Pancreatic cancer: How Nobelist Ralph Steinman beat the odds, but Steve Jobs didn't

Both men died with a disease that has an exceedingly low survival rate, but they're actually different cancers. One is measured in years, while the other is measured in months.
Written by Janet Fang, Contributor

Steve Jobs lived with pancreatic cancer for 8 years. Although 2011 Nobel laureate Ralph Steinman lived with it for 4, he’s the one who beat the odds. Scientific American’s Katherine Harmon explains.

Over half of pancreatic cancer cases are diagnosed after the cancer has already spread – resulting in an exceedingly low survival rate. Just 1.8% live for more than 5 years after diagnosis. (And for all types of that cancer, the average 5-year survival rate is 3.3%.)

Jobs survived for 8. He had a rare form of the cancer – pancreatic neuroendocrine tumor, which grows more slowly and is easier to treat. For that type, survival is measured in years, as opposed to Steinman’s cancer, which is measured in months.

Steinman had the type that is usually fatal within a year after diagnosis – called adenocarcinomas. He died on just 3 days before his Nobel Prize in Medicine was announced.

Adenocarcinomas originate in the main part of the pancreas, which makes digestive enzymes. Scattered throughout the pancreas are thousands of little islands of tissue that make hormones secreted into the blood. Jobs had a cancer of these islets.

So, one reasons pancreatic cancer is deadly is because there aren’t all that many early symptoms. Only recently has research begun to suggest that the disease might not have so sudden an onset.

Neogenix Oncology has found a couple of genetic markers that are present in pancreatic cancer and not in normal tissue. Their goal is to develop something to catch the disease earlier.

If the cancer is caught early, doctors usually remove it with a risky surgery. And there’s a big chance of it coming back within 2 years. If the cancer has already spread, as it had in Steinman’s case, chemotherapy drugs are used.

There are 2 newly approved drugs to treat treat the type of cancer Jobs had: everolimus (Afinitor) and sunitinib (Sutent). Steinman received gemcitabine (Gemzar).

And being an immunologist, he then tried 8 different experimental therapies that enlist the immune system to fight cancer. Each drug was in phase I clinical trials. Steinman managed to beat the average odds for his type of pancreatic cancer by years... though we don’t know which made the difference.

One treatment that isn’t recommended is a liver transplant. The liver often gets invaded by the spreading cancer, but the immunosuppressants necessary to avoid organ rejection can reduce the body's ability to fight off remaining cancer cells. Jobs received one in 2009... but we can't conclude whether the transplant made him live longer, the same, or shorter.

From Scientific American.

Images from Wikimedia and Rockefeller University

This post was originally published on Smartplanet.com

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