Judging from what we see of Jobs in the media and other reports about his physical appearance—especially those emphasizing his "gaunt" appearance in the past few years—help us glean anything about what current health challenges he might be facing?
He's always looked very thin to me. He's a lot more gaunt than I am.
Some people are suggesting that as part of his 2004 cancer treatment he had a so-called Whipple operation (in which parts of the bile duct, pancreas, stomach and small intestine are removed). Would that procedure explain some of the possible complications he might be facing now?
I only know from what I've read, but my understanding is that his pancreatic cancer resection was not a Whipple. Now it doesn't really matter, and the bottom line is that it shouldn't have any affect on his transplant. If he had had a Whipple it would have made the initial transplant more difficult, but it shouldn't be making a difference now.
Are there other ways Jobs' liver health might have been affected by his bout with pancreatic cancer?
First, when health care providers say "pancreatic cancer," they generally refer to adenocarcinoma—which is not what he had. We don't do liver transplants for metastatic adenocarcinoma of the pancreas. There are thousands of people every year who have metastatic adenocarcinoma. Because of the high-profile cases, people think they can have a transplant for that, and that the reason centers are turning them down is because they are not Steve Jobs. That is not the situation at all. He had what is called a neuroendocrine tumor, more specifically an insulinoma. And based on the biology and presentation—those that are metastatic only to the liver—only those are suitable for transplantation. He developed metastasis in his liver—and only in his liver—and that was able to justify transplantation.
Given what we know about liver transplants and their success rate in neuroendocrine pancreatic cancer patients, is there any way to speculate about what we might expect to see for Jobs's health in the near future?
It's impossible to know what we're going to see down the road when we don't know what the issue is. Some of the potential complications won't affect your ability to work, and some of them will.