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Published On: Thu, Nov 3rd, 2011

Steve Jobs

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Cancer, Diabetes and Obesity Awareness and Prevention

-by Dr. Connie Stapleton, PhD

The inimitable Steve Jobs once said, “I want to put a ding in the universe.”   No doubt he is one of a handful of people to have accomplished that task. I wonder if the Apple computer guru ever thought he’d make a ping in the world of awareness and prevention of cancer, diabetes, and obesity. 

Steve Jobs wasn’t overweight, much less obese. To my knowledge (which is admittedly limited), he did not have diabetes. So why would I suggest he may end up having an impact on the awareness and prevention of these diseases? Because he did have pancreatic cancer. And diabetes is correlated with pancreatic cancer. Diabetes has an even stronger correlation with obesity. And obesity appears to also play a role in pancreatic cancer. 

A diagnosis of pancreatic cancer does not bring with it much hope for long-term survival. In 2005, Steve Jobs said this about his diagnosis: “My doctor advised me to go home and get my affairs in order, which is doctor’s code for prepare to die. It means to try to tell your kids everything you thought you’d have the next 10 years to tell them in just a few months. It means to make sure everything is buttoned up so that it will be as easy as possible for your family. It means to say your goodbyes.” It turns out that Steve had a few years left, and we all know that he took care of his business (and most likely said everything he needed to say to his loved ones, as well). 

Today’s medicine can cure many diseases. Pancreatic cancer is not yet one of them. What about diabetes? How about obesity? Both of these diseases are, if not curable, remittable. And both of these diseases have been linked in epidemiological studies to an increased risk of pancreatic cancer. The correlation between pancreatic cancer and diabetes is well accepted. (An interesting side note: Smoking is the other factor clearly associated with pancreatic cancer. Alcohol use, on the other hand, often thought to be, is not commonly found to have a direct link to pancreatic cancer. However, people with cirrhosis of the liver – caused by things such as hepatitis and the use of alcohol – do appear to have an increased risk of developing pancreatic cancer.) 

Type 2 diabetes is more commonly associated with pancreatic cancer than is type 1. The pancreas, a gland behind the stomach, produces the hormone insulin, which is necessary to carry sugar from the bloodstream into the cells. Diabetes occurs when the pancreas does not produce enough of the hormone insulin or the body is resistant to the action of the insulin. In type 2 diabetes, the most common form of the disease, affecting 90 to 95 percent of people with diabetes, the body is resistant to the action of insulin, meaning it cannot use insulin properly, so it cannot carry sugar into the cells (from http://www.hormone.org/Diabetes/overview.cfm).

Although type 2 diabetes is widely considered to be associated with pancreatic cancer, it is not clear if the diabetes causes the cancer or vice versa. It appears that pancreatic cancer is causally related to persons who have had diabetes for many years. For others, who have had diabetes for only a few years, the diabetes seems to be a symptom of, and a result of, the pancreatic cancer. 

According to the National Institutes of Health, the prevalence of type 2 diabetes has tripled in the last 30 years, due in large part to the increasing numbers of obese people.  Incredibly, 80 percent of people with Type 2 diabetes are obese

(from http://www.time.com/time/health/article/0,8599,108431,00.html).

 The Centers for Disease Control and Prevention note that obesity is the leading risk factor for type 2 diabetes. While the link between obesity and type 2 diabetes is crystal clear, the relationship between obesity and pancreatic cancer is less certain, although it has been implicated. 

As noted previously, I do not know if Steve Jobs had diabetes or if he smoked, two factors related to pancreatic cancer. Therefore, I don’t know if his cancer might have been preventable. I do know that obesity was not a factor in his cancer. I also know that for those persons who are obese, their risk of developing type 2 diabetes is greatly increased. Having type 2 diabetes is a noted risk factor for pancreatic cancer and therefore, obese persons who develop type 2 diabetes are at greater risk for that unrelenting killer. If a person smokes, is obese, and has type 2 diabetes, their chances of developing pancreatic cancer increase significantly. 

Hmmm… smoking is preventable. No question. Obesity is also preventable in many cases. Since type 2 diabetes is often caused by obesity, many cases of this disease are also preventable. Makes me wonder how many cases of pancreatic cancer might be preventable. 

“My job is not to be easy on people. My job is to take these great people … and to push them and make them even better.” Ah – another quote by Mr. Jobs, one that I truly love. I feel the same way in my work as a psychologist.  I spend most of my professional time working in the field of recovery from addiction and recovery from obesity. Many times that requires me to utilize what I refer to as my “firm and fair” method of therapy. In regard to losing weight and/or maintaining a healthy weight, it means holding people accountable for their choices and encouraging them to maintain sight of their goals. These goals often include improving their health (i.e., ridding themselves of excess pounds and the often-accompanying type 2 diabetes), engaging in healthy food choices, maintaining an exercise program, and dealing with emotional scars related to obesity. Again, in the words of Steve Jobs, who wasn’t referring to weight loss, although it fits: “It comes from saying no to 1,000 things to make sure we don’t get on the wrong track …” Losing weight, preventing obesity and therefore many cases of type 2 diabetes, can be tough and does require personal effort. Prevention and recovery from obesity and diabetes require saying no to foods that are tasty but not nutritious, saying no to sitting on the couch watching television and yes to a brisk walk outdoors, and saying no to food-pushers at the office who carry boxes of donuts from cubicle to cubicle, offering empty, pound-producing calories. 

No one I know ever wanted to become obese. No one wants to develop type 2 diabetes. And certainly no one wants to be stricken with pancreatic cancer. I’m certain a man like Steve Jobs, who loved to create, who loved to inspire others, who loved his life, did not want to develop pancreatic cancer. Steve Jobs appeared to do the things people who try to prevent illness do: he maintained a healthy weight and (from what I could find on the internet), he did not smoke. He reportedly did say this; “Doing the right thing can never be the wrong thing.” I’m going with the idea that he did the right things when it came to taking care of his health. And so can you. And so can I. One of my favorite sayings from the recovery world is this: “I am only responsible for the effort I put into whatever I do.” In the case of obesity prevention, diabetes prevention and consequently many forms of cancer prevention, this means that we are each responsible for making the effort to choose healthy foods, get exercise on a regular basis, forego smoking, and make many other positive choices, including going to therapy if we need to. We cannot, however, always predict the outcome. Some people who make consistently healthy lifestyle choices end up getting horrible diseases. Steve Jobs got a horrible disease. He has been an incredible role model for so many and his work will forever be remembered for its quality. Perhaps his death will spark increased awareness and prevention of pancreatic cancer and in turn, increased awareness and prevention of diabetes, one of the factors associated with this cancer. Steve’s death may also increase awareness and prevention of obesity, so often a factor in the development of type 2 diabetes. 

Steve said, “Be a yardstick of quality. Some people aren’t used to an environment where excellence is expected.” Expect excellence in your health choices and be a yardstick of healthy choices for those in your world. Together we can create an environment where excellence in health is expected and where disease prevention is the norm. 

Thank you, Steve Jobs, for the life lessons you taught us and the gifts and toys you left us with.



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