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Steve Jobs, Visionary Leader of Apple Inc., Dies at 56
Date:10/7/2011

are in New York City.

Patients who have had surgery to remove the tumor, but have had the cancer return, often have the cancer come back in the liver. That is probably why Jobs had a liver transplant, Libutti said.

"My speculation is that the tumor returned after the liver transplant and he succumbed to recurrent disease, that would be my bet," he said.

Pancreatic cancer expert Dr. Craig Devoe, from the department of medicine at North Shore-LIJ Health System in New Hyde Park, N.Y., said that "neuroendocrine tumors are uncommon, with only a few thousand cases a year."

For those that affect the pancreas, the numbers are even lower with fewer than 1,000 cases a year in the United States. In contrast, there are around 40,000 cases of other pancreatic cancers a year, Devoe said.

Dr. David M. Levi, a professor of clinical surgery, liver and GI transplantation at the University of Miami Miller School of Medicine, said neuroendocrine cancer "is an unusual tumor. It can arise in a number of places, including the pancreas." Such tumors can also start in the lungs.

It's one of the few tumors that can benefit -- to some extent -- from a transplant, Levi said. Jobs' cancer started in the pancreas and then spread to the liver, making the liver transplant an option, Levi said, adding he has treated patients with this type of cancer and done liver transplants.

While the prognosis for neuroendocrine cancer is often better than for the more common type of pancreatic cancer, in which patients generally live less than a year after diagnosis, neuroendocrine cancer "can also be bad," Levi said.

Neuroendocrine cancer can return after treatment, Levi explained. And while a liver transplant can be effective, "it is not as great a picture as we first thought," he said. "A lot of these patients who have transplants eventually do recur."

"The vast majority of patients that have recurrent disease will die of their disease. One of the p
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