John McCain Diagnosed With Brain Cancer
Sad news about a Washington stalwart.
Arizona Senator John McCain, who underwent surgery last Friday to remove what was initially described as a blood clot from an area above his left eye, has been diagnosed with an aggressive form of brain cancer that seems likely to keep him out of action for at least several months:
WASHINGTON — Senator John McCain, the 2008 Republican presidential nominee known for his independent streak over more than three decades representing Arizona in the Senate, has brain cancer, his office disclosed Wednesday night in a statement from the Mayo Clinic.
Mr. McCain, 80, has a glioblastoma, one of the most common but also one of the most malignant brain tumors. It can be treated with chemotherapy and radiation, but medical experts said it almost always grows back.
Mr. McCain’s office said he was recuperating at his home in Arizona and “appreciates the outpouring of support he has received over the last few days.”
His office said Mr. McCain would decide when to return to the Senate as he consults with his medical advisers.
Medical experts said the type of tumor Mr. McCain has is particularly aggressive. The median survival of a glioblastoma is about 16 months, said Eugene S. Flamm, chairman of neurosurgery at Montefiore Hospital in the Bronx. Senator Edward M. Kennedy of Massachusetts died in 2009 from the same kind of aggressive brain tumor.
Mr. McCain learned of the tumor after undergoing surgery late last week at the Mayo Clinic Hospital in Phoenix to remove a blood clot above his left eye.
Mr. McCain, the son of a prominent family dedicated to military service, has been in American life since the 1960s. He was the public face of the mistreatment of American prisoners at the North Vietnamese camp known as the Hanoi Hilton, where as a Navy pilot he was confined and tortured for over five years. Decades later, he was the happy-go-lucky captain of the Straight Talk Express, the campaign bus where he cultivated his image as a candid political maverick in his failed 2000 presidential run. He was elected to a sixth Senate term this past November.
Four presidents — Donald J. Trump, Barack Obama, Bill Clinton and the elder George Bush — issued heartfelt statements wishing Mr. McCain a speedy recovery late Wednesday.
“Senator John McCain has always been a fighter,” Mr. Trump said.
Mr. Obama, who defeated Mr. McCain in the 2008 election, called the senator a “hero & one of the bravest fighters I’ve ever known.”
“Cancer doesn’t know what it’s up against,” Mr. Obama tweeted. “Give it hell, John.”
The diagnosis shook the Senate, where Mr. McCain is a popular figure despite his occasionally heated disputes with colleagues in both parties. His illness had implications this week for the health care debate, causing Senator Mitch McConnell, Republican of Kentucky and the majority leader, to postpone a floor fight until Mr. McCain returned to Washington.
“It was very emotional,” said Senator John Hoeven, Republican of North Dakota, who was present. He said finding a solution to the health care impasse was “more challenging without him.”
Mr. McConnell called Mr. McCain a hero to both Senate Republicans and the nation at large.
“He has never shied from a fight, and I know that he will face this challenge with the same extraordinary courage that has characterized his life,” Mr. McConnell said Wednesday night. “We all look forward to seeing this American hero again soon.”
Mr. McCain endured grueling rehabilitation from his time in the prison camp but later led the effort to reconcile with Hanoi in a striking gesture of forgiveness. After quickly becoming prominent as a House member in his first election in 1982, Mr. McCain won the Senate seat given up by the Arizona icon Barry Goldwater in 1986. He became a fixture in the Senate, where he denounced the corrosive effects of big money in political campaigns and was a central player in congressional debates on military policy, immigration and health care.
Wednesday’s disclosure suggested that Mr. McCain’s condition was more serious than initially believed, although the statement said that “he is recovering from his surgery ‘amazingly well,'” according to his doctors, “and his underlying health is excellent.”
(…)
Mr. McCain currently leads the Senate Armed Services Committee and is a top proponent of using military force overseas. The Senate is preparing to take up the annual Pentagon policy measure produced by the committee.
In Congress, he is probably best known for his efforts to champion changes in campaign finance laws over the fierce objections of some of his Republican colleagues, particularly Mr. McConnell.
The standard of care includes surgery to remove as much of the tumor as possible, and then radiation and chemotherapy. In the past, radiation sometimes diminished patients’ brain function, but techniques have improved so that more healthy brain tissue is spared and patients fare better, said Dr. Mitchel S. Berger, a neurosurgeon and glioblastoma expert at the University of California, San Francisco.
Jeff Flake, the junior Republican senator from Arizona, acknowledged the seriousness of Mr. McCain’s diagnosis in a still-hopeful Twitter post. “Tough diagnosis, but even tougher man,” Mr. Flake wrote.
Here’s the statement issued by Senator McCain’s office:
Washington, D.C. - At the request of Senator John McCain (R-AZ) and his family, Mayo Clinic released the following statement today:
“On Friday, July 14, Sen. John McCain underwent a procedure to remove a blood clot from above his left eye at Mayo Clinic Hospital in Phoenix. Subsequent tissue pathology revealed that a primary brain tumor known as a glioblastoma was associated with the blood clot.
“Scanning done since the procedure (a minimally invasive craniotomy with an eyebrow incision) shows that the tissue of concern was completely resected by imaging criteria.
“The Senator and his family are reviewing further treatment options with his Mayo Clinic care team. Treatment options may include a combination of chemotherapy and radiation.
“The Senator’s doctors say he is recovering from his surgery ‘amazingly well’ and his underlying health is excellent.”
The office of Senator John McCain also released the following statement:
“Senator McCain appreciates the outpouring of support he has received over the last few days. He is in good spirits as he continues to recover at home with his family in Arizona. He is grateful to the doctors and staff at Mayo Clinic for their outstanding care, and is confident that any future treatment will be effective. Further consultations with Senator McCain’s Mayo Clinic care team will indicate when he will return to the United States Senate.”
The form of cancer that McCain has been diagnosed with, glioblastoma, can be a particularly aggressive form of cancer that will often prove to be fatal unless it is diagnosed early enough and hasn’t spread to crucial areas of the brain or led to cancer appearing in other parts of the body. It also happens to be the same form of cancer that both former Senator Ted Kennedy and Beau Biden, the son of former Vice-President Joe Biden, were diagnosed with prior to passing away. In both those cases, the diagnosis seems to have come far too late for treatment to have any real impact on the spread of the disease. In Kennedy’s case, for example, the diagnoses came after he suffered a seizure in May 2008 and it led to him undergoing surgery followed by a course of chemotherapy and radiation treatments that had a severe impact on his health. As a result, Kennedy’s appearances back in Washington were limited, although he was able to appear at the Democratic National Convention that year and deliver a speech that he had to memorize since his impaired vision made it difficult to read a teleprompter. Kennedy also continued to push for the adoption of health care reform as Congress pursued that goal in the early years of the Obama Administration. Ultimately, though, Kennedy passed away in August 2009. Hopefully, the course of treatment for Senator McCain, who apparently sought treatment for the pain and other symptoms that led to the discovery of the mass above his left eye that was extracted during last week’s operation, will be more successful. Until treatment begins, though, it’s going to be hard to tell just how successful treatment has been until further testing has done.
As news of the diagnosis spread around Washington and across social media, best wishes for the Senator poured in from a wide variety of quarters, including the men that McCain ran against in 2008 and his running mate in that election:
John McCain is an American hero & one of the bravest fighters I’ve ever known. Cancer doesn’t know what it’s up against. Give it hell, John.
— Barack Obama (@BarackObama) July 20, 2017
John and I have been friends for 40 years. He’s gotten through so much difficulty with so much grace. He is strong – and he will beat this.
— Joe Biden (@JoeBiden) July 20, 2017
Incredible progress in cancer research and treatment in just the last year offers new promise and new hope. You can win this fight, John.
— Joe Biden (@JoeBiden) July 20, 2017
.@SenJohnMcCain‘s patriotism and courage are vital to the nation. With the fearful news tonight, Ann and I pray for his recovery.
— Mitt Romney (@MittRomney) July 20, 2017
John McCain is one tough fighter – we know he’ll face this diagnosis with courage and strength. Our family… https://t.co/XXTUltNGey
— Sarah Palin (@SarahPalinUSA) July 20, 2017
As did McCain’s close friend Senator Lindsey Graham and his daughter Meghan:
Lindsey Graham on John McCain’s brain tumor diagnosis: “This disease has never had a more worthy opponent.” https://t.co/r366D4dHCU pic.twitter.com/R6Vk9usR37
— ABC News (@ABC) July 20, 2017
Statement regarding my father @SenJohnMcCain: pic.twitter.com/SMte9Hkwkq
— Meghan McCain (@MeghanMcCain) July 20, 2017
McCain’s treatment, which already resulted in a delay in the Senate’s consideration of a health care reform bill, is likely to have an impact on that issue going forward as well. Despite recent setbacks, Republicans seem intent on returning to the drawing board and trying to pass some kind of bill before the August recess. With Senator McCain out of action, though, that puts the GOP down one vote and makes it more difficult for any proposal to get to fifty votes even without taking into consideration the number of Senators who have reacted negatively to both of the recent Senate GOP proposals. Those political issues, though, pale in comparison to the fight that Senator McCain has in front of him. As his time as a Prisoner of War demonstrates, John McCain has always been a fighter, though. Now that he once again faces a fight for his life, I’m sure I’m not alone in wishing him the best and hoping that he can beat cancer the same way he beat the horrible conditions of the Hanoi Hilton. Best of luck in this fight, Senator, I’m sure I’m not alone among Americans in hoping you’ll be back to work soon.
Update: As several of the articles that have been written about this diagnosis have noted, this isn’t McCain’s first battle with cancer. As we learned during his runs for President in 2000 and 2008, McCain with diagnosed with and treated for malignant melanoma, a particularly difficult to deal with form of skin cancer. By all accounts, that treatment was successful and there weren’t any reports about cancer reappearing in the intervening 23 years. Thus, it’s unclear if McCain’s previous case of skin cancer has any connection to the brain cancer that last Friday’s surgery revealed. Nonetheless, as NBC News notes in a post about McCain’s current diagnosis, “incidences of gliomas were greater among melanoma cases than in people who had never been diagnosed with skin cancer.” Bill Jempty wrote a piece for OTB about McCain’s bout with the disease during the 2008 campaign.4
Update #2: Senator McCain responded to the messages of support he’s received this morning:
I greatly appreciate the outpouring of support – unfortunately for my sparring partners in Congress, I'll be back soon, so stand-by!
— John McCain (@SenJohnMcCain) July 20, 2017
Amazing irony that McCain’s likely-fatal tumor might be the thing that saves millions of Americans from their untimely death because of a lack of health care coverage.
When I first heard the news, I thought of McCain’s malignant melanoma history. Melanoma often metastasizes to the brain. So far as I know, glioblastoma are not the result of melanoma.
I wrote at OTB in 2008 about McCain’s melanoma history.
https://www.outsidethebeltway.com/mccain_nyt_and_melanoma/
I’ve been diagnosed with 2 more melanomas since.
I stand corrected on the possibility of this being melanoma related
http://www.nbcnews.com/health/cancer/what-glioblastoma-mccain-s-brain-tumor-aggressive-type-cancer-n784681
But it has been some time since McCain last had a melanoma diagnosis and melanoma spreading ten years or more after the last sign of disease is not common. He could have a undetected MM that has spread. Even with constant dermatological follow-up another MM can pop up rather quickly. I go to my derm 3 times a years and I had two more of these diagnosed, one in Nov 2015, the other in May 2016.
I understand the happy talk and wish him well, but this is probably the end for him.
glioblastoma has something like a 14-month median survival rate. 2-year survival rate is ~30%.
It’s a tough way to go. He has my sympathy.
@Tony W:
The Lord works in mysterious ways. For a lot of religious people I know, this is a sign. Prayers went out last night for him and his family, any family that has the same problem but no news coverage and for all who’s hearts have been hardened to see why healthcare needs to be a considered a human right. Church was full of reconsidering souls (well, reconsidering for the night, anyways)
Empathy is a human trait that’s unfortunately blessed by many on those who they care about or happen to be in line of sight. Be well, John McCain even though your diagnosis is grim. May your plight help those who don’t have the ear of the media to be well too.
A wild coincidence that it was Ted Kennedy’s illness that cost the Democrats the 60 vote majority when Obamacare was being passed, and now McCain’s illness hurting the Republican efforts to repeal it…
Very unfortunate, and I do wish him the best of luck.
I am reflecting now on the 2008 election when my biggest concern outside of policy differences was his temperament to be POTUS. I was being silly, though. Compared to Trump, the good Senator has the patience of a saint and the focus of a laser.
Don’t evaluate a hypothetical POTUS by comparison to Trump. Frank Gallagher would be a good POTUS compared to Trump. Dexter Morgan would be a good POTUS compared to Trump.
@KM:
I’m sincerely curious: what kind of sign?
@James Pearce:
Yes, it is. 5 yr survival at only 4%. Even more importantly, outside of a very, very few aggressive responders when they throw the kitchen sink at it he will probably be laid low or somewhat compromised. He professes that he will stay at Mayo Phoenix, but if I am still current the best work is being done at Duke and or MD Andersen.
BTW – to the ghouls. Insurance has nothing to do with it.
@James Pearce:
You probably announce loudly that Christmas is a Pagan holiday, right? 😛
Tom Levenson at Balloon Juice offers sincere best wishes to McCain and his family. And anyone else in McCain’s situation. As do we all. Levenson notes that McCain has relied on the U. S. government for healthcare from his birth to the excellent care he is, as he should be, getting now. Levenson proposes that the Democrats craft a plan that would make the modest fixes needed for Obamacare and expand it to universal health care and name it in honor of McCain.
I’m sure I’ll get comments that that’s cynical and manipulative. Were positions reversed, wouldn’t stop the Republicans for ten seconds.
@Guarneri: I’m not sure what “it” you’re referring to, but insurance has everything to do with what care an individual receives, unless they are extremely wealthy.
Good for John McCain that he has good insurance, with no lifetime limits, and that he is extremely wealthy. He will undoubtably have more treatment options than the vast majority of people.
If he had a modest income and a pre-Obamacare policy on the individual market, he would be pretty screwed. Either he would hit the lifetime cap, or he would find his rates rising to the point where he couldn’t afford it the next time his policy was renewed.
I happen to know someone who was diagnosed with the same type of cancer as McCain more than ten years ago. From the accounts, it appears that McCain’s diagnosis is coming at an earlier stage of tumor development than happened in this case. After surgery, chemo, and radiation, they’ve been cancer-free for more than five years now. While there are some side-effects that I won’t go into, they’re leading a healthy, productive life. Of course, this is someone who was much younger than McCain at the time of the initial diagnosis.
So, survival is possible. But, no, the odds generally are not very good and likely less so given the McCain’s age. He’s going to need all the strength he can manage for this one.
@gVOR08: that is excellent.
I hope that John McCain can fight this, but this is a pretty swift-moving cancer.
The other problem with chemotherapy is that it makes you feel so awful that some people just give up fighting the cancer mentally out of exhaustion. The sister of a friend of mine went that way–she went through the treatments but you could just tell her heart wasn’t in it and that she had given up.
We really do need those nanotech-based treatments to get out of the lab….
@gVOR08: Yes, it’s
I wish the Dems would drop this pandering, self effacing ‘we acknowledge there are problems with the ACA’ formulation and say things like, ‘Obamacare is working pretty well, exceeding CBO estimates, and with a few small tweeks will serve us well for decades.’ It has the advantage of being true.
@Doug Mataconis: 10% of people with glioblastoma survive more than 5 years. Sounds like your friend was one of the lucky few.
@Guarneri:
If he’s staying close to home, it may be for palliative reasons. I hope he’s spending more time with the grandkids and less time listening to doctors.
I wish John McCain all the best for a full recovery (I’m not sure “swift” would be the right word; true recovery is going to take time for an 80-year-old). And I wish every American has the same treatment under the same conditions as an American Senator.
@teve tory: From what has been said, it looks like the major factors are a)at what stage the cancer is discovered, and b) how quickly it is growing. Since cancer of the brain isn’t usually discovered until it’s already been wrecking havoc within the body, this is why a brain cancer diagnosis is usually so lethal.
On the good side, this was discovered totally secondarily to another (easily solved) health issue, so they’ve identified it early in the game. On the bad side, McCain is already in his 80s which can’t help matters.
Keep fighting, John. We’re pulling for you.
@grumpy realist: A good friend of mine died of GBM. He was 34 when it was diagnosed. His wasn’t discovered until he had a seizure, so probably later than McCain’s. My friend lasted about two years, but he wasn’t “himself” for much of that time. And again, he was in his mid-30s, not 80.
The treatment is aggressive and the side effects significant, sometimes debilitating all on their own. I think it’s quite likely McCain will have difficulty carrying out the duties of his office. But we’ll see, maybe he’ll be one of the lucky ones.
@grumpy realist:
This may come across as counter to accepted wisdom, but were I in McCain’s shoes (80 years old, already moving down the health escalator, etc) I would have a very narrow definition of what I would do to fight this. All too often as individuals we don’t think through what it means to “fight to the last gasp” with fatal illnesses. Of course McCain’s family will not be bankrupted by such a fight, but even leaving that aside, we aren’t aware enough of what effect this can have on ourselves and our families.
Before antibiotics a fight to the last gasp didn’t make much difference. As you became weaker you would usually get an infection that put you down relatively quickly. So in fairness, past generations didn’t have to make this choice. But in this day and age mecical interventions can keep us going (in the US, this assumes we have access to health care without bankrupting us) for months, even years, past a pre-antibiotic endpoint.
@MarkedMan:
Having seen, up close, the progression of this cancer in a young person, I think if I were 80 years old and diagnosed, I might just find a doctor in DC willing to help me to the exit.
I see my life as yet another book I have to write. I didn’t control the beginning, but I’ve written the middle and I hope to write the end. Faced with the choice between waiting as a tumor eats my brain, taking apart memory and cognition, perhaps depriving me of control over my own body, I’d rather write ‘the end’ myself.
I’m glad California has a death with dignity law. I don’t know who the whole ‘fight to the last’ notion is supposed to be for, but by age 80 it has to have occurred to Senator McCain that the Reaper is on his way.
What I hope for McCain is that he exits at a time and place, and in a condition, of his own choosing. If he wants to battle till the end, I support that. If he wants to say goodbye while still himself, I support that as well.
@MarkedMan: Can’t speak for KM, but I think of it as the kind of sign that the Baptist denomination that I grew up in got when I was being taught that cancer was a punishment from God for living a sinful life. We believed that right up until the day that the president of our denomination was diagnosed with cancer.
I’m not sure what we’re supposed to suss out from the sign; I’m not even sure that it’s a sign at all, but if people want to treat it as a sign so that they can can set aside their @Bob-like thinking (from a post yesterday), I’m for it.
@Guarneri: I beg to differ on “insurance has nothing to do with it.” The likelyhood of anyone with inadequate insurance receiving care at all in a state that doesn’t have fairly expansive Medicaid programs is quite remote. In fact, I remember what a captain of industry much like I would imagine you to be if I believed any of the shirt you bloviate about yourself told a friend of mine who is in remission with liver and colon cancer: “You’re sure lucky I fired you when I did. Getting cancer while you were on our insurance would have doomed you. You’d have never gotten treatment. Looks like I did you a big favor.”
@Just ‘nutha ig’nint cracker:
Guarneri lives in a fantasy world where the entirety of the safety net is unnecessary. Unless at some point he ends up needing it.
@MarkedMan:
So far it’s been taken as punishment for the GOP’s actions (GOP mind you, not conservatives). Remember, for many McCain was their choice for President not so long ago – to be stricken with this type of cancer on the eve of yet *another* repeal attempt (this one with no fig leaf to cover the screwed) was taken as God’s hand intervening to force some empathy from His flock. Even potential Presidents aren’t safe from His reach. No such thing as coincidences, I guess.
I likened it to a slap upside the head from the Almighty that yeah, healthcare’s kinda necessary and lack of it can kill rather quickly. He’s not happy that His ostensible followers are OK with this happening to people in more dire straights. For once, my irreverence was greeted by a thoughtful pause instead of eyerolls. Tony W was right: this might be enough to sway some stone-cold Trump-supporting minds on how heartless the intent of this bill really is.
If you want to be really disgusted, read what the alt-right is saying about McCain’s cancer.
At this point the only thing I want to do is buy my cute Victorian house, make lace, and use a shotgun on any alt-right idiot who ever comes into my view.
@grumpy realist:
Not gonna lie, that’s how I thought it would go at the service considering some of the….. people…. who attend but surprisingly no one expressed a wish McCain would die or that God was punishing him for essentially going against Trump. In fact, it was the opposite: those who called it a sign of punishment felt it was for being lukewarm in his efforts to stop healthcare repeal and that he was picked because as a past contender, he could have “done something” about all this.
Just goes to show even if God came down personally to lay out the law, 67 different interpretations would be online within the hour with some more hateful then others.
That actually sounds like a good setup for B&B. Arsenic, Lace and Shotgun Shells, checkout’s at 10.
@wr:
That occurred to me. It is pretty ironic.
One difference is their relative level of importance to the whole health-care debate. Kennedy was the friggin’ godfather of Obamacare. He was working on the issue back in the ’70s, originally an advocate of single-payer before concluding the most politically feasible solution was one that made use of the private insurance companies. He was also heavily involved in the Massachusetts plan signed by Mitt Romney. If he had lived and Scott Brown had not scored his upset win in Kennedy’s former seat, Obamacare likely would have been better crafted with fewer of the problems it’s experienced.
McCain, in contrast, has long been a minor player on the issue. While he did float a sort of reform plan during the 2008 campaign (similar to the one Bush ran on in 2004, involving tax credits), I doubt he’d have pursued it had he won. And since Obamacare’s passage, while he hasn’t bravely opposed the repeal efforts he was never at the forefront of them either. As far as the GOP’s current efforts are concerned, he’s just another number.
As Peter Jennings said you are survivor from the moment that you are diagnosed with cancer. I hope that everything goes well for McCain, I’m not happy with anyone dying from cancer.
“…taken as God’s hand intervening to force some empathy from His flock.” I really do wish that I had your ability to see the goodness in my brothers and sisters in the Lord. I just have to be glad that someone can see their goodness because I can’t anymore.
“Here I stand. God help me, there is no other place.”
@Mikey:
I have watched and am still watching a number of the most important people in my life entering their last years. And I realize that quite often, as cognitive ability declines, people become much simpler. Not stupid and certainly not in any way less our loved ones. But they do tend to discard theoretical things like politics and literature and focus more on fundamentals. And (I may get lambasted for saying this, but so be it) as people focus more on these simple and basic things they start to shift from quality of life to simply staying alive. I’ve seen a number of examples but probably the most direct was a relative, a good, practical man who in his sixties wrote a very careful and complete end of life directive outlining the type of care that was acceptable and the type that would extend his life too far past dignity. This directive was very similar to the one on file for me right now. But as he reached his late 70’s and his health declined, he began to worry about that directive more and more, and eventually made sure that all copies of it were destroyed. He ended up dying in a state that the sixty year old self would have regretted.
I think about that for myself. Here in my mid-fifties I’m very clear about what I consider too much care. But what will I think in the 70’s or 80’s? I don’t have any answers in this. My one wish is that we, as a nation, discussed this a lot more. It has become so politicized (Death Camps!) that collectively we have mostly shied away from public discussion.
@MarkedMan: My grandfather died last year, at age 96. He was less and less mobile the past few years, but his mind remained sharp. Even though he was mostly confined to his home, he didn’t seem to mind. He was happy just living. He ended up dying peacefully in his sleep.
On the other hand, my uncle suffered from pancreatic cancer, and when it spread to his other organs and the pain meds quit working he just took them all at once and died on his own terms.
@MarkedMan:
You have no idea how many DNR’s get changed right quick when the diagnosis turns grim. People tend to change their mind when it stops being a piece of theoretical administratia and starts being your own death warrant. The most basic directive of life is to *live*. We quibble about the difference between being alive and quality of life but the fundamental biological instinct is to keep breathing (higher brain functions a plus). We are all instinctively terrified of death – there’s no shame in being afraid of an uncertain and visible uncomfortable prospect.
I once read a line about a man on his way to execution and that he’d spent years coming to terms with it. How the guards were impressed with his poise and calm, letting himself be strapped into the guillotine with no fuss. It was only as the blade was coming down and it hit him that this was IT that he screamed and panicked. For all the proceeding calm, it’s the last few moments that strike home the utter finality of it all.
@KM: KM, if I could ask, have you seen this about DNR’s first hand? After watching my father’s long and drawn out decline I was half tempted to get DNR tattooed to my forehead…