The puzzle of Pancreatic cancer- Steve Jobs & Ralph Steinman

https://www.scientificamerican.com/article/pancreatic-cancer-type-jobs/

The prognosis or the outcome of a particular cancer depends on quite a few variables.

Grossly we talk about the Patient factor & the Tumor factor.

The patient factors include age, general health and any comorbidities (diabetes, a heart condition, blood pressure etc). The tumour factors include the organ of origin, the pathological variant/ subtype and the stage of the disease. Body reserves, mental strength and support (physical, social, psychological) also play an important part.

Pancreatic cancer usually doesn’t have a good outcome, primarily because most of the time it is diagnosed in the advanced stage. The role of surgery (Whipples Pancreaticoduodenectomy) is limited to the early localised stage. The chemotherapy forms the bulk of the treatment modality & radiation playing its part in the non-surgical settings. The recent advances in medical sciences are being looked upon with great expectations, but we are still searching for the right answers to the disease.

The above article about Steve Jobs & Nobel laureate Ralph Steinman highlights the above point.

Though both of them had pancreatic cancer and sadly both of them did succumb to the disease- the variants of the cancer were different. Steve Jobs had a neuroendocrine tumour (has a better outcome) while Steinman had the usual variant- adenocarcinoma which usually gives no time.

The article highlights the reason for their comparatively long survival post-diagnosis owing to favourable histology (Job) and a combination of novel therapies /immunotherapies (Steinman).

Don’t get disheartened by the diagnosis. No two cancers are alike, it’s the various permutation & combinations of the patient and the tumour factors that define your cancer. Every treatment is tailor-made, of course following the standard guidelines with the due impetus given to the recent advances.

We have to look at the positives. We shouldn’t get dejected seeing our glass half full.

The other day, one of the patients said—doc, we can refill the glass to full, isn’t it!!

YES- he truly made my day, thank you!!

2 Likes

Dr Kabir thanks for sharing in the information, especially talking about two famous protagonists.
Both suffering from the ‘same ‘ Cancer , but yet ‘Different’.

Can you please illustrate more on Pancreatic Cancer in terms of how is it different from other Cancers, it’s general prognosis and the types of treatment which has been discussed in the article.

The article through the case study of Steinman have spoken of dendritic cells. Is this treatment protocol followed worldwide or was it case specific?
Also to what extent is it practised in India ?

The case study of Jobs has spoken about liver transplant and has also opened up a multiple questions on the non standard protocol of treatment followed. As the article, Categorically states that Liver Transplant is not an accepted standard form of treatment, and there is a lack of evidence to show that it works.
What is your take on the subject as an oncologist?
Can you please enlighten us.

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