You’ve probably heard the story going around that Steve Jobs’ death was avoidable, if only he hadn’t been so gullible as to steep himself in quack medicine. It turns out, though, that the story is a lot more complicated than that: David Gorski has written the best summary I’ve seen so far.
In short (because it is Gorski, after all, so it’s exhaustively long), there was an element of woo in Jobs’ early response. After his pancreatic cancer was first diagnosed, he delayed surgery for 9 months to try out some improbably dietary approaches. It was a massive operation that was strongly recommended, so it’s a little bit understandable that he wanted to avoid it, but surgery was also the best and most demonstrably successful approach to take. So first point goes to the verdict of gullibility against Jobs.
However, his cancer was a slow-going kind with a reasonable prognosis, so the delay can only be said to have possibly contributed to the worsening of his condition. Jobs made a poor decision, but not necessarily a fatal one. And subsequently, once he saw that the diet nonsense wasn’t working, he threw himself thoroughly into science-based medicine, getting the best treatment oodles of money could buy, getting the surgeries recommended to him, and even trying out some experimental therapies (real experimental therapies, the stuff where scientists monitor and evaluate the results honestly, not the random shenanigans quacks like to flatter with the word “experimental”).
So the final result is that real science kept him alive and healthy as long as possible, and that an early flirtation with ‘alternative’ medicine might have contributed somewhat to lowering the odds of survival, but that what killed him is cancer. And cancer is a bastard.
(Also on Sb)
Where health and medicine is concerned, woo never helps, and it often hurts.
At best, Jobs likely suffered more from insuloma than necessary, and may have delayed treatment long enough that he went terminal.
Innovative thinking by amateurs almost never works when the issue is disease.
Glen Davidson
Indeed, cancer is a bastard. When it comes to cancer, it is well recognized that time is proportional to survival odds. Although odds only predict for groups and not individuals, I would still say his odds were changed by the delay. But for him as an individual, maybe it did not make any difference.
I’m sure by now some fundie xians somewhere have claimed it was god’s smiting because Steve Jobs wasn’t the right sort of xian.
Or because he didn’t pray hard enough to the right Sky Monster.
#3 (raven), Indeed .. The Westboro Baptists (Fred Phelps’ peeps) sent out a tweet that they were going to picket Steve Jobs’ funeral. “He [Jobs] had a huge platform,; gave God no glory and taught sin.”
(The tweet was sent from an iPhone!)
I’m relieved to read this article, both because I think Jobs was more sensible than to sit around playing with woo and also because when I read the headline I thought this was going to address the annoying rumors that he “secretly” had AIDS.
It’s ridiculous both because it plays on the cruel stigma about AIDS and also because Job’s was quiet about his illness but not secretive. Most people, for instance, read what he wrote about getting transplants and how wealth and privilege affect his chance of survival as opposed to anyone else’s.
I wonder how long it will be before some obnoxious woo-ist turns up claiming that Jobs would have survivied if he had only given the dietary woo a chance, and so it is science-based medicine that actually killed him? These bottom feeding snake-oil salesmen are quite capable of trying to turn a profit from Jobs’ death, after all. It woudn’t be the first time they deployed such a tactic.
I’m sure the Phelps’ knew that they were tweeting from an iPhone and I’m sure they fully understood the irony. But since nobody would be talking about it otherwise (I mean, whose funeral don’t they picket?) It was marketing strategy, pure and simple.
This is why we need a go-to-the-moon style government initiative to treat and cure cancer. You might say we do have a cancer institute but their budget is literally pennies compared to the military and other superfluous (in my opinion) budgets. Just for comparison
National cancer institute – 5 billion/y
Military budget – 670 billion
Oil subsidies – 41 billion (high estimate)
The news media got it wrong. It was a neuroendocrine tumor (NET, very treatable) that presented in the pancreas, not pancreatic cancer (very fatal).
Yes, what a wonderful person Jobs was. Buying an earlier transplant, instead of waiting in line like a regular person. I feel no sympathy for him as a person. I feel sympathy for the ones he hurt in his lifetime; here’s looking at you, Lisa Brennan-Jobs, and of course the Woz.
That makes more sense. Given it was reported he had pancreatic cancer I was very surprised he live as long as he did. People unfortunate enough to have pancreatic cancer are lucky if they are still alive 12 months later.
While islet cell neuroendocrine tumours are very slow-going as far as cancers are concerned, it probably did progress in the nine months Jobs tried to eat it away. I don’t know if the Whipple procedure would have been curative had it been performed nine months prior. To my knowlegde it very often is though when the tumour is promptly caught and treated.
That nine month delay may have sealed his fate.
I take absolutely no pleasure in the fact Jobs is dead and may be due to woo. Even if it is the case that, nine months prior, the Whipple procedure would have been curative, I certainly don’t feel he deserved death for rejecting evidence-based medicine. The whole story is sad.
Rachel @ #12:
What’s sad? That a guy who was FORCED to acknowledge the existence of his daughter by the courts after claiming to be sterile and fathering three more children died from illness?
Sure, Jobs was an innovator and cancer blows, but someone would have come up with a similar “Apple idea” eventually.
We put so much focus on douchebag celebrities and not enough on what really matters.
It’s worth remembering that the motivation for Jobs not getting immediate treatment is still a mystery. There are a lot of good reasons for postponing a risky life saving treatment. For examples, a novelist in the middle of crafting her greatest work, a mathematician close to proving a famous conjecture and a researcher on the verge of curing a disease might all opt to postpone such a treatment so that they can try and finish what they started.
Jobs was reinvigorating a company. He was negotiating deals and defining new marketplaces. He was charting a creative course for what has become one of the biggest companies in the world. Such work requires enormous energy and a certain minimal amount of health. My suspicion is that upon diagnosis Jobs opted to delay the surgery so that he could “put things in order” before running the risk that the surgery would “take him out of the game”. In other words, even without the woo Jobs would have made the same decision.
To summarize: Jobs delayed surgery and engaged in woo does not imply that Jobs delayed surgery because of the woo.
“cancer is a bastard.”
As someone who got cancer when he was just 3 years old, I couldn’t have said it better myself. Short, succinct and to the point.
Sure, Jobs was an innovator and cancer blows, but someone would have come up with a similar “Apple idea” eventually.
But they didn’t. Why wait, when he made things possible now?
I don’t give a shit about Steve Jobs’ personal life. All I care about is the stuff he made that made my life more enjoyable. He was an asshole in real life? So what? Most people who get where he did are assholes! Bill Gates is an asshole! David Geffen is an asshole! Steven Spielberg is an asshole!
They’re all assholes! Get over it!
@Greg #6:
I’ve already seen at least a few people posting exactly that on Facebook. Hopefully no one with a bigger audience takes up the message.
His death caused a number of people pain. I do consider that sad.
I’m not an Apple user so I’m not approaching this issue from the perspective of losing a great innovator. I don’t feel that way. I’m not worried about how Steve Jobs being gone will impact me personally.
The fact he was an asshole doesn’t mean a number of people aren’t really hurting having just lost their dad/husband/kid/friend.
Several quacks already have claimed Jobs would still be alive if he’d just given their alternative therapies a chance.
“I feel sympathy for the ones he hurt in his lifetime; here’s looking at you, Lisa Brennan-Jobs, and of course the Woz.”
He patched things up with Lisa when she was still very young, and put her through Harvard, and he made Woz a wealthy man. Without jobs, Woz would have been selling incomplete “solder on the keyboard and power supply” computers to hobbyists, and wouldn’t have had the money to blow on his US Festival concerts.
I wish someone would hurt *me* like that.
“Buying an earlier transplant, instead of waiting in line like a regular person.”
He did wait in line. He simply had the means to pick which line he would wait in. Most people aren’t able to easily relocate and get on a different waiting list, don’t have a private jet so that if they have to leave the state they can get back quickly if an organ becomes available.
It’s all within the rules. The problem is that the solution doesn’t scale, so regular folks can’t take advantage of it too.
Re raven @ #3
It is my information that Mr. Jobs was a practicing Buddhist.
And cancer is a bastard.
Yes it is. Furthermore, it’s our bastard and it isn’t going to go away. Not smoking helps but it won’t save you from all cancers. Eating right helps, but ditto. Exercise helps but…you get the picture. Oh, and 1% people? Having money helps, but doesn’t stop cancer. Jobs had plenty of money and he still got cancer and died of it. Cancer is a part of life. Anyone can get it. And the only thing that can save us is heavy duty high tech medicine. We need to fund cancer research and make sure that cancer drugs stay available so that people don’t die of the ones we can cure. Or die.
Orac beat you to this.
http://scienceblogs.com/insolence/2011/10/steve_jobs_neuroendocrine_tumors_and_alt.php
OR he could have died on the operating table during the initial delayed operation.
Well, he was rich, the rules favor the rich, so he took advantage of the less well-off and that’s all fine because he was rich and it’s allowed.
So that’s settled now.
Glen Davidson
With cancer, prevention is far easier than curing. Thus, the real issue here is not how Jobs’ cancer was treated after discovery, but rather how it arose in the first place.
Source: Epidemiology and risk factors for pancreatic cancer – Lowenfels & Maisonneuve, 2006(PDF)
Tobacco is the best understood risk factor. The role of tobacco smoking in generating reactive agents like benzo(a)pyrene, which forms adducts with DNA, is fairly well understood. Both of Job’s parents died from lung cancer brought on by heavy smoking, so he likely suffered heavy childhood exposure there, plus perhaps some genetic inheritances.
It’s believed that carcinogens from tobacco (or other environmental/occupational sources) enter the bile and then cause pancreatic cancer by reflux through the pancreatic duct. Other cancers, such as more common lung, stomach, liver, large bowel and prostate cancers, are more common but the exposure routes are obviously similar.
However, the body has defense mechanisms that exist to detoxify and excrete carcinogens and other toxins, such as cytochrome system enzymes, N-acetyl transferases, glutathione conjugate enzymes, etc. It’s possible that genetic deficiencies in such enzymes make some people more vulnerable to environmental exposures than others.
The bottom line?
Perhaps a cohort study in some of Apple’s regulation-free Chinese sweatshop manufacturing facilities is called for? There are lots of novel carcinogens employed in electronics manufacturing, after all. What a visionary move that was, boosting shareholder returns by offshoring labor! A real humanitarian move, that was. Of course, Jobs banned smoking in Apple offices here in the U.S. – but low paid Chinese workers are more expendable, it seems.
People often seem to do that when someone sick is skinny before they die, even if they were thin to begin with. It’s so dumb. It’s not like plenty of conditions andor their treatments don’t cause weight loss.
***
Sorry for using your thread, but I just wanted to mention again my request for people to help fix the “Alternative Medicine” page at SourceWatch. The cancer section is one of the worst parts.
Gosh, he’s as verbose as that Gorski fellow PZ linked to! ;P
@27: Jobs had endocrine pancreatic cancer, not exocrine pancreatic cancer. It’s an entirely different beast, probably not especially related to smoking, though possibly to alcohol consumption. Pancreatic cancer isn’t like lung cancer where a simple intervention, like not smoking, can prevent 90% of the disease. It’s more complicated and most people have no special risk factors. No victim blaming, please.
@ 16: Bill Gates happens to be the greatest philanthropist in the world right now, and has devoted more time, effort, and, obviously money, than you or most people ever will to fighting global issues. I would not consider “asshole” to be an appropriate term for him now.
The biggest issue I have with Steve Jobs right now is the extreme white-washing he received by the media and people everywhere for accomplishments he never actually achieved . He was not a philanthropist, or a huge contributor to the arts, or even technology. He was a businessman involved with or who owned companies that made contributions to the arts and technology on par with the majority of other companies in their respective areas. That’s it. It’s disappointing to see even people like P.Z. making remarks along the lines of Microsoft has always been playing catch-up with Apple, when P.Z. and the millions of other people making similar remarks, or elevating Steve Jobs to near, excuse the expression, saint-hood, when these are people who simply owned and used Apple products and their actual knowledge of the tech industry ends there.
Pancreatic cancer is really damn hard to survive, and liver transplants are pretty risky too. I didn’t expect him to live super long after all that, especially after he got weirdly skinny. How everyone else was so shocked by his death is beyond me.
yep, gates is doing what he should be doing. That should be expected from the super-rich. He is an enemy of the anti-vax people for his campaigns to vaccinate against preventable diseases all over the world, so I am somewhat surprised by the hate flung his way on places like FTB. I also agree that the way the media has treated jobs after his death is ridiculous. I swear, the media only does this when they want to distract people from important shit going on in the world.
Rats. How could Orac have beaten me to the Gorski article? It’s like he’s psychic or something.
@tim
Err… I hope you do see the similarity between Gorski’s and Orac’s style.
What gets me about the cancer issue in the U.S. is the way in which our govt has worked to inhibit research into the uses of cannabis extracts – not simply for pain relief and nausea symptoms, but to shrink tumor cells. By keeping cannabis as as schedule 1 substance and thereby maintaining an official policy that cannabis products have no medical benefit, the DEA works against medical research.
Cannabinoids to fight cancer sounds like quackery, but there are studies that indicate a benefit (from concentrated extracts.) There have been various lab and animal-stage experiments that have shown promise in shrinking various types of cancer cells.
Lung tumors (Harvard, 2007) in lab and mice studies.
Also the spread of breast cancer cells (California Pacific Medical Center Research Institute, 2007)
Brain tumors (Complutense University, Madrid, 2000) mice and later (I think 2005), a small human trial.
Research in 1974 that was supposed to show a negative effect of cannabis use (which is the only way someone could get funds and the cannabis to do any tests) instead demonstrated anti-tumor properties – for breast cancer, lung cancer and a form of leukemia – and also prolonged the lives of mice with cancer cells.
http://www.ncbi.nlm.nih.gov/pubmed/1159836
Yet, just this summer the DEA stated that cannabis has no medical value. Maybe that’s quackery, too.
I agree with you. In malignant tumor, surgical resection is best one. But pancreatic cancer is early metastasizing thing. Even if early surgical approach was done, life expectancy is not very long.
From PZ’s link (and reiterated in the comments here):
I used to think that it was the granola-eating left that led the charge for woo-based medicine and “natural” healing. Currently, however, it’s difficult to outpace the woo-meisters at right-wing outlets like Newsmax or WorldNetDaily. Today Newsmax issued a characteristically loopy bulletin:
Cool. Eat this spice and avoid cancer. Right. It looks like a medical degree is no guarantee that the person who sports it doesn’t live out on the scientific fringe. Anyone know anything substantive about Dr. Wascher?
Maybe his cure was patented by someone else ;).
ShavenYak @ 17 and Rachel P @ 19;
Already? Wow, it’s even worse than I thought. It takes a really nasty piece of work to take the case of a man whose death may have been contributed to by their woo, and try to use that death to further propogate that self same ineffectual woo, and all in a bid to fleece the gullible or desperate.
Some people really are a waste of genetic material.
I guess some folks’ DNA is 100% junk.
Actually, “Dianne”, cancer has not always been a “part of life” that “anyone can get” – as far as we know, in pre-industrial societies, cancer was primarily a disease of elderly people, unheard of in children and young adults, except for those with unique exposure routes – such as children employed as chimney sweeps in Dickensian London.
The explosion of cancer in the 20th century is clearly due to the industrial revolution and the expansion of the use of industrial chemicals throughout the globe. It’s only in the past few decades, as a better understanding of the molecular biology of cells has developed, that clear connections can be drawn.
Look, “Dianne,” Your attempt to draw a distinction between “exocrine” and “endocrine” forms of pancreatic cancer vis-a-vis the original source of the cancer is ludicrous. Exocrine is related to the production of digestive enzymes, endocrine to the production of digestion-related hormones – but both have the same exposure route, both are stimulated by the flow of food into the stomach.
Let’s say that again – both have the same exposure route. Hence, your argument is completely bogus.
The primary source of cancer in modern American society is through exposures to environmental toxins that were not present in the pre-industrial system. Ever since Rachel Carlson published “Silent Spring,” the producers of these toxins have financed massive PR efforts – efforts that extend to academia, certainly – to keep this fact hidden from the public.
Isn’t that true, “Dianne?”
You sound like a True Believer™ in the environmental poison theory. I suspect aging, where a lot of folks getting into the ’70s an higher make it look like that, based on numbers of occurrence. You need to look at age diagnosed. Also feed in better diagnosis.
I can’t help hearing ikesolem’s last sentence in “Are you talking to me?”-voice.
Yes, so-called “Dianne”, isn’t that true?!
[*snicker* Sorry, sorry, couldn’t resist. I’m in a silly mood this evening.]
No “nerd of redhead”, I’m not a true believer in anything. Not even atheism, actually. Belief is an overrated mental process, that’s my position.
But, thanks to the work of hundreds of scientists over the past twentieth century, I’m aware of at least two factoids:
Factoid One: The cell cycle controlling replication in multicellular creatures is a very complicated and sensitive affair, subject to all manner of problems (which our immune systems are attuned to).
So yes, cancer is a “natural process” – but our immune systems are capable of identifying and eliminating such “rogue cells” under normal conditions, in fact, this is one of the primary functions of our immune systems.
Second factoid: a wide variety of carcinogenic molecules have been dumped into the air, water (and hence food) supplies as a side effect of fossil fuel use and industrial chemical production. Some of these chemicals (like ethidium bromide, something I’ve used too many times to count, but always with gloves on) intercalate into DNA. Others bind more permanently to DNA (methyl bromides, for example). Others bind to proteins that bind to DNA (such as dioxins), thus disrupting cell regulatory cycles. Then you’ve got your hot radionuclides, leftovers from nuclear bomb testing, which directly damage DNA and proteins. And so on, and on, and on.
Now, if that damage affects a key regulatory stage in the cell cycle, then you get rogue cells. If you happen to damage an immune system component tasked with getting rid of such rogue cells, you’re in serious trouble. This is all well understood, heavily studied – there’s really no question about it. Obesity? That just means your fatty tissues accumulate more nasty DNA-damaging toxins.
So, yes, industrial toxins produced as a byproduct of everything from fossil fuel refining to PVC pipe production play central roles in the prevalence of cancer in modern society. There’s zero scientific doubt about this, just as there’s zero scientific doubt about fossil combustion leading to global warming – but the vested corporate interests would rather lie through their teeth in order to protect their profit margins, wouldn’t they, “nerd”?
Who is their ally in this PR agenda? American academic institutions run by corporate interests (who insist that all cancer is genetic), and cancer foundations dependent on donations from corporate chemical concerns (who refuse to address prevention).
It’s called “corporate Lysenkoism” – and yes, the USSR operated the same way, too. Just look at Chernobyl.
Ah, so that’s totally his fault, right? So he shouldn’t take every opportunity to save his life? Just like, I’m sure, you’d refuse to take available methods to receive treatment out of a sense of social responsibility. In fact, I’m sure you’d even avoid the oncologist entirely since the very poor can’t afford specialists.
*Runs to buy popcorn*
as far as we know, in pre-industrial societies, cancer was primarily a disease of elderly people, unheard of in children and young adults, except for those with unique exposure routes – such as children employed as chimney sweeps in Dickensian London.
Citation needed, to say the least. In fact, there is fossil evidence of cancers in dinosaurs and other pre-human animals. Gary Larson’s suggestions aside, I doubt dinosaurs really died out because of smoking and other “modern” toxic exposures. The same reference also reviews descriptions of cancer in pre-modern humans, including in young adults and children. No, it was not unheard of. Just not understood.
Medical woo has always been a bipartisan endevour. Just look at the right wingers who were convinced fluoridation was a Communist plot of some sort.
A sourse for the claim that cancer was “virtually unheard of” amongst young folk before the 20th Century would be greatly appreciated.
American academic institutions run by corporate interests (who insist that all cancer is genetic)
Um…no. Not even close. There are a number of documented causes of cancer, only a few of which are genetic. Smoking. No question about it, no ambiguity, smoking causes a lot of cancers. Not all cancers, but quite a lot. Viruses. It’s pretty clear that a number of cancers including hepatoma, cervical cancer, a number of head and neck cancers, Kaposi’s sarcoma, and others are (usually) caused by viruses. Decreases in hepatoma rates have already been documented in populations with high uptake of the hepatitis B vaccine. “Toxins”…eh, maybe. You’ll have to be more specific. It’s not just “modern society”. Cancer rates dropped in the early 21st century. Mortality rates dropped more. It’s slow, but we’re getting less cancer and dying of it less often. And not because we’re using more rhino horn or whatever “natural” remedy ik is selling.
Are you aware that there is a world outside the US?
Oh, and PZ – your ScienceBlogs link at the bottom of the post takes you to this site, rather than the article at the other site.
Ever since Rachel Carlson published “Silent Spring,” the producers of these toxins have financed massive PR efforts – efforts that extend to academia, certainly – to keep this fact hidden from the public.
Oh, yeah, of course. Just hiding the True Answer to All Cancer because no drug company would ever be able to find a market for it. Unfortunately, with the economy like it is, they’re late with their payoff so I’m going to have to reveal it. Take notes everyone. The cure for all cancer is…arrgghhh….
(A different hand begins typing)…the security budget is still intact.
(Beatrice isn’t the only one in a silly mood this evening.)
who refuse to address prevention
Sorry, got to do one more because this one drives me nuts. Cancer prevention in mainstream medicine:
Smoking screening: prevention. Effective prevention too. Get someone off tobacco and their risk of cancer plummets.
HPV and HBV vaccines: prevention.
Pap smears: prevention.
Screening for excess alcohol intake: prevention.
Colonoscopy: prevention.
Mammography and various attempts to diagnose prostate cancer early: alas, not prevention, just early detection. Still, people who are diagnosed with stage I breast and prostate cancers have very good 5- and 10-year survival so worth doing even if not technically speaking cancer prevention.
I’m sure that I’m forgetting some obvious ones… Rorschach, anyone else, want to jump in?
Several chemicals are known carcinogens.
To be fair, I think the claim, exaggerated though it was, was not about the influence of drug companies but of chemical (or chemical product) producers.
If the discussion is going to devolve into “Chemicals cause pretty much every cancer!” vs. “Chemicals don’t cause any cancers!” it will be fruitless.
People turn to woo(usually) when medical science fails or has no acceptable answer. Desperation is last place anyone wants to be in but when you find yourself there all bets are off.
Cancer is still primarily a disease of elderly people.
Cancer Research UK data for 2006-2008:
0-14 years 0.5%
15-24 years 0.6%
24-49 years 10%
50-74 years 53%
74+ years 36%
Thus 89% of all cancers in the UK during 2006-2008 occurred in people over 50.
Cancer is a disease of old age. No doubt about it.
These are prevention methods that address individual behavior. They do not address corporate behavior that can put thousands or millions of people at risk.
Medical associations all over the world are involved in getting known carcinogens banned (or at least getting their use reduced).
David Gorski, as Orac, wrote an interesting post a year or so ago suggesting that widespread screening for prostate cancer was unlikely to be effective. It seems there are a good number of false positives, making it an expensive screening process since all those potential positives need to be followed up. Also many prostate cancers are slow growing, and are often not the cause of death in a patient with such a cancer. Given treatment for prostate cancer can lead to impotence and urinary incontinence it is often better not to treat a cancer that is not causing any symptoms.
Of course if the patients presents with symptoms that suggest prostate cancer then test are appropriate.
Here’s a list from the ACS, which is far from cause-centered:
http://www.cancer.org/Cancer/CancerCauses/OtherCarcinogens/GeneralInformationaboutCarcinogens/known-and-probable-human-carcinogens
It wouldn’t be good to assume this is exhaustive, especially as exposure is not in isolation.
***
Some are. This reinforces my point.
One cannot simply talk of some things being carcinogenic without talking about dose.
Unless you are the Daily Mail that is. The Daily Mail is on a fearless quest to divide absolutely everything into things that cause cancer and things that cure cancer.
I must admit that your point escapes me.
Dianna said that prevention is part of medicine, yet you seem to take exception to this, since they don’t address corporate behavior, but only individual behavior. I then point out that medical associations do address corporate behavior, and you say it reinforces your point.
What point is that exactly, and how does it relate to the conversation? (please note, I am genuinely puzzled here)
@60: Good point. Prostate cancer is a quagmire. Should have left it out altogether. Mammography is a better example of successful screening (even there, there’s some controversy, of course.)
A one time catastrophic incidence. Look at increases in leukemia in the area of operating nuclear facilities in Japan, US, and Europe. Any significant increase. Oh, and talk to Brownian about how to find cancer clusters due to environmental problems. All you need is real research, not from paranoid fuckwits with an agenda.
Oh, and Ike, one of longer lived professions is chemistry. Maybe exposure to all those toxins aren’t the whole story. (The carcinogens I’ve been exposed to is a long list.) There are other factors at play.
Rachel P @19 : The usual run of quacks and scammers have come out of the woodwork — Gonzalez, Null, Adams etc. All of them have said what amounts to “Jobs would still be here today if he had only used my quackery.”
PZ @ 33: yeah, it’s uncanny how Orac always finds those articles by Gorski.
Clearly.
Dianne said that prevention is an important part of corporate-government response to cancer in response to the loon. The loon had been talking about chemical exposure more broadly – not that controllable by individuals. Do you really not get this?
Well, yes.
My point was that corporate chemical exposure is an important cause of cancer, and it can’t be addressed by changes in individual behavior. The fact that medical associations address some corporate-chemical carcinogens obviously suggests that chemical exposure is indeed an important cause of cancers. Get it?
Have you read Rachel Carson, by any chance?
These are prevention methods that address individual behavior. They do not address corporate behavior that can put thousands or millions of people at risk.
Corporations so rarely come in for their annual checkups. Makes it hard to do proper prevention counseling with them.
The ACS list of environmental toxins includes aflatoxin, a fungus produced toxin that can be a contaminant in food (more frequently in less developed countries, but also in the US), areca nut (a plant, obviously), tobacco (which is, after all, a plant not an evil “unnatural” toxin), and quite a number of infectious agents.
Unquestionably, there are a number of industrial byproducts that are bad for you, including many that can cause cancer. Appropriate regulation of companies and enforcement by the FDA are, of course, critical to public health. But simply saying, “it’s all industrial toxins” is not useful. Identify and minimize specific toxins-natural or otherwise.
*sigh*
Many of the anti-cancer drugs can be carcinogens in their own right too. A lot are “natural” products, made from bacteria, fungus, or mold, like aflatoxin.
It occurs to me that I may be overreacting to the earlier silliness and sounding like I think that industrial pollutants play no role in cancer. This is wrong. They definitely do. Companies should be held responsible for what they put into the air and water and government should discourage, not encourage, dangerous practices. (See, for example, Corbett, fracking.) But the regulation needs to be targeted and in response to known carcinogens, not just a vague fear of industrial muck. (Not that industrial muck isn’t pretty gross on its own, even when not actually toxic.)
WTF. What’s wrong with you? Do you care about public health or not? Is this supposed to be funny?
So the fuck what? The discussion was about industrially produced chemicals. Of course they don’t exhaust the list of known carcinogens.
YES. And a significant part of the point is that those that can cause cancer aren’t fully known because resources aren’t being directed towards the investigation of chemical exposure.
YES. And not receiving enough attention.
FFS. I warned against this above.
Ah. Our posts crossed – sorry.
Well, I agree with this somewhat, except for the fact that there’s not enough research into potential carcinogens (or problems for organisms that don’t involve cancer). So focusing only on known carcinogens would be a problem.
So focusing only on known carcinogens would be a problem.
I agree. There are clearly a lot of unknown carcinogens out there. Wouldn’t it be nice to have the funding to look for them?
A lot of reasonably suspected carcinogens, too.
Not just nice – imperative.
That is what folks like Brownian are doing. And that includes similar folks in the US looking for “hot spots” via epidemiological studies.
Indeed, because everything is made out of chemicals. Chemicals are neither good or evil – some are carcinogens, some are not, and how natural they are has nothing to do with it.
Maybe “environmental” would be a better word.
There is already a lot of data available on carcinogens – all chemicals that are sold must have a MSDS sheet, where toxicology data appears in most relevant cases. Used to see a lot of those back in the days I worked in a lab – it gave us an idea of what kind of protection to use when handling them.
All cancer IS genetic.
The fallacy is that genetic and environmental causation must be mutually exclusive, as opposed to complementary.
*yawn* *eyeroll*
Addressing actual issues would be good.
Thanks for saying that cancer is a bastard.
It seems mainstream now to treat cancer as though your decisions determine what happens to you if you have cancer. Too many things are unknown about (it)[them]. There are too many cancers.
Total rejection of scientific medicine will reduce your chances to a minimum, but embracing it will not guarantee your survival at all. With what we know now, chance (or at least, the unknown) plays a major role.
OT: eye candy
Cancer is no more prevalent in young people now than it ever war. It’s much more prevalent overall because people are living longer than ever. The longer you’re around, the higher your likelihood of developing cancer is. Developing cancer in old age is normal. We’ve got more old people than ever.
This would be the case whether the industrial revolution had occurred or not. vc
The role industrial pollutants play in cancer (which isn’t a positive one) is absolutely nothing compared to the role increased life expectancy has.
Thanks for your unsubstantiated and nonresponsive assertions, Rachel P.
@80 : There are no guarantees, at anything. That said, Alternative Medicine is not Medicine, it’s the Alternative To Medicine. Will you be cured of your cancer 100% of the time using science-based medicine ? no. There are no guarantees. full stop.
Your odds of survival using the various sCAMS? The same as if you had taken no treatment at all — i.e. slim and none. It’s a risk vs reward situation, and the risks of going untreated are immense, while the reward of going untreated is incredibly small.
Meanwhile, the risk of evidence-based treatment is relatively small, and the reward is usually fairly high. Not always. not for every patient or every cancer, but for the majority, early diagnosis and treatment means a much higher survival rate.
I find the list of ‘known carcinogens’ at the retail level has become useless. Because toxins are in some rare woods or in (now banned) plywood, ‘sawdust’ is a carcinogen to the State of California. It isn’t! Because microscopic cuts cause cell damage and cell regeneration creates cancer, any dus is not a carcinogen. Because it’s more important to cover your ass than look at actual causes, we just label everything carcinogens!
And why would someone bring up a case from 1980 as being two-faced vs something else that happened fifteen years later? That’s stupid. Why did Slammo even bring it up?
True, although calling it normal stretches the point. Not all old people develop cancer and after 90, the indidence starts downward for unknown reasons. In general cancer rates increase exponentially with age in humans. This has been known for decades.
The old estimate of environmentally caused cancer in the USA is 6%. Most researchers think that is too low but no one is sure what the actual number is. It’s nontrivial to determine because there isn’t a good control group.
It isn’t that alternative treatments “might” have contributed to lowering his odds of survival. They absolutely did. That is what odds are all about. If every person in Jobs’ condition took his path, the overall rate of survival would decrease because there is direct correlation between how long one lives and when one begins treatment. That doesn’t mean Jobs’ actually died earlier because he invested in quackery, but his odds of survival did decrease. Even if he lived 900 years in Ironman athlete condition, his odds of survival decreased because the statistical facts say waiting to treat cancer lowers life expectancy.
There’s no doubt environmental factors account for SOME percentage of cancers and that some of those environmental factors didn’t previously exist.
I was unaware of the dip occurring after ninety, which is really interesting. Of course some old people won’t develop cancer but incidences of cancer do skyrocket with age. We’ve got more old people around than ever. Why on earth wouldn’t we be seeing more cases of cancer due to life expectancy having increased to such a huge extent? The simple fact lots of these people wouldn’t be around any longer a hundred years ago means their cases of cancer never would have occurred.
Is it really news to anyone that instances of cancer increase with age?
Now isn’t that interesting? I mean really, how could that happen? You’d think all those ghastly chemicals would have some negative effects. To say nothing of all those late night parties with pure ethanol flavoured with a dash of acetic acid! ;-)
I think it’s pretty simple why cancer rates go down after a certain age: Cancer needs cell division to be created; as you age your cell division reduces. This is why estrogen therapy has a cancer risk: It pushes cells to regenerate more often.
But it would be a bit tough to know what sorts of risks you have from environmental – everyone is exposed to a certain amount of many dangers, and risks aren’t absolute; everyone isn’t affected equally, it’s one-out-of-x. Not to mention the number of people we have in modern society who don’t die early from what are now treatable diseases! Of course we’ll see upticks in many other things.
Insufficient oxygen supply to the brain. Same as everyone else.
Do chemistry jobs have a higher than average rate of providing health insurance benefits?
Steve Jobs – or anyone – is entitled to use whatever medical system they wish. I certainly don’t want to use Jobs as a poster child for my particular take on cancer (partly because I don’t fully understand it). But it’s his choice and nobody else’s – that’s the one thing I do know for a fact.
BTW medicine is technology based, not science based. For it to be actually science based, all medical professionals would need science degrees as well. Many physicians wouldn’t know the first thing about science or philosophy of science.
In the real world, medicine is no more noble than politics. Which is why I stay away from doctors unless I really have a problem which I cannot fix myself. Thank goodness I haven’t had serious illnesses. I wish the same for everyone.
karimghantous:
No one said different. There’s medicine, then there’s woo. Period.
Wrong. Science is required to figure out what works and what doesn’t. How do think that happens, magic?
Bullshit. Are you this ignorant about other subjects as well? Even the way you’re using science is wrong.
I certainly hope you learn to think before you get one.
It is a bit of an issue.
The current chemophopia (fear of any substance name that “sounds” like a chemical) isn’t helping in giving credibility to anyone pushing research into carcinogens.
People obsessively reading ingredient lists in their food and cowering in fear of “toxins” every time they encounter some harmless chemical they would be surprized to learn is naturally present in some other food they eat are legion (some are even nutritionists). As are people who claim that cancer didn’t exist before industrialisation, or in animals in the wild, or in third world countries, or that the rates for all types of cancers have raised significantly, which are all lies.
Vague and irrational fear of anything new or unknown isn’t a good guide for research. Which doesn’t mean that there’s no productive research to be done.
For instance, I think one serious candidate for a cancer with not very well-known environmental causes is non-hodgkin lymphoma, a cancer which affects peoples of all ages, is difficult and sometimes impossible to treat, and which has seen a definite increase that is focused on some geographical areas of North america.
Personaly speaking, no (but I am canadian so I was provided with health insurance the day I was born). I think it’s partly because we chemists tend to know what we’re manipulating and to use adequate protection against it, which is not always the case for an industrial worker.
There are, BTW, some chemists who do fall sick because of what they manipulated in the lab – this is part of the data that is accumulated on chemicals. For instance, it became known that benzene causes leukemia from such data, and from the workers who used to manipulate it for their jobs. Consequently, benzene is not a very commonly used solvent in most labs (we mostly replaced it with toluene), and when absolutely needed will be used with caution.
drat.
chemophopia = chemophobia
And everybody knows technology has nothing to do with science, isn’t it ?
What engineers do is magic.
Now excuse me while I go study my new spells for next week’s exams.
This is the dumbest thing I’ve read today.
Not just nice – imperative.
I don’t disagree. In fact, I agree entirely. It’s just that we’re missing so many essentials right now that it’s hard to get as excited as I should about yet another one. Patients are failing to get treated or even diagnosed because they lack insurance or are not US residents and therefore don’t qualify for emergency medicaid (depending on the state). Patients’ treatments are being delayed because they DO have insurance and their insurance companies fight tooth and nail to keep them from using their benefits. People with wonderful health insurance from companies that genuinely want to help their customers are failing to get standard of care treatment because drug companies aren’t making the necessary drugs. The water in Pittsburgh is fracking radioactive and (per rumor at least) can be set on fire due. It’s hard to know where to start.
This is so stupid, it is actually humorous. Keep babbling KH, there is bound to be some more great comedy in there.
The average US lifespan a century ago was 47. We’ve gained 30 years in a century thanks to modern science and medicine. Most people are happy with an extra 3 decades.
Cancer needs cell division to be created; as you age your cell division reduces.
Recent studies on aging have found that the body upregulates specific genes that cause apoptosis in cells that are dividing too quickly. They could be cancer cells, they could be skin, liver, or bone marrow cells regenerating after an injury. So part of “normal aging”, the reduced ability to recover from trauma or illness, is a cancer defense mechanism. Biology’s a bastard sometimes.
Of course physicians don’t need to be scientists for medicine to be science-based.
I mean, technology is science-based anyway. Astronauts used to be test pilots.
yep, agreed: dumbest thing today.
I’ve seen this “his choice” excuse pop up a lot in Jobs posts around the nets. First of all, alt-meds is not “medical”, and second, it should be an informed choice.
Better to be honest than to be coyly imply a false equivalence on particular “takes” re: medicine vs. alt-“med”.
haha
That would make them bad physicians if they can’t differentiate between scientific and non-(or pseudo-)scientific methods. Bad MDs exist, therefore medicine is bad?
If you wanna remove your own teeth, that’s your problem, but don’t pretend it’s an equivalent practice to actually going to the dentist.
No, but that wasn’t all you said. And of course environmental causes are not mutally exclusive with age. It’s not like cancer necessarily occurs immediately after first exposure.
***
I have no such fears, and haven’t argued that they are a good guide for research.
***
I think that much of the money for new drug development would be far better used extending existing care and treatments to everyone; millions of people are dying from preventable conditions. I’ve been arguing this for years. But all of what you said is as true for research into treatments or cures as it is for research into causes. What I’m arguing is that whatever the money and time spent on research, a much greater portion of it should go to research into environmental causes. I do think it’s a problem that the ACS takes so much money from companies that make potentially carcinogenic products, and I think this does influence research priorities.
And, as Orac (who’s both a physician and a scientist) often points out, many don’t have much scientific understanding. Jay Gordon, for example, is a successful Pediatrician to the Stars and appears to lack a grasp of the most basic concepts of science.
All it takes to lose most of one’s automatic respect for physicians is to teach pre-meds for a few years.
What I’m arguing is that whatever the money and time spent on research, a much greater portion of it should go to research into environmental causes.
I tend to argue that there should simply be more money available for research into both. But since that’s not going to happen until the government goes sane and starts spending serious money to get the economy going, I think that the calculation is complex. One has to take into account what will be of greatest benefit, what will benefit the most people, and what is most likely to work. It seems to me that there are a number of pretty simple, easy things that aren’t being done (i.e. testing of the water supply for hydrocarbons and radioactivity on a regular basis and acting on the results, vaccinating everyone for HPV, etc). I’d want to fund those things first, before going off into more speculative issues. We also need to stop wasting money on things we already know don’t work. Decrease funding to or eliminate NCAAM. Or at least get them to stop funding more trials of ecchinacia in URIs. There’ve been multiple negative trials. We can give up now. Then there are issues like whether to fund the most beneficial (if it works) research or most likely to work research. A highly speculative trial that might knock our lung cancer or a further refinement of treatment for almost-curable CML? Really both should be funded, but in what proportions? Usually, at this point, I come to the conclusion that my initial impulse was correct and really this is one of those problems that just needs more money thrown at it.
I do think it’s a problem that the ACS takes so much money from companies that make potentially carcinogenic products, and I think this does influence research priorities.
The ACS lost me when they decided to refuse $500K from Foundation Beyond Belief because, icky atheist money. And, yes, it does influence their research priorities. How can it not? At least there are a large number of donors so that any single one isn’t critical to their funding (and so can be blown off if need be.)
Some might (deliberately) misconstrue this as an anti-Jobs statement, but why all the silence across FTB at the death of Dennis Ritchie last Wednesday?
http://en.wikipedia.org/wiki/Dennis_Ritchie
I did a search and not one single item mentions him. His importance to computing far exceeded what Jobs did.
.
That should be pretty obvious.
P Smith:
Tsk. There were more than a few posts about it, but you would have missed them, seeing as there wasn’t one by PZ, just us commenters.
Now, have anything on topic to say? You know, medicine, woo, cancer?
Discovery Channel is having a special tonight called iGenius: How Steve Jobs Changed the World, at 8 ET/7 CT, to be repeated at 1 am ET/12 am CT. It’s hosted by Adam and Jamie of Mythbusters. Going to set my DVR.
“His importance to computing far exceeded what Jobs did.”
Not really. While enormously important, especially after becoming more widespread in the mid-80s, C and Unix didn’t play a role in early personal computers. C is an excellent systems language, but it’s not necessary. Other languages can be used for operating systems.
The original Mac was developed with assembly and pascal. There was nothing about C and Unix that pushed for the move of computing off the PDP-11 and into homes, schools, and phones. I kinda doubt that was even on Ritchie’s radar, since he worked for AT&T.
Put it this way: Linus had personal computers for which to write his version of Unix, because IBM put out the original PC, in response to the Apple II.
Well, yeah. It’s an extra layer in between reality (nature) and medicine. Which would be okay if the medical profession had a culture worthy of respect. And I have no doubt that the technology (e.g. chemo) works – it’s just that it’s wrong-headed and simplistic to think that you can fix a person just by ‘zapping’ the pathogen or cell.
Calling medicine ‘science-based’ makes it sound nice and clean and lets skeptics sleep well at night. It’s as simplistic as a ‘personal relationship with Jesus.’ There is more to both theology and medicine than those catch-phrases imply.
It’s no excuse. He’s old enough to drink, bonk, drive and vote. He can make his own choices, full stop.
Ouch. But sadly, this is the picture I’m getting. I’ve heard similar from Neil deGrasse Tyson. Medicine pretends to be grand, but in reality it’s just a bureaucracy. For the most part. I’m a fan of aspirin. And proudly so.
Argument by association? How lazy.
I’ve heard similar from Neil deGrasse Tyson.
Huh? Neil’s an astronomer. If he’s ever worked directly with medical students it’s news to me. Graduate students, yes, but medical students? Why?
I’m a fan of aspirin.
Interesting choice. I think aspirin is a missed opportunity. There is a fair amount of animal work and some human data that suggest that aspirin might have chemopreventative properties. But proper studies will never be done because it is long off patent and no one has financial incentive to do so. Myself, I think Bayer ought to slap another methyl or acetyl group onto it, rename it Zaxaspirin and start testing it in everything from heart disease to cancer. (After which, the NIH or maybe someone in Canada could fund the trial that shows that the original aspirin works just as well, saving bunches of money…isn’t capitalism wonderful?)
Non sequitur much? stop spewing nonsense.
So we shouldn’t say anything about con artists who con people into making “their own choices”, then? And YES, I AM saying that generally speaking alt-med peddlers are largely con artists.
PZ dissapoints once again. He wouldn’t be giving Pat Robertson the benefit of the doubt if it was Robertson who died instead of Jobs. Enough with the blind unwarranted hero worship. I want the cool PZ back.
[meta]
Tom:
How high are your expectations, then? ;)