McCain's bouts with melanoma


Happy Monday! It’s raining cats and dogs this morning in Austin. Great day to catch up on what’s in the news. Here’s a story that caught my eye about Sen. McCain’s history with cancer and how it’s rarely mentioned publicly or written about much. Of course, most of us at the LAF would welcome it being a more frequent topic – cancer affects 12 million Americans, after all, and touches all of our lives. We’d also love to hear how the Senator plans to step up the fight against cancer. Any of you out there have a chance to ask him, let us know what he says!

Little spoken on the campaign trail: McCain’s bouts with melanoma
By Lawrence K. Altman
Sunday, March 9, 2008.

Along with his signature bright white hair, the most striking aspects of Senator John McCain’s physical appearance are his puffy left cheek and the scar that runs down the back of his neck.

The marks are cosmetic reminders of the melanoma surgery he underwent in August 2000. McCain, the presumed Republican presidential nominee, sometimes tells audiences that he has “more scars than Frankenstein.”

The operation was performed mainly to determine whether the melanoma, a potentially fatal form of skin cancer, had spread from his left temple to a key lymph node in his neck; a preliminary pathology test at the time showed that it had not.

But because such a test cannot be definitive, the surgeons, with McCain’s advance permission, removed the surrounding lymph nodes and part of the parotid gland, which produces saliva, in the same operation, which lasted five and a half hours.

The final pathology analysis showed no evidence of spread of the melanoma, his staff said at the time. McCain, of Arizona, has said he did not need chemotherapy or radiation.

In 1999, during McCain’s first race for president, he gave the public an extraordinary look at his medical history – 1,500 pages of medical and psychiatric records that were amassed as part of a U.S. Navy project to gauge the health of former prisoners of war. This reporter, who is a physician, interviewed the senator’s doctors in 1999 with his permission.

But this time around, McCain has yet to make his full medical records or his physicians available to reporters. At least three times since March 2007, campaign officials have told The New York Times that they would provide the detailed information about his current state of health, but they have not done so. The campaign now says it expects to release the information in April.

So McCain’s prognosis for the recurrence of melanoma can be gauged only by talking to experts not connected with his case. Those experts say his prospects appear favorable.

The melanoma removed in 2000 was Stage IIa on a standard classification that makes Stage IV the most serious. For Stage IIa melanoma, the survival rate 10 years after diagnosis is about 65 percent. But the outlook is much better for patients like McCain, who have already survived more than seven years.

For patients with a melanoma like McCain’s who remained free of the disease for the first five years after diagnosis, the probability of recurrence during the next five years was 14 percent and death 9 percent, a study published in 1992 found.

No spread has been detected in the three or four dermatologic checkups McCain has undergone each year since 2000, stress tests show no evidence of heart disease and “his doctors consider him in very good health,” his campaign staff said in a recent statement.

Even if the melanoma returns, McCain would not be the first sitting president to have had cancer. From what information he has disclosed, he is at increased risk for melanoma and other skin cancers because of his medical history, fair skin and prolonged sun exposure at a young age – long before the wide use of sunscreen.

McCain has had four melanomas. In 1993, he waited more than six months before seeking care after a navy doctor recommended that he consult a dermatologist for a lesion on his left shoulder that turned out to be his first melanoma. It was excised and has not recurred.

Pathology tests showed that the two other melanomas – detected on his upper left arm in 2000 and on his nose in 2002 – were of the least dangerous kind, in situ. In that type the malignant cells are confined to the outer layer of skin.

The most serious melanoma was spotted on his temple in 2000 by the attending physician at the U.S. Capitol after it had escaped the eye of McCain’s personal physician at Mayo Clinic Scottsdale, in Arizona.

Michael Cooper contributed reporting.


  1. Growing up in Arizona like Senator McCain did, I’ve had my bouts with skin cancer. I’ve gotten of lucky with only two case of basal cell carcinoma, and a quick round of chemo drugs, I’ve had enough biopsies for melanoma concerns that I “don’t have enough good hide left to make a decent lampshade” ( ‘Travis McGee’ – as written in a novel by John D. MacDonald).

    I certainly hope Senator McCain will use his experiences to convey to people “sun and skin safety” in the future, and I also hope he take pride in his status as a (multiple time) cancer survivor.

    Cancer is nothing of which to be ashamed. Survivorship is not always easy and Senator McCain is an example for just what a cancer survivor can accomplish.

  2. Brian Dowd says:

    Bravo Michael! I total agree.

  3. Steve Skwarlo says:

    My melanoma was noticed in 1969 on a visit for a different problem. I am thankful Dr. John Howard, a General Practitioner, kept up with published research. He knew what he saw and removed it. I’ve been on ‘cancer watch’ ever since. Early detection resulted in successful treatment of many skin cancers (basal, squamous, Merkel) but no more melanoma.

    I’ve been privileged participate in and support the LAF, LIVESTRONG Challenge, TEAM LIVESTRONG and the Tour of Hope. My representatives in Washington hear from me and the LIVESTRONG Army. I’m grateful for these ways to promote cancer awareness and support research. This is payback for me. Let your voice be heard too!

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