John McCain Diagnosed With Brain Tumor

Longtime Arizona senator and former presidential candidate John McCain has been diagnosed with primary glioblastoma, a malignant form of brain cancer.  Senator McCain’s office said the diagnosis came after McCain had surgery last week to remove a blood clot above his left eye at the Mayo Clinic in Phoenix, Arizona. Lab results from the surgery confirmed the presence of glioblastoma.

McCain is reportedly weighing whether to undergo an aggressive treatment of radiation and chemotherapy, and has not said when he might return to Capitol Hill. Glioblastoma is the most common of all malignant brain tumors, representing 15.4% of all primary brain tumors, according to the American  Brain Tumor Association (ABTA), who estimate there will be over 12,000 cases before the end of 2017.

With the permission of McCain’s family, CNN’s Chief Medical Correspondent Dr. Sanjay Gupta spoke to doctors involved in the senator’s care.  Gupta learned McCain had felt tired over the last few months and had a bout of double vision, but blamed it on his intense travel schedule.  Doctors ordered a CAT scan and an MRI scan of McCain’s brain that revealed the tumor.

The symptoms of glioblastoma are usually a result of increased pressure on the brain.  The ABTA lists headaches, nausea, vomiting and drowsiness as symptoms for the tumor. Depending on where the tumor is, however, weakness on one side of the body, memory and speech difficulties and visual changes can all be developed as a result.

The ABTA labels the prognosis for glioblastoma survival in terms of median survival — the length of time at which an equal number of patients do better and an equal number of patients do worse. Depending on the type of glioblastoma and treatment used, this can range from 14 months to three years.  The association also cites a 2009 study that found 10% of patients with glioblastoma may live five years or longer.  The average survival time for malignant glioblastoma is around 14 months with treatment.

There is no specific treatment used for glioblastoma but there are a few different approaches doctors can take.   Gupta said “This is a malignant cancer, what that means in this case is that you operate on this,” “It needs to be treated as well with chemotherapy and radiation.”

When a cancer is malignant, cells are dividing uncontrollably and can invade nearby tissues. The cancer cells may also spread to other parts of the body through the blood stream or lymph system in the body.  Gupta added because of the nature of the tumor, McCain will likely need more procedures in the coming weeks.  “The concern is that it will come back. That’s the big concern with these types of tumors,” he said. “In order to try to give him the best chance at that, it is likely he’ll undergo further treatments over the next several days.”

McCain’s cancer is the same form that claimed the lives of Senator Ted Kennedy and Vice President Joe Biden’s son, Beau Biden.   This is not McCain’s first battle with cancer; in 2000 he underwent a procedure to remove a type of skin cancer called melanoma from the left side of his face.  McCain, 80, also had a melanoma removed from his left arm in 2000 and another removed from his nose in 2002. Both were determined to be the least dangerous types of melanoma.