I am a physician and I have actually performed a few Whipple procedures in my training. I can say that upon reading this letter, I immediately smelled big-time BS.
There are some treatable medical causes of cachexia (profound weight loss) but they are not difficult to diagnosis. If he had pancreatic insufficiency following his pancreas resection, this should have been quickly noted because it is common and his newfound symptoms of diabetes are easily recognized.
Hyperthyroidism is another cause of weight loss, but any doctor worth his salt would have screened for this right away. Celiac disease is another possibility but again this is not a difficult diagnosis because of the GI symptoms (lots of diarrhea).
The most likely cause of weight loss in this setting is cancer, cancer, and cancer. It can sometimes be very difficult to find where exactly the cancer metastases have recurred, and this can delay the proper diagnosis.
The main thing that Jobs has going for him is that this weight loss was first publicly noted some time ago now, and he does not have other signs of cancer that we know of. Jobs does not seem to be the type to hide it if he knew he had cancer. At least, he didn't hide it the first time, right?
shellac.