Excellent David Gorski wrap-up on what we now now about Steve Jobs’ cancer. It is highly worth reading reading in its entirety. As Gorski, a surgical oncologist says in the closing, the lessons are more about the limits of cancer treatment than anything else.
Isaacson contrasts the fragmented approach to care at Stanford to the far more integrated approach at Methodist Hospital in Memphis, where Jobs underwent his transplant and where Dr. James Eason was portrayed as having “managed Steve and forced him to do things…that were good for him.” Although it is certainly possible that the difference could be accounted for more by the lack of a person at Stanford with a strong enough personality to tell Jobs what to do and get him to do, compared to Dr. Eason, who clearly had a personality as strong as Jobs’, the description of fragmented care rings true to me, as I’ve seen this problem myself at various times during my career. One wonders if there is a way to infuse healthcare with some Apple-like integration of care, to build it into the DNA of the system itself as it is built into Apple’s DNA, without having to rely on personalities as strong as Dr. Eason’s apparently was.
Steve Jobs’ eight year battle with his illness is remarkable not so much because he had a rare tumor or because he flirted with alternative medicine for several months before undergoing surgery. Rather, I see Jobs’ case as providing multiple lessons in the complexity of cancer, the difficulty of the decisions that go into cancer care, and how being wealthy or famous can distort those choices. I’ve said it before, but now is as good a time as any to say it again: In cancer, biology is still king. Perhaps one day, when we know how to decode and interpret genomic information of the sort provided when Jobs’ had his tumors sequenced and use that information to target cancers more accurately, we will be able to dethrone that king more than just part of the time and only in certain tumors.