Steve Jobs resigns as CEO of Apple amid worries about his health

Steve Jobs’ announcement yesterday that he’s resigning as chief executive of Apple Inc. has some wondering if his health may be suffering due to complications from his rare form of pancreatic cancer.

Although no information updating his condition has been released, Jobs took an extended medical leave last January after undergoing a liver transplant in 2009 and had surgery seven years ago for the disease. In 2009 he revealed he had a hormone imbalance.

“I am speculating, but I suspect that either the disease has recurred, or he’s having complications from his liver transplant, such as rejection or an infection,” said Dr. Craig Devoe, an oncologist who specializes in pancreatic cancer. Devoe, in the department of medicine at the North Shore-LIJ Health System in New Hyde Park, New York, emphasized that his belief was only a supposition.

Liver transplants for this type of cancer are uncommon, he added: “They’re generally done when you’re out of other options, or when the disease is mostly in the liver. But I don’t think anyone believes this is a cure.”

Jobs’ rare form of pancreatic cancer, called pancreatic neuroendocrine cancer, can produce islet cell or pancreatic neuroendocrine tumors. It is typically less aggressive than the exocrine form, which comprises about 95% of pancreatic cancers. Pancreatic cancer is the fourth most common cause of cancer death in the U.S.

Neuroendocrine tumors tend to grow slowly and can secrete hormones, which can produce symptoms such as stomach ulcers, high blood sugar or skin rashes. Nonfunctioning tumors don’t produce hormones or symptoms and can grow without being detected.

The good news is that there are several forms of treatment for pancreatic neuroendocrine cancer, and patients can live for several years after diagnosis.

“The bottom line is that unlike other forms of cancer, such as breast or colon cancer, where the mainstay of treatment is chemotherapy, for this we have many types of low-toxicity targeted therapies that can keep it under control often for man years,” said Dr. Edward Wolin, co-director of the Carcinoid and Neuroendocrine Tumor Program at the Samuel Oschin Cancer Center at Cedars-Sinai Medical Center in Los Angeles. “People can live with a good quality of life, and it can be treated as a chronic illness, much like diabetes.”

Some of the therapies, he said, include peptide receptor radiotherapy, in which peptides find neuroendocrine tumor cell receptors and radiate them. “It’s like using a mollecular cruise missile,” he said. Low-toxic oral chemotherapy can also be used.

Two drugs typically used to treat kidney cancer -- Sutent and Afinitor -- were shown in 2011 studies in the New England Journal of Medicine to also be effective in treating neuroendocrine cancer. The drugs appeared to slow tumor progression.

How long someone can live with pancreatic neuroendocrine cancer depends on a number of factors, Wolin said, including how advanced or aggressive the cancer is and how the body responds to treatment.

“Some people might live for more than 20 years, while others may live for three to five,” he said. “But this is a disease where there is room to be hopeful.”