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Home News and Update Year 2011 Few cases of Apple icon’s cancer, says city surgeon

Few cases of Apple icon’s cancer, says city surgeon

Times of India
07 October

Several websites reported Apple Inc chief Steve Jobs succumbed to a rare form of pancreatic cancer, but doctors in Mumbai said it is essential to differentiate between various cancers.
Onco-surgeon Dr P Jagannath from Lilavati Hospital said it would be apt to say Jobs was fighting a neuroendocrine cancer that had developed in his pancreas. Jagannath has, incidentally, treated the largest series of patients with neuroendocrine tumours, better called as NETs, in the country. “It’s so rare that we have over the years managed a registry of only 100 patients,’’ said Dr Jagannath, who last week presented his Mumbai NET experience to cancer surgeons at an international conference in Melbourne, Australia.
Few cases of Apple icon’s cancer, says city surgeon
As the term neuroendocrine suggests, it’s a network of the body’s various hormone-producing glands that begins with the hypothalamus, the site of the brain that controls various hormonal functions as well as moods and body temperature. Cancer in the hormone-producing cells is a neuroendocrine tumour.
Endocrinologist Shashank Joshi said NETs are
tough to diagnose. “Though modern diagnostics have made it easier, but manifestations can be so varied that it’s difficult to pinpoint in early stages,’’ he said. But NET patients live longer than those with non-NET pancreatic cancer—which would explain why Jobs survived for seven years after the cancer was first detected. “Patients live for two decades if not for a minimum of seven years,’’ said Dr Joshi, adding it has a strong genetic connection. The distinction can be better understood when one considers pancreas has three types of cells; one produces the pancreatic juice and others produce hormones. The most common and deadly form of cancer occurs when the disease hits cells producing pancreatic juice. Hollywood actor Patrick Swayze died within two years of discovering that he was suffering from this form of cancer. Jobs, on the other hand, had cancer in the islet cells of pancreas, which produce hormones like insulin. Foreign media reports say Jobs made this distinction himself when he first announced his illness and surgery in 2004. “I had a very rare form of pancreatic cancer called an islet cell neuroendocrine tumor, which represents 1% of total cases of pancreatic cancer diagnosed each year, and can be cured by surgical removal if diagnosed in time (mine was),’’ he had said.

This form is rare in India as well. “The incidence is barely 2.5 or 5 cases per 1,00,000 people,’’ said Dr Jagannath, who was the first Indian to be elected president of the Asia-Pacific Hepato Pancreato Biliary Association at a time when cancers related to the liver and pancreas are rising in India. His registry shows pancreatic NET to be the most common. “Pancreatic NETs accounted for 55% of our registry,’’ he said, adding patients survived for 15-20 years after surgery. “Many new options are now available,’’ he said, adding treament options have improved and long-term survival is a rule rather than an exception.

About The Tumour

Neuroendocrine cells are found in the nervous system that carries messages from the brain, and the endocrine system that releases hormones for important body functions
As neuroendocrine cells are present throughout the body, tumours of these cells, called Neuroendocrine Tumours or NETs, can occur at many sites
Apple creator Steve Jobs was reportedly treated in 2004 for a pancreatic neuroendocrine tumor, called islet cell carcinoma, a rare form of pancreatic cancer, whose incidence is 0.1-1 per million per year
Most NETs grow slowly, others can be very aggressive and spread to other parts of the body (metastasize)
NETs develop most commonly in the lungs, appendix, small intestine (duodenum), rectum and pancreas
SYMPTOMS &TREATMENT

Symptoms and treatment depend on the type of tumour, including where it grows, whether it produces excess hormones, how aggressive it is and whether it has spread

Different NETs have varying prognosis. For insulinoma (a tumour in derived from the beta cells of the pancreas and secretes insulin), longterm survival following surgical removal exceeds 90%. But for carcinoid tumour (which occurs mainly in the gastrointestinal tract), the five-year survival rate is 67%

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