Medical experts said Monday that Steve Jobs' health problems may be linked to his prior surgery for pancreatic cancer, and are probably treatable, just as Jobs said.
Dogged by rumors of ill health, Jobs released an open letter on Monday saying he has a "nutritional problem" and hopes to regain his weight by spring. He did not mention his previous bout with cancer.
Without more specific information about Jobs' medical history, medical experts - none of them involved in his care - said they can only speculate about what might be causing his gaunt appearance. But they said pancreatic surgery patients sometimes do suffer such weight loss and have been been successfully treated with oral supplements.
Jobs underwent surgery for pancreatic cancer in 2004 and has grown thin in recent months, fueling concern about the future of the strong-willed leader and his ability to continue successfully leading the company.
Doctors have finally determined the cause of his mysterious weight loss, Jobs said, citing a "hormone imbalance that has been 'robbing' me of the proteins my body needs to be healthy." Jobs said treatment is relatively straightforward, but declined to identify his condition.
"There are probably 30 different disorders that can cause malabsorption, and some of them could be related to cancer or treatment," said Dr. Margaret Tempero, a pancreatic cancer specialist at University of California-San Francisco.
But given Jobs' history of a rare form of pancreatic cancer, called islet cell neuroendocrine tumor, experts said his weight loss is likely related to the cancer or its treatment.
"I think it would be misleading for anybody to conclude that this is just an isolated hormone imbalance leading to a nutritional disorder," said Dr. Jeff Mechanick, chair of the nutrition committee of the American Association of Clinical Endocrinologists and clinical professor at Mount Sinai in New York.
More likely, Mechanick said, Jobs' weight loss is due to complications from his prior surgery. Such complications may occur years later.
A healthy pancreas is critical to proper digestion, producing hormones and secreting digestive enzymes that break down fats, proteins, and carbohydrates.
Removing a pancreatic tumor involves taking out part of the pancreas, bile duct and small intestine, and such a major surgery often leaves patients less able to absorb nutrients.
In addition, surgery can cause adhesions, or "kinks," in the intestine. If a part of the intestine gets blocked off, too many bacteria can grow in the tube and lead to a syndrome called "malabsorption," similar to the condition Jobs describes in his letter.
A recurrence or progression of Jobs' cancer could also cause inability to absorb nutrients, doctors said. Islet cell tumors are known to produce hormones that can produce a wasting syndrome.
However, since Jobs said he expects to regain weight by spring, it's conceivable that his weight problems are a result of surgery instead of a recurrence of the tumor, said Simon Lo, director of the pancreatic diseases program at Cedars-Sinai Medical Center in Los Angeles.
Jobs is reportedly a vegetarian, but doctors said his diet alone was unlikely to be responsible for the dramatic weight loss.
Depending on what's causing his weight loss, doctors said Jobs could potentially recover by spring with proper nutrition and pancreatic enzyme supplements.
"If it's just an issue of malabsorption and he needed to just adjust his diet and get healthy," Mechanick said, "this could be reversible and he should enjoy a recovery."
By Hadley Leggett and Lisa M. Krieger
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