Apple’s Jobs Said to Be Considering Liver Transplant By Connie Guglielmo, John Lauerman and Dina Bass
Jan. 16 (Bloomberg) -- Apple Inc. Chief Executive Officer Steve Jobs is considering a liver transplant as a result of complications after treatment for pancreatic cancer in 2004, according to people who are monitoring his illness.
Patients with Jobs’s condition can survive for 20 years or more from the time of their original cancer diagnosis, and the surgery often gives good results, said Steven Brower, professor and chairman of surgery at Mercer University School of Medicine in Savannah, Georgia. Brower hasn’t treated Jobs and doesn’t know details of his condition.
Jobs, who appeared increasingly thin and frail throughout 2008, hasn’t provided details about his condition. In a statement released Jan. 5, Jobs said he was suffering from a “hormone imbalance” and that the remedy for his weight loss was “relatively simple.” On Jan. 14, he announced that he was taking a five-month medical leave because his health issues were “more complex” than he originally thought.
In a telephone interview today, Jobs said he won’t comment further on his health.
“Why don’t you guys leave me alone -- why is this important?” Jobs said.
Apple spokesman Steve Dowling declined to comment. The company’s board members -- including Intuit Inc. Chairman Bill Campbell, former U.S. Vice President Al Gore and Google Inc. CEO Eric Schmidt -- either couldn’t be reached or declined to comment.
Private Matter
Apple didn’t comment in detail on Jobs’s health last year, saying it was a private matter. In June, after his appearance at an Apple developers’ conference renewed concern among investors that his cancer had returned, the company said only that Jobs, 53, was suffering from a “common bug.”
Apple, based in Cupertino, California, fell $1.05 to $82.33 at 4 p.m. New York time today in Nasdaq Stock Market trading. The shares lost 57 percent last year.
Jobs, who co-founded Apple in 1976 and returned in 1997, transformed the company by updating the Mac with sleeker and thinner models, including the iMac in 1998 and the ultra-thin MacBook Air notebook last year. His focus on stylish and simple- to-use gadgets won over millions of buyers, turning the iPod media player and iPhone handset into best sellers.
Surgery
Jobs said in 2004 that he underwent surgery to remove a neuroendocrine islet cell tumor, a rare, slow-growing type of cancer that affects as many as 3,000 people in the U.S. annually. These tumors are distinguished by their tendency to overproduce hormones such as insulin. Excess hormones can lead to low blood sugar, low blood pressure or other symptoms.
Neuroendocrine tumors that originate in the pancreas, as Jobs’s did, often spread to the liver. One option doctors have in these cases is to perform a liver transplant, Brower said.
“It’s one of the tumors for which transplantation can be considered,” said Brower, who is a member of the American Society of Clinical Oncology. “It’s rare, but it’s sometimes done.”
Jobs underwent extensive abdominal surgery when his tumor first appeared. He may have undergone a Whipple procedure, in which parts of his pancreas, small intestine, stomach and bile duct would have been removed, to try to rid his body of all cancerous tissue. The pancreas often ceases functioning after such surgery and needs to be removed.
Treatment Outcome
Brower said the transplant might work out well in a patient whose neuroendocrine cancer began in the pancreas, in part because this tumor type often spreads only to the liver and grows so slowly. Even after having had a Whipple procedure, a patient might expect to have good quality of life, he said.
“The outcome can be quite good,” he said. “With immunosuppressive drugs, the patient can expect to have a significant, durable life expectancy.”
Some liver transplant patients get part of an organ from a living donor. After the operation, the livers of the donor and recipient grow back to normal size.
A patient getting a liver transplant for a neuroendocrine tumor that has spread from the pancreas might get a partial organ, Brower said. Complete organs that come from cadavers are in short supply, and are generally reserved for patients with liver failure, cirrhosis or certain kinds of liver cancer, he said.
Companies have a requirement to clear up any misleading information on a CEO’s health, said Stanley Sporkin, a former federal judge and U.S. Securities and Exchange Commission enforcement director. While the SEC doesn’t require a company to disclose health information, the company still should, he said.
Informing Shareholders
“The company almost has a duty or responsibility not to let the company be run by rumors,” Sporkin said. Informing shareholders is good corporate governance, while failing to do so may open the company up to insider trading, he said.
A shareholder suit related to Apple’s disclosures about Jobs’s health would be difficult, said Mark Molumphy, who represented investors in a lawsuit that claimed Apple executives lied to shareholders about backdated option awards. Apple settled the suit in September.
“Someone would probably have a good argument that this information is material,” Molumphy said. “The hard part would be to show that the board or company officers withheld information on his true health condition. How do you prove what his true health condition is?”
To contact the reporters on this story: Connie Guglielmo in San Francisco at cguglielmo1@bloomberg.net; John Lauerman in Boston at rgale5@bloomberg.net. Dina Bass in Seattle at dbass2@bloomberg.net;
Last Updated: January 16, 2009 16:28 EST
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