Tuesday, September 16, 2008

The world's best-known melanoma survivor

John McCain may be the world’s best-known melanoma survivor, but he doesn’t blog about his health. That gives me hope that I may yet catch him. In fact, McCain and his campaign strategists go to great lengths to communicate that for a 72-year-old man, he’s fit and healthy. I guess if I was running for president I’d try to avoid looking or acting like a “cancer victim” too. It’s a lousy career move.

Some people in the melanoma community are critical of McCain, however, for not speaking out about his cancer and warning people to protect themselves against UV radiation. He is known to slather on the SPF30 while on the campaign trail, and is usually seen wearing a baseball cap. Unfortunately, most sunscreen lotions are pretty useless in preventing melanoma. And to really be effective, a hat should have a brim wide enough to cover all of the face and neck. McCain reflects the public’s continued denial that melanoma is shockingly common and that it can be deadly. Should he win the election, you can be sure the silence about his cancer history will continue.

The CDC places an American’s lifetime risk of contracting melanoma at 1 in 32. More than 8000 people will die of the disease this year. In addition to McCain, other famous people who have battled melanoma include Troy Aikman, Sam Donaldson and Anderson Cooper. Tony Snow, the former White House press secretary, died a couple of months ago of melanoma. Bob Marley and Maureen Reagan are also famous victims.

Despite having had four melanomas, McCain is one of the lucky few. His first cancerous mole was removed from his left shoulder in 1993. Then in 2000, a wide but relatively shallow melanoma was removed from his left temple. Even though a procedure called a sentinel node biopsy showed that cancer cells hadn’t spread to the most likely lymph node in his neck, McCain and his doctors decided at that time to remove all nodes in the region and part of the parotid gland. He now bears the cosmetic reminders of that aggressive surgery—the puffy left check and the scar that runs down the back of his neck. No cancer was found in any of the tissue.

McCain has subsequently had relatively minor (in situ) melanomas removed from his left arm and nose. He will occasionally joke that he has “more scars than Frankenstein.” That’s not a line the Obama camp has chosen to pick up for its ads.

Based on what’s known publicly, and on the opinion of leading oncologists, McCain’s odds of dying from melanoma are not great. He was staged IIa at the time of his surgery, which gave him a 35% chance of dying from melanoma within 10 years. Now, after 8 years, his odds are much improved: only a 10% chance. Melanoma is notoriously fickle, of course, and no one who has been diagnosed with melanoma is ever “in remission.” There is no cure. Just the same, given where he’s been, McCain has done well to survive and to be as healthy as he is. His history of cancer does not disqualify him from the presidency.

It was several years after Bob Dole lost the race for president in 1996 that he appeared in TV ads for Viagra. That was just plain stupid. If McCain loses to Obama in November, we can hope that he puts his political fame to better use and assist a national campaign against a disease that nearly claimed his life.

1 comment:

Tom Hess said...

Excellent essay and conclusion! Interferon must make you a better writer!