isaacson.
By the beginning of 2008 it was clear to Jobs and his doctors that his cancer was spreading.(476) In
April 2009 he underwent a liver transplant. “When his doctors took out his liver, they found spots on the
peritoneum, the thin membrane that surrounds internal organs. In addition, there were tumors
throughout the liver, which meant it was likely that the cancer had migrated elsewhere as well.”(484)
“But, by July 2011, his cancer had spread to his bones and other parts of his body…”(555). Almost
everyone had admitted defeat. He died October 5, 2011 from a body full of cancer that began when he was
a teenager working in Silicon Valley.
The overall consensus was, and still is, that Jobs acted selfishly, stupidly, and irresponsibly when he
refused surgery in October of 2003, at the time of his original diagnosis. Based on the natural history of
his disease, Jobs acted in none of these ways. The cancer had spread many years before his diagnosis,
and was unstoppable by any means.
Job’s Vegan Diet Prolonged His Life
Jobs became a vegetarian in his freshman year at Reed College in Portland, Oregon.(36). He would at
times eat only fruit, and considered himself a fruitarian.(63, 68, 83) He was a lifelong strict vegan (no
animal foods), except for occasional lapses.(91, 155, 260, 458, 527, 528) Jobs often became very upset
when his meals were not prepared to his specifications. When a waiter at a restaurant served him a sauce
with sour cream, Jobs got nasty.(185). He was observed to “spit out a mouthful of soup one day after he
learned that it contained butter.”(260)
Throughout most of his life he was considered a “prickly, whip-thin vegetarian.”(243) He was described
as looking “rather like a boxer, aggressive and elusively graceful, or like an elegant jungle cat ready to
spring at its prey.”(297) However, most of his family, friends, and coworkers did not understand or
sympathize with Jobs’ vegan diet.
His diet was in sharp contrast to that of his Apple co-founder, Steve Wozniak, who ate at Denny’s and
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