The World mourns the legendary STEVE JOBS

Steve Jobs Ipod
  •  Apple fans flock to Beijing Store- Wall Street Journal
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  • Apple’s legend, Jobs had transformed our lives- Obama
  • Thanks for showing that what you build can change the world- Mark Zuckerberg

That Steve Jobs had been battling with cancer is not news anymore than that now at his death, the world mourns and reflects on his immense courage and indescribable depth of insight in the way he viewed life. The effects of the revolutionary Ipad, Iphone and Mac, transcends just the IT world to the entire globe by changing how we do things and challenging imaginations.

All sicknesses even in the least form is a pain, to hear the ‘C’ word within the walls of a hospital is great pain, then to hear it’s a cancer of the pancreas- that is just inexpressible pain…

What is Cancer of the Pancreas?

The pancreas is just a 15cm long roughly 80g gland sandwiched between a part of the small intestine (duodenum) and lies directly over the two biggest blood vessels (the inferior vena cava and the abdominal aorta) amongst many others, described in elementary anatomy as having a c-shaped head (actually shaped like an umbrella hook held horizontally tapering down to its tail). When an organ that small is rowing with the big guns, it kinda gives you a hint as to its importance in the body.

By definition, a gland is a collection of specialized tissues that functions to produce hormones/chemicals which act as messengers in the body. The pancreas however, is even more peculiar as it is a dual gland possessing features of  both Exocrine (into the external environment ) and Endocrine (into immediate environment ) cell types; so it has a ‘collecting system’ to channel its products while it links up with the gall bladder to empty into the intestine .

In response to eating, the pancreas secretes enzymes into the small intestine to aid digestion via its exocrine cells; while its endocrine (islets of langahans) produces mainly Insulin- yes you guessed right, the pancreas is also the seat of Diabetes Mellitus!  Overall, 80-90% of the pancreas consists of the former, so it is also understandable that the commonest type is Cancer of the Exocrine Pancreas, but there are several other forms.

Cancer of the Pancreas is said to be the sixth leading cause of cancer death in the UK and rated fourth in the US, yet it accounts for only 2-3% of all cancers (very deadly huh). Sadly, there are no simple screening tests only a forebode consciousness and specialist counseling if you are susceptible by way of any directly inherited family history with risk factors like cigarette smoking or chronic pancreatitis. It is actually documented to be more common among black males.

Most cancers of the pancreas are located within the head and tends to spread locally quickly, invading the liver, then steadily grow bigger to obstruct the bile flow channel, digestive enzymes and other hormones, and also get to other organs like the lungs via the bloodstream. Practically all cancers act similarly (isn’t that how they earned their name: cancer= ‘crab-like’ so called because of the way they viciously grasps any tissue it invades) which makes them so scary. Their growth rate is usually very rapid and uncontrollable sucking up all the blood supply around just to nourish itself alone!

Typical Clinical features: Jaundice (yellowness of the eyes and membranes) is the most common symptom that draws one’s attention to a possibility of a cancer involving the pancreas head, accompanied by dark urine, pale coloured stools and generalized itchiness of the skin. Weight loss is also seen as with most other cancers but marked here because the obstruction causes both indigestion and mal-absorption. A couple of people may develop new onset diabetes mellitus.

If however, the cancer is not located within the pancreas’ head, symptoms may just be weakness, vague stomach discomfort, anorexia, and change in bowel habit which may be very easily dismissed by the person and even the doctor initially.

Treatment Options: As with all cancers, the line of treatment is based on the “staging” of the cancer. Until recently, surgery has been and to a large extent, still plays a major role in the treatment for most cancers. Sadly, majority of cancers are diagnosed late and would have already had some miniature spread (metastasis) necessitating the need for adjuvant like chemo and/or radiotherapy.

In Cancer of the pancreas head, surgery is often imperative to relieve the obstructive jaundice and create a bypass for the enzymes while stopping the itchy skin. However, if it is already at a late stage where the tumor is already too embedded in surrounding tissues, or the person is now in a debilitating state, just palliative care of pain relief, stabilizing vital organs and aid quality of life may be the only medical option.

The reported 5-year survival following resection of the cancer of the pancreas head ranges from 6-7%. Considering that at best, 15% of people have resectable disease, for now the outlook is very gloomy. Unfortunately, these depressing stats are only for the commonest cancer of the pancreas. There are records of a few other rare cancers of the pancreas that may even be cured by surgery. For instance, the average 5-year survival rate for pancreatic neuroendocrine tumor is 40-42% which according to the news is what Steve Jobs had, thus explaining his near seven years survival period.

Steve Jobs IpadI dare say that is a heroic long time to countdown on your days left on the face of the earth. Indeed, only a rare genius will stare death boldly in the face and create such overwhelming impact across the globe in spite of his own frail body.

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