Martina M. Cartwright

Martina M. Cartwright Ph.D., R.D.

Food For Thought

Alternative Medicine & The Death of Steve Jobs

Did delaying traditional medicine lead to Jobs' early death?

Posted Oct 21, 2011

Today it was announced that Apple pioneer Steve Jobs chose to pursue alternative therapies to treat his pancreatic cancer, a decision he came to regret. After this announcement people began issuing judgments of how "such a smart man could make such a stupid choice." Harsh. Steve Jobs left us with an example of how medical treatment decisions are not black and white--they are highly personal.

I started my research career some 23 years ago working on pancreatic cancer. It is a relatively rare, yet ugly and often aggressive disease that usually is asymptomatic until later stages. The type Steve had was an "islet cell neuroendocrine" tumor, a somewhat less aggressive type that is more responsive to early treatment. When Mr. Jobs was first diagnosed in 2003, he chose to pursue alternative therapies, including acupuncture, herbal, diet and fruit juice therapy and spiritual consultations. Many of these therapies he found on the Internet. Despite pleading from his distressed family, friends and physicians, Steve chose to delay surgery and chemotherapy for 9 months. When dealing with aggressive cancers, a delay of this magnitude can shave years off of one's life. However, chemo and surgery are not without their unpleasant side effects either.

According to today's reports, Steve's wife said that he feared of being "opened up." Surgery is a scary proposition for anyone, especially for those with cancer. Pancreatic cancer often involves a complicated surgical procedure called a "Whipple" or pancreaticoduodenectomy. Even in the hands of the most skilled surgeon, there are risks. Aggressive chemotherapy can significantly impair a person's quality of life, too. The decision of what therapy to pursue and when is highly personal. I currently have close relative with terminal breast cancer and a close friend with pancreatic cancer. Both are choosing divergent strategies to treat their cancers.

Having worked in critical care for over 15 years, it has been my experience that some patients who choose 100% alternative therapies over any traditional Western medicine do so either out of fear or because of a desire to control an out of control situation. Some research supports this premise as well. Walter Isaacson, the author of Jobs' biography, said, "I think he felt if you ignore something you don't want to exist, you can have magical thinking. It had worked for him in the past and he would regret it." As a man who led a multi billion-dollar organization and one who was used to making tough, independent decisions, it didn't surprise me that Jobs chose only alternative therapies for his initial treatment. He was more comfortable being in control and extreme dieting gave him the illusion of control. However, Steve was also a calculated risk taker. He chose to pursue alternatives despite the lack of evidence. So why did he do it? Research supports that many restrictive diets, disordered eating patterns and ardent alternative therapy practices stem from a strong desire to control, particularly in response to diagnosis of a life-changing disease.

After trying the alternatives for a while, Steve decided to move forward with traditional medicine. Reports suggest that Steve lamented his decision to wait. He went on to receive a liver transplant and spend thousands of dollars are the most pioneering treatments, including genome sequencing and targeted drug therapy. Experts suggest that if he had received chemo and surgery when he was first diagnosed, he likely would have lived longer. But what about his quality of life? Living longer doesn't necessarily translate into living better. Chemo and surgery are expensive and take a physical and emotional toll on the body. However, many of these therapies are proven to extend life, whereas alternative treatments are not.

Many of my cancer patients have chosen "complementary" medicine. That is a combination of alternative and traditional medicine. For example, there is some research that suggests acupuncture is successful for treating chemo-induced nausea. I encourage exploration and use of targeted complementary therapies that ease symptoms. However, In Jobs' case, it was EITHER alternative OR traditional, not a combination. Plus, he was seeking the elusive cancer cure. One of the most troubling things about working with those with cancer is to see them being taken advantage of by uninformed charlatans promoting "natural cancer cures." The disappointment of false hope and the amount of time and money poured into unproven and expensive therapies can be significant...but maybe the same can be said with prescription medicines? Cancer medications are costly, but health claims must be supported by years of controlled research and science. Moreover, prescriptions drugs are held to high manufacturing standards, whereas alternative therapies are not. Not all herbs and vitamins deliver on what they promise. (see www.consumerlab.com for unbiased reports on supplements).

When it comes to complementary therapies, I frequently ask the client "Will the therapy you are considering significantly harm you emotionally? Physically? Spiritually? Or Financially?"

Current research suggests that alternative treatments are not helpful in curing certain conditions like cancer, but may be helpful for symptom management. If pursuing such treatment does no harm, then there is no reason to chastise the patient. With Steve Jobs, his decision to pursue alternative alone may have done irreparable harm, but it was his choice. His wife and friends were frustrated but came to realize they couldn't force Steve in making a decision he wasn't ready to make.

While the decision to pursue treatment lies with the individual, it is imperative that they be given accurate information to make informed and educated treatment decisions. Too many times information from unverified Internet sources or well-meaning relatives or friends, does more harm than good. I can think of at least a dozen cases of individuals with cancer who were given "nutrition" therapy from a well-meaning person only to end up in the hospital with serious nutrition-induced complications (electrolyte imbalances leading to heart issues etc.).

As far as my personal experiences, my two close contacts with cancer are each on their own journey. One has chosen complementary medicine, the other strictly traditional. In each case, a Registered Dietitian (RD) delivers the nutrition therapy. (www.eatright.org). RDs are licensed, highly trained professionals that understand the impact chemo, complementary therapies and surgery have on the body. So far both are doing better than expected and making informed decisions. As far as Steve Jobs, his decision, upon initial diagnosis, to completely favor one type of treatment over another may have done harm, but his cancer journey is a valuable example of courage, humility, strength and the power of decision.

Reference for quotes: http://www.nytimes.com/2011/10/21/technology/book-offers-new-details-of-...

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