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July 23, 2008, 1:34 pm

Steve Jobs’ health: What’s going on

Steve Jobs’ health is in the news — again. Apple isn’t talking — again. And investors are freaking out — again.

So now’s probably a good time to remind ourselves what we know, and don’t know, about the health of Apple’s CEO.

In 2003 Jobs learned that he had a malignant tumor in his pancreas — a large gland behind the stomach that supplies the body with insulin and digestive enzymes. The most common type of pancreatic cancer — adenocarcinoma — carries a life expectancy of about a year. Jobs was lucky; he had an extremely rare form called an islet cell neuroendocrine tumor that can be treated surgically, without radiation or chemotherapy.

On July 31, 2004,  Steve Jobs underwent a modified Whipple procedure — or pancreatoduodenectomy — that removed large parts of his digestive system and reassembled the remaining parts in a new configuration.

Patients undergoing the procedure typically lose up to 10% of their body weight and may suffer digestive problems for the rest of their lives.

The nature of the surgery was first reported in general terms by Fortune investigative reporter Peter Elkind in a March 5 cover story, (“The trouble with Steve Jobs”) and in some detail on this site on June 13 (”Why does Steve Jobs look so thin“).

It is possible that Jobs’ cancer has returned; that fear, and Apple’s reluctance to discuss the matter during its quarterly earnings conference call this week, helped drive Apple (AAPL) share prices down more than 10% in after-hours trading Monday. Apple shares recovered most of the lost territory on Tuesday and were trading higher again Wednesday, after investors calmed down enough to take a second look at Apple’s record third-quarter earnings.

The fact is, the effects of the Whipple procedure are probably sufficient to explain Jobs’ weight loss, without assuming any recurrence of the original cancer. Wednesday’s New York Times reports that Jobs has assured friends that he remains cancer-free, and that he underwent a second operation earlier this year to address a problem that was contributing to a loss of weight. (One hedge fund hired a private detective to tail Jobs four years ago on his way to hospital appointments to determine out how sick he might be, according to a Wall Street Journal report, and some hedge fund managers are talking about hiring private eyes again.)

Apple insists that Steve Jobs’ health is a “private matter.” But it’s also a matter of public record. Jobs has publicly discussed his bout with cancer, both in a memo to his staff and — quite movingly — in a commencement speech to Stanford University’s class of 2005 (see here).

Apple and Steve Jobs may be forgiven their reluctance to delve deeper into the details of his digestive issues. But a little disclosure on that front might go a long way to calming Wall Street’s rattled nerves.

Everybody is talking about a neoplastic pancreatic condition. The most frequent pancreatic malignancy is ductal carcinoma. Let’s suppose he does not suffer from that condition and that, as he says, he has a tumoral endocrine pancreatic disease which is treatable. In that case we look for diseases like MEN (multiple endocrine neoplasia) Type I (MEN I). With symptoms provoking chronic diarrhea, weight loss with tumors of the parathyroid glands, pancreatic islet cells and hypofisis. Sometimes most of the pancreas must be removed in order to control the endocrine symptoms. The disease is longlasting and death can happen in cases of complications. Is he suffering from Insulinoma ?, or a gastrin pruducing tumor of the pancreas ? Who knows, is one of those his condition ? Are they hiding a more frequent and severe disease like ductal carcinoma because of Apple stock price. The insiders are the only people aware of the truth. By the way a Whipple procedure is a type of surgery in which the pancreas and the duodenum are radically removed. It is mostly used to treat pancreatic cancer with the intention to cure.

Posted By Steve Wozjobs, Cupertino, California : January 15, 2009 10:08 pm

As a simpleton from the south, someone PLEASE explain to me why the sky would fall if something is, indeed, wrong with Steve Jobs?!? God forbid, but is he actually the ONLY person who could run Apple? Wall Street is full of nuts!

Posted By Lori, Brandon, Mississippi : December 19, 2008 10:18 am

Yah, that Apple could run on without Mr. Jobs was what they said 15 years ago and we all know how that went.
No Jobs – and Apple will soon be another for profit American company that is going nowhere but out of business!

Posted By Allan, Vancouver, Washington : December 17, 2008 6:51 am

who is ex ped?

ex ped: Sorry. It’s short-hand for “from Philip Elmer-DeWitt.”

Posted By Dan Cordoba Austin, Tx : July 28, 2008 6:04 pm

Unbelievable. Hired a private investigator to tail Jobs on his way to doctors appointments… Wow. I hope all that money is worth the cost of your dignity.

Posted By Patrick, Chicago IL : July 27, 2008 11:08 pm

I think that the REPORTERS are beating a death horse. This keeps resurfacing…..at the benefit of the hedge fund managers who are shorting the stock ????? Also, comments like the belows should be included to be fair and thus keep the reporters being neutral:

“Jobs has so effectively turned his charisma and personality traits into business processes of Apple that he could easily step away and the company would continue to function quite well without him,” said Leander Kahney, editor of Wired.com and author of “Inside Steve’s Brain”, a book about the Apple leader.
“Chief Operating Officer Tim Cook, whose laconic Southern style distinguishes him from the intense Jobs, has won praise from analysts for his firm grasp of day-to-day operations, and is thought to be a likely successor”.

“Jobs may be the public face of products like the iPod, but it is Apple’s top-flight design team led by Jonathan Ives that is responsible for the iconic shapes of the company’s computers and gadgets”.

“Steve clearly is the voice of the company, but it would be a big mistake to state that he’s the only one driving the vision of Apple,” said Tim Bajarin, head of Creative Strategies, a consultancy.

Posted By Tom Pham, Sugar Land, Texas : July 24, 2008 2:49 pm

Eu não sabia nem seu nome Steve Jobs ,

sou da sua idade (fiz 53 anos em 30 de maio)

resolvi escrever pq minha família materna tem histórico da câncer e meu pai também teve cancer(83 anos e está vivo).Eu ouvi e acredito nisso: Deixe tudo que aborrece e o preocupa .Vá fazer alguma coisa que o deixe bem feliz ,aliás muitas coisas.
Que um anjo bom esteja ao seu lado.
IEDA

Posted By ieda /rio de janeiro/brasil : July 24, 2008 11:25 am

“One hedge fund hired a private detective to tail Jobs.”

Well, I would like to donate to any hitman that would “stalk” not harm the hedge funds. TiT-for-TaT

But some like oil marketer SemGroup who filed for Chapter 11 bankruptcy protection, citing among other things a loss of at least $2.4 billion in crude oil futures – - HA no speculation in the markets – - just shoot themselves in the foot sooner or later.

Posted By Hardhead, Uijongbu, South Korea : July 24, 2008 9:14 am

“But a little disclosure on that front might go a long way to calming Wall Street’s rattled nerves.”

God forbid that the speculators on Wall street should get nervous in their greed for profit.

Look, let us get something clear, OK? Folks admire Jobs because he built something. Out of nothing. He created. He still creates. He took an idea and made it change the world.

These folks who speculate on Apple stock, they are the very opposite of what Steve Jobs represents. They sit and watch others, hoping for a chance to make some money by betting the right way. The don’t want to create anything, they don’t want to build anything. They just want more money. So they can chase more money.

There is something profoundly ghoulish and wretched about appealing to someone like Jobs to calm the nerves of so many vultures who feed from his work and who clearly do not represent what he has stood for his whole life. For the record, America was built by men like Jobs, and Europe was made lame by speculators.

Posted By cynik, switzerland : July 24, 2008 6:44 am

They should freeze steve like they did walt disney..

Posted By joe ny,ny : July 24, 2008 2:49 am

I’ve never been a Steve Jobs fan but this is not good. He has so much to live for and offer. Why does this happen to those who… well, why not to others who… may the Creator Yahueh bless him.

Posted By AWT, New Braunfels, Tx. : July 24, 2008 1:14 am

Apple and stock performance aside, Mr. Jobs deserves our respect if simply as a fellow human being. Personally, I pray for health and strength both for Mr. Jobs as well as his family.

Posted By LWB, Burton, OH : July 23, 2008 9:47 pm

so when he wishes to be private you post a blog with an illustration of his gut: coarse, tasteless and disrespectful…

Posted By Azazello, NYC : July 23, 2008 8:31 pm

News does not require an ‘event’ in order to trigger a news article for publication. And blending news with editorializing is legit when that is the reporter’s known style. Lou Dobbs does it on every broadcast, and he is one of the best. DeWitt wrote an important piece here. We all know what happened to Apple when Jobs left the first time, and we all know what happened when he came back…

Posted By Frank, West Point, CA : July 23, 2008 8:14 pm

I remember the last time Steve Jobs left apple and it was not pretty. I hope he is in good health but make no mistakes about it, he is the visionary responsable for all good things at apple for a very long time. He is more inportant to Apple than Gates was to Microsoft.

Posted By Jim A, Greensboro, NC : July 23, 2008 7:55 pm

My first computer was an apple. I loved it and used it for many many years. Apple is a great company because of its products that are sturdy and innovative. It is not so easy to separate the company from the man. I wish him well and I hope that, like two of my friends who have survived but were told by doctors not to tell, lest they give people false hope,he too will conquer it. Apple as a company will survive, but people who buy stocks do not separate Apple and Steve Jobs. Even in my mind, they are one, as Larry Ellison and Oracle are one.

Posted By Melinda from Lafayette, Louisiana : July 23, 2008 7:43 pm

key question here:
does apple have a credible succession plan for its key executive(s)?

Posted By xappl, saratoga ca : July 23, 2008 7:33 pm

Sometimes reporters with hyphenated names lose their jobs because of their loss of self-identity – not knowing which person is writing the story the reporter or the tattler. Not so with Apple, having a fairly good knowledge of how the company works they have a good estimation of who they are and where they are going. May be you along with the other press should stick to reporting the news rather than inventing it. Remember the recession you guys tried to convince us of? Fortunately for your industry outside influences helped your dream come true.

ex ped: OK, you lost me. Must be the hyphenated name.

Posted By Dan Cordoba, Austin TX : July 23, 2008 5:44 pm

Apple will survive without Steve Jobs. The reverse is not so true. His health issues should not be a stock shocker as it appears to be. MacIntosh branded computers are increasing in number and iPod sales are still on the increase.

Posted By James M., Tucson, Arizona : July 23, 2008 5:19 pm

I can’t help but think that those people who work in and run the US stock market are individually rather intelligent people, but collectively they are a bunch of whinging knee-jerk reactionary retards!

Posted By jammydevil, Sarasota, FL : July 23, 2008 5:16 pm

I’ve slammed you enough that, when you do good, I should say so.

Excellent article (it still ain’t news) with interesting opinion attached (that’s why it ain’t news).

ex ped: Thanks.

Posted By Shawn King, Danbury, CT : July 23, 2008 4:35 pm

We have nothing to worry about. Steve Jobs did a successful surgery for his cancer. He’s doing well and everything will be fine. Steve Job’s Apple is doing great job. I’m sure that with the iPhone, iPod and Mac Apple’s stock prices will go up.

Posted By Richard K, New York, NY, www.ecompetitors.com : July 23, 2008 4:34 pm

Jobs is a visionary but the entire Apple team is a group of mini Jobs so I am confident they will be able to weather whatever happens in the executive suites at Apple.

The perfect irony would be if the Bill and Melinda Gates Foundation discovers a cure for Job’s illness and saves him only to have Apple gain majority market share from Microsoft with the release of the much anticipated killer app that has been talked about longer Steve Jobs health issues.

Posted By Jim Marshalltown, IA : July 23, 2008 4:25 pm

Thank you, for this article. But in my view, Apple executive’s health is a private matter. Moreover, Steve Jobs is doing well after the surgery in 2004.

Posted By Irene eCompetitors, NY, www.ecompetitors.com : July 23, 2008 4:16 pm

If I were Steve Jobs, I’d advise him to say “none of your flocking business”. Give them an inch and they’ll take a mile.

Besides, as an old employer of mine once said, “the graveyards are full of indispensible people”.

That’s not to minimize the contribution Mr. Jobs has made to Apple in particular and consumers in general. But because of that, Apple has a tremendous momentum right now. With Steve or without him, this company has nowhere to go but up.

I tell my friends that Apple is like a cork life preserver on the Titanic. When the Titanic (i.e., the U.S. economy) goes down, it sucks a lot of things down with it. But a cork is still a cork, and will inevitably bob to the top.

So which would you prefer to hang on to: the Titanic, or the cork? I know which one I’m hanging on to, with or without Steve Jobs!

Posted By Sacto Joe, Sacramento, CA : July 23, 2008 3:29 pm

eh..he lived a full and rich life anyway…he’s got nothing to complain about… see ya..

Posted By BillG : July 23, 2008 3:13 pm

hey, this is surfacing whenever apple issuesome good news about their product. there are 10 well knowledgeble persons are ready to take care of apple donot scare us with his personal issue

Posted By davy madison tn : July 23, 2008 3:08 pm

the majority of ground breaking cancer research is funded through private donations. Once a treatment is “perfected” then the gvt steps in to help and screws up a good thing. I like millions of $$ donors prefer to allocate our donations to good, qualified cancer research foundations….”that government which governs least, governs best”.

Posted By G. Thompson / peabody, ma : July 23, 2008 2:58 pm

Actually, half of all pancreatic cancer patients (adenocarcinoma) die within 6 mos of diagnosis. Less than 0.2% of the U.S. federal budget goes to cancer research, which is scandalous and economically stupid.

Posted By Martin K, Washington DC : July 23, 2008 2:34 pm

The Cause of Steves weight loss after a Whipple procedure is quite well explained by this article and the Mayo Clinic drawings are accurate. I think there is less chance his weight loss is from a recurrent cancer than post operative digestive problems that are extremely common.

Posted By Bill Linder MD FACP (GI) Monte Sereno CA : July 23, 2008 2:29 pm

If it were just about any other CEO it wouldn’t matter so much but, Steve Jobs is Apple in most peoples eyes and as Steve Jobs goes Apple goes. If Jobs were to leave the company for any reason I would immediately sell half my stock as would a lot of people I’m sure. I bought the stock when Jobs was hired back when things were bleak. We all saw how well Apple runs without Jobs after they kicked him out of his own company years ago and look at the turn around since he came back.

Steve Jobs is Apple.

Here’s to Steve Jobs outliving us all.

Posted By Nodack Phoenix AZ : July 23, 2008 2:17 pm

Why is this old story being reposted with today’s date? NYT reports today Steve is cancer free, reported he had minor surgery sometime this year to fix weight loss problem.

ex ped: It’s actually new story — one that includes the NYT report — with a pointer to the old. We posted it because so few of the reporters writing about Jobs’ health this week seemed aware of the nature of his cancer or the surgery he had to treat it.

Posted By John, Seattle, WA. : July 23, 2008 1:56 pm

The least time someone (last fall/winter – the Fed) set out to “calm Wall Street’s rattled nerves” the price of oil doubled. I am not saying the price of oil will double again if Jobs provides daily detail about his health, like how many bowel movements he had the previous day (and their color), sex life, what kind of underwear he wears, etc. but I think it is equally important to have this same level of information from those who report, so we the general public can fairly evaluate the content of their articles. So I ask you to take the lead in the TIR (truth in reporting) movement by fully disclosing all of this pertinent info on a daily basis.

ex ped: Regular as rain this morning. Thanks for asking.

Posted By Ken Hamermesh, Lakewood, CO : July 23, 2008 1:55 pm
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Philip Elmer-DeWittSilicon Valley veterans like to joke that Steve Jobs must be surrounded by a reality distortion field; if you get too close to him, you start to believe what he's saying. Thanks to the success of the iPod, the launch of the iPhone and the renewed interest in the Mac, Apple has made believers out of millions of customers - and made a lot of investors rich. But Philip Elmer-DeWitt believes that an ounce of skepticism never hurts when writing about the company. He should know. He's been covering Apple - and watching Steve Jobs operate - since 1982, first for Time Magazine, then for Business 2.0, and now for Fortune.
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