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January 20, 2011

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Questions over Jobs' medical problems

It would be easier to gauge Apple CEO Steve Jobs' current medical problems if he had said more about the ones he has faced in the past.

Jobs, who turns 56 next month, on Monday said he would take a third leave of absence - he didn't say how long - to focus on his health. It may not be as serious as many fear, but coming from a man who has had cancer and a liver transplant, the lack of detail is causing concern.

Jobs had a neuroendocrine tumor removed in 2004 - a rare and very treatable form of pancreatic cancer - but never said if it had spread to lymph nodes or how extensive his surgery was.

"We don't really know how much of his pancreas was removed. He may just have a remnant," and that may be causing continued digestive difficulties, said Dr Charles R. Thomas of the Ohio State University's Knight Cancer Institute.

Nor has Jobs said why he had a liver transplant in the spring of 2009. It could have been for an unrelated problem, but some experts not involved in his treatment speculated that his cancer had spread.

"These tumors are notorious for recurrence. It may take many years for them to reappear" because they grow so slowly, said Dr Igor Astsaturov of Fox Chase Cancer Center in Philadelphia.

Since the transplant, Jobs has been very thin and has not appeared at recent events.

"If he's jaundiced, there's a concern the liver may not be working as well as it should," Thomas said. Fatigue and weight loss also are troubling signs, he said.

Jobs could be suffering side effects from immune-suppressing medicines to prevent organ rejection. Even if his cancer has recurred, there are many treatment options, including chemotherapy and newer drugs that target various cancer pathways.

"It would be reasonable to consider surgery" or another procedure to destroy small tumors if the cancer turned up in his new liver, Thomas said.

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