Five and a half years in the Hanoi Hilton is not good for your skin. Blistering sunburns, particularly in the blue-eyed and fair of skin, are a risk factor for melanoma as well as for the less dangerous squamous and basal cell skin cancers that the presidential candidate John McCain has experienced on his face, left arm, and shoulder. The information released today by Mayo Clinic doctors at his request indicates that each time the tumors have been detected early, removed successfully, and shown no evidence of recurrence.
His doctors deem him to be cancer-free. However, the melanoma resected from his left temple in August of 2000 was invasive—or, technically, malignant—which poses some future risk. But this is a risk that, his doctors have pointed out, has diminished over time and is quite small. To be safe, his doctors did an extensive resection of local tissue and 33 lymph nodes surrounding the melanoma on his temple, and there was no sign of tumor spread. But the procedure left him with a readily visible scar on the side of his face—which he frequently jokes about when he describes himself as old as dirt and with scars to prove it.
He may be old but, relatively speaking, 71 is not nearly as old as it used to be. He also seems to have great genes if one looks at his robust, 96-year-old mother.
More important, the thousands of pages of medical records released by the senator, including ones that go back to his years in the military that he released in December 1999, make him undoubtedly the presidential candidate who has exposed more about his mental and physical well-being than any other in the history of the republic.
In the disclosures are numerous details of his life as a patient that most Americans can relate to—though many may feel that it is more than they really care to know. He has had kidney stones and a few benign kidney cysts. He had some enlargement of his prostate, but it was treated surgically, leaving him with a perfectly normal urinary stream. He has regular colonoscopies and has had benign polyps removed on two occasions. His heart is strong and fit, and he keeps it that way by sticking to a heart-healthy regimen that includes a daily dose of aspirin and a statin. The blood vessels to his brain are clear, and a CT scan of his lungs is normal.
McCain's time as a Navy pilot speaks to other scars in his body in the form of healed fractures in both arms and a leg, sustained when his plane was shot down during the Vietnam War. Not receiving the best care as a prisoner of war in Hanoi, and receiving fractures of both shoulders from torture, he is left with some restriction in movement of his arms and left knee, but happily no bone or joint pain.
In a telephone news conference, McCain's three Mayo Clinic doctors took questions that delved into a range of issues, including his occasional dizziness when he gets out of a chair quickly, the smoking habit he kicked a while back, and his prostate-specific antigen levels (which are normal).
His skin, and in particular the malignant melanoma removed almost eight years ago, got the most attention. McCain's doctors, including dermatologist Suzanne Connolly and surgeon Michael Hinni, reiterated his good prognosis. While acknowledging that no one has a crystal ball, they said it was unlikely that that tumor would ever recur. When pressed for a number, his doctors rightly stated that statistics are population tools that don't mean much for any one patient. With that caveat, Connolly said the chance of a recurrent problem was in the single digits.
I must say I was most impressed by the details of the disclosures and the frankness of his doctors in response to all questions from the media. In the process, McCain has shown himself to be an unusually open and sturdy fellow and, as his internist, Dr. John Eckstein, said, blessed with excellent mental and physical health and more than fit to serve this nation as president with the greatest of vigor and energy.