• Was Steve Jobs Really A Difficult Patient?

    Posted October 27, 2011: by Bill Sardi

    The CNN article entitled “Steve Jobs: A Difficult Patient” provoked hundreds to comment online. Here is a sampling of some of the responses:

    • The one man who could get the best possible treatment on earth ultimately did not survive. What point does this prove?
    • What an idiot, he basically killed himself off by his own stupidity.
    • He forgot to try leaches — that is why he died.

    Mr. Jobs survived by nearly 9 years a slow-growing form of pancreatic cancer first discovered in 2003. He initially shunned surgery (a drastic operation called a Whipple procedure) which is a very trying operation for surgeon and patient. You can get a view of this complicated operation at the Mayo Clinic website here. The operation involves removal of the head of the pancreas where most tumors originate as well as removal of the gall bladder and the first part of the small intestine (duodenum) and reconnection of the digestive organs.

    The criticism of Mr. Jobs’ decision to delay surgery appears to be unsubstantiated. A recent study shows average survival after surgical treatment of this type of tumor is about 9.5 years, about the survival time achieved by Mr. Jobs.

    Surgery does not necessarily slow tumor growth. It may or may not buy time. It certainly does de-bulk a tumor and reduce pain and other life-threatening problems as the tumor expands. But contrary to the CNN report, surgery does not inhibit the spread of cancer. In fact, because surgery provokes wound healing responses it promotes new blood vessel formation (angiogenesis) which is how tumors obtain nutrients to grow.

    In cancer surgery there is no such thing as “got it all.” If a 1-millimeter ball of tumor cells remain after surgery that would equal 10 million tumor cells. Surgeons will remove a wide margin of tissue from the edge of the tumor in an attempt to remove all of the cancerous tissue but the fact is the new blood vessels that form to feed tumors (called angiogenesis) emanate outside the tumor zone.

    Sadly, modern medicine has no effective treatment designed to halt the spread (metastasis) of cancer, which is the mortal form. Roaming cancer cells can spread to other surrounding or distant organs, often the liver (which Mr. Jobs had removed and replaced because of metastatic tumors there) and sometimes the brain, bone, lung or other organs.

    It becomes all important to optimize the immune system to generate white blood cells known as neutrophils, macrophages and natural killer cells to digest or destroy roaming cancer cells before they colonize at a nearby or distant site. While immunotherapy has been called the end-game for cancer, virtually nothing is done to optimize the immune response in cancer therapy today. It needs to be said that all three conventional approaches to treating cancer impair the immune system. No one should belittle Mr. Jobs or any other cancer patient for seeking alternative therapies that may help restore immunity against cancer.

    Another alternative strategy is to inhibit adhesion of roaming tumor cells as their movement in the blood circulation must be halted for 30 minutes for colonization to begin. Usually metastases develop where blood clots in small blood vessels form and block the movement of tumor cells. There are various natural (fish oil, garlic, resveratrol, nattokinase) and drug (blood thinners) strategies to inhibit clotting and therefore the spread of cancer. It is not likely Mr. Jobs ever learned of these or other science-backed alternative strategies to beat cancer.

    Inevitably and invariably tumors develop resistance to chemotherapy and then cancer must be battled without medicine and a weakened immune system. These toxic treatments only produce temporary shrinkage of a tumor.

    It is said that Mr. Jobs practiced quirky dietary measures before and after diagnosis of his tumor including fasting. He must have known something was amiss inside his body. He most likely practiced fasting intuitively rather than based upon any published science. However, it is well known that fasting can starve tumors and is a confirmed strategy to stave off the growth of tumors. In fact, the use of a limited calorie diet has been shown to reduce the size and severity of pancreatic tumors.

    In regard to the prevention and treatment of cancer in general, and pancreatic cancer specifically, modern medicine already has identified the primary molecular pathway that leads to cancer. It is called the nuclear factor-kappa B (NF-kappa B) pathway. NF-kappa B is a protein that binds to specific DNA sequences controlling the flow of genetic information from DNA to messenger RNA, which is how new cells replace old.

    Various natural molecules are well known NF-kappa B inhibitors, such as molecules from spices (curcumin from turmeric), from grapes and green tea (resveratrol, catechin) and other herbs (silymarin from milk thistle). Because of Mr. Jobs’ interest in alternative therapies, had he been schooled in these natural medicines he would likely have employed them with some success. Despite the promise of natural NF-Kappa B inhibitors, they largely are ignored, dismissed and unused by modern medicine.

    It is instructive to learn that genistein, a molecule obtained from soybeans, inactivates NF-Kappa B and increases the anti-tumor activity of the most commonly employed chemotherapy drug (gemcitabine) used to treat pancreatic cancer. In a lab dish chemotherapy killed ~25% of tumor cells whereas if tumor cells were pre-treated with genistein 60-80% of tumor cells were killed.

    The tumor-cell killing action of gemcitabine is also enhanced when it is used in combination with vitamin C and in cells that are totally resistant to the drug vitamin C inhibits tumor growth by 50%.

    Vitamin E succinate is yet another natural compound that exhibits strong anti-pancreatic tumor cell activity.

    It is widely known that gemcitabine, the standard treatment for advanced pancreatic cancer, is not very effective when employed alone. The red wine molecule resveratrol works non-toxically to inhibit the growth of pancreatic tumor cells and works synergistically with gemcitabine in animal studies.

    The point of citing these scientific reports here is to show that alternative therapies for cancer should not be dismissed outright. They have a scientific basis and while unproven must be compared against the “slash, burn and poison” approach of conventional cancer care which have been repeatedly disproven. Ridiculing Mr. Jobs for seeking alternative therapies is uncalled for.

    For those individuals who cannot possibly fathom how natural medicines can trump the best man-made molecules, skeptics must be confronted with evidence that some natural molecules inhibit all three stages of cancer – initiation, growth and spread – something that no existing anti-cancer drug can claim. The biological action of synthetically-made anti-cancer drugs is too narrow to fully address all the challenges posed by cancer.

    Two natural molecules come to mind when searching for natural medicines to address cancer – curcumin derived from turmeric spice and resveratrol known as a red wine molecule.

    Curcumin exhibits broad biological action. Researchers say curcumin exhibits great promise as a therapeutic agent for cancer and it inhibits NF-Kappa B – the pathway that leads to cancer. Unlike single-gene targeted anti-cancer drugs like Erbitux and Herceptin, curcumin targets many genes and is posed as an inexpensive way to address many diseases, especially cancer.

    Resveratrol has recently been found to cause pancreatic cancer cells to die off without the toxicity characteristic of chemotherapy. Unlike chemotherapy, resveratrol does not harm normal (non-cancerous) cells in the pancreas.

    Natural molecules have yet to be used even as adjunctive therapy for cancer, despite promising reports of their safety and potential effectiveness.

    Another particularly promising molecule (IP6 phytate) from rice bran has been demonstrated to have strong anti-cancer activity in the pancreas. When combined with other natural molecules (IP6 + catechin from green tea) it is even more powerful.

    Resveratrol stands out among all natural molecules in the fight against cancer. In the late 1990s researcher John Pezzuto was commissioned by the American Cancer Institute to scour the planet for natural molecules that had anti-cancer action. After screening 30,000 molecules he concluded that resveratrol (rez-vair-ah-troll), a red wine molecule, stood out among all molecules tested. His 1997 report in Science Magazine was widely acclaimed at the time but has been long forgotten. It is unlikely Mr. Jobs ever learned about resveratrol, the most promising anti-cancer molecule currently in existence.

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