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Comment by thwest | Hacker News Reader

The reports of Jobs' treatment elections are conjecture.

"although neither Apple nor those close to Jobs were willing to discuss the treatments he elected or the course of his disease," the community continues to assume that rumors about Job's health coming out of financial publications (Forbes) are somehow accurate.

This post is trite and condescending no matter how long it came after Jobs’ death. Dealing with death is a personal matter. You have no right to demand that anyone submit themselves to the cold, alienated approach of aggressive medical treatment. Let people pass with dignity, however they choose.

The purpose of life is not to be a mobile mass of cells for as long as technologically possible. In fact, the statistics show that people who skip the N+1th round of chemo and switch to hospice care have better outcomes. http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_...

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> the statistics show that people who skip the N+1th round of chemo and switch to hospice care have better outcomes.

Have you even read the article? This was not a case of choice between living two months with chemo or one month without. The cancer was detected early enough and the treatment prospects were excellent. But, no doubt influenced by irresponsible propaganda about the "cold, alienated approach of aggressive medical treatment", Jobs decided to wait a few crucial months while trying alternative medicine (and had the surgery anyways, except with less favorable prospects, due to the delay).

Once a cancer is metastatic, I guess it's just a question of quality-of-life vs extending-the-time-you-have. Last-ditch chemo is pointless if you have to go anyway. But people who get an operation immediately, then get chemo survive much better than the ones who wait for the tumor to get big and / or metastatic.

You don't want to do what many people do - prevaricate till it's too late, then try the heroic (but sometimes counter-productive) last-ditch measures.

Let's just say: if this causes a few of us to see a doctor earlier, and thus saves a few lives (well, improve the quality and quantity of the days we have left), wouldn't that make it worthwhile?

> Once a cancer is metastatic, I guess it's just a question of quality-of-life vs extending-the-time-you-have.

Not anymore (and not always, anyway). There are some forms of cancer that can currently be kept in check indefinitely, with next-gen chemo.

The general public cannot be expected to make a responsible decision concerning alternative 'medicine' if they are not aware of the facts and situation. If this article is to be believed, it's rather clear that Steve Jobs wasn't content to 'die in dignity' (how is it dignified to reject medicine? baffling...), and turned to science based medicine towards the end. Had he been more aware, he could perhaps be alive today.

The best legacy Steve Jobs could possibly have is to raise awareness of woo and it's woo-isms, so that perhaps just a few more people don't die unnecessarily.

I wholeheartedly agree, but want to point out that for him to do so is to cast doubt on the cult of personality and product that he created.

We're not talking about the N+1th round of chemo here. According the article, it was the 1st round of treatment he skipped, the one that probably would have saved his life. More than just saving his life, it should have given him a good quality of life for many years.

Actually, the damage is deeper than the [direct] loss caused by Jobs' (what I consider poor) judgment.

Remember that when his Plan A didn't work, he needed to fall back to a liver transplant. Transplantable livers don't grow on trees; it's likely that by using this liver, someone else didn't get it.

It's quite conceivable, then, that Jobs' decision cost not only his own life, but another person's as well.

UPDATE: clarify first sentence by adding "direct".

What if the next person on the list was also using alternative therapy to treat cancer?

I have to disagree here. The author might be insensitive for raising this point so soon, but that doesn't diminish the point's validity.

There's a difference between "Steve Jobs survived with cancer for 5 years" and "Steve Jobs barely reached half the median survival rate for his type of cancer." No one has reported on this point.

>This post is trite and condescending no matter how long it came after Jobs’ death. Dealing with death is a personal matter. You have no right to demand that anyone submit themselves to the cold, alienated approach of aggressive medical treatment. Let people pass with dignity, however they choose.

Don't know why you're taking it this way but (assuming that it's true, need more facts from reliable sources) this is more of a warning to people not to get taken in by alternative medicine alone and to be a little skeptical of it as a cure-all.

Great reply. I thought the OP toxic enough to make one ill.

The thought of bullshit fake medicine taking another life should be enough to make anyone feel ill.

Speak for yourself.

I am. "Should be enough" is very clearly an opinion.

My opinion is that it should be enough to make anyone fill ill, because everyone should approach the matter rationally.

The fact is that alternative 'medicine' is not rational.

You are welcome to your opinion.

"By definition, alternative medicine has either not been proved to work or has been proved not to work. You know what they call alternative medicine that has been proved to work? Medicine."

- Tim Minchin

Absolutely brilliant :)

For those not familiar with Tim Minchin's work: http://www.youtube.com/watch?v=HhGuXCuDb1U

see this journal:

"Evidence-Based Complementary and Alternative Medicine (eCAM) is an international, peer-reviewed journal that seeks to understand the sources and to encourage rigorous research in this new, yet ancient world of complementary and alternative medicine."

http://www.hindawi.com/journals/ecam/

The point being made here is that if something has been proven to work, it is no longer alternative medicine. "Evidence based alternative" is a contradiction.

Alternative medicine is any healing practice: "that does not fall within the realm of conventional medicine." http://en.wikipedia.org/wiki/Alternative_medicine

"Conventional medicine" being "medicine for which there actually exists evidence of it working."

source ?

don't forget : 51% Unknown effectiveness ..

http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp

one example "Unknown effectiveness"

"Pancreatic cancer New option(s) added for: Chemoradiotherapy for resected pancreatic cancer One long-term follow-up study added. It found no significant difference between adjuvant chemoradiotherapy and surgery alone for overall survival or progression-free survival at 11.7 years' follow-up. Categorisation unchanged (Unknown effectiveness), as the evidence is not strong enough to draw definitive conclusion."

So you're defending the idea that cancer can be halted by diet. Anyone who speaks out against that is toxic?

If all people had to do to halt cancer is vary their diet, far fewer people would succumb to the malady. The only way you can make that work is by taking a derisive and dismissive attitude to everyone, saying they must be too stupid and stubborn to want to live; moreover you must also posit that all doctors involved in oncology are evil and ignoring the facts.

This seems like a far more toxic worldview than quiet regret that Steve isn't still with us that I get from this article.

INTENSIVE LIFESTYLE CHANGES MAY AFFECT THE PROGRESSION OF PROSTATE CANCER

http://www.abundantwellbeing.com/Nischala/CancerStudyOrnish....

"Purpose: Men with prostate cancer are often advised to make changes in diet and lifestyle, although the impact of these changes has not been well documented. Therefore, we evaluated the effects of comprehensive lifestyle changes on prostate specific antigen (PSA), treatment trends and serum stimulated LNCaP cell growth in men with early, biopsy proven prostate cancer after 1 year

...

Conclusions: Intensive lifestyle changes may affect the progression of early, low grade prostate cancer in men. Further studies and longer term followup are warranted." DOI: 10.1097/01.ju.0000169487.49018.73

===== and ....

"Clinical Events in Prostate Cancer Lifestyle Trial: Results From Two Years of Follow-Up"

http://www.sciencedirect.com/science/article/pii/S0090429508...

"Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention"

http://www.pnas.org/content/105/24/8369.short

"Increased telomerase activity and comprehensive lifestyle changes: a pilot study"

http://www.sciencedirect.com/science/article/pii/S1470204508...

"Can lifestyle changes reverse coronary heart disease?: The Lifestyle Heart Trial"

http://www.sciencedirect.com/science/article/pii/01406736909...

Please show me where in these documents it recommends ignoring other treatments and I will upmod your post.

The idea that "diet" is alternative is ludicrous. What's alternative is "curing cancer" with diet. The science of how diets affect cancer—and the resulting medical advice that falls out—is an open and somewhat understood topic and a good part of a whole spectrum of treatment; one that all indications suggested were ignored in this case.

I always think it's funny that naturopaths say they're treating the "whole patient" but almost inevitably they focus on ONE THING that CURES EVERYTHING, whereas doctors come at the problem with a whole spectrum of tools ranging from diet and lifestyle to chemical interventions.

The idea that "diet" is alternative is ludicrous.

Diet is largely considered alternative medicine in America. Obviously pancreatic cancer cannot be cured with diet. However, some conditions respond favorably to diet and other lifestyle modifications.

Hypertension can be reversed through weight loss and diet, the Mayo Clinic even publishes books about how to do it. However, in the USA, it's largely considered a secondary line of treatment because doctors assume (correctly) that most Americans won't change their eating habits, even if it's a matter of life and death.

Eh, your experience will of course vary, but when it was determined that I had hypertension the first thing my (american) doctor told me is that I had to knock off the activities that.. err... inspired my HN handle ;)

I think doctors probably make a judgment call based off your described lifestyle and age. In my case diet and weight loss were easy, since I've been vegetarian at various points in the past and am fairly young.

Most people don't think twice when their doctor tells them to change their diet. They just ignore it.

It's only when a diet is some outrageously expensive and super-implausible idea like "only eat berries and uncooked food" that it enters the realm of alternative medicine. "Diet & Exercise" is even in the American vernacular.

The only people who want to co-opt diet is alterantive are the CAM proponents who are attempting to use it as the thin edge of a wedge to get themselves funding and legitimacy.

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