After a year with cancer, what’s next?
Observers unsure on McCain prognosis, his return to D.C.
One year has passed since U.S. Sen. John McCain was diagnosed with a type of aggressive brain cancer that remains incredibly difficult to halt.
It is a mysterious — and complicated — milestone. To some medical experts who do not treat McCain, the one-year mark suggests he may have a less aggressive form of this deadly cancer, known as glioblastoma.
But it also could mean he is approaching the outer limits of what those with more serious forms can survive.
McCain, 81, and those closest to him have not publicly revealed his long-term medical prognosis, but Cindy McCain, in a lengthy statement Thursday to The Arizona Republic, thanked the medical professionals at the Mayo Clinic in Arizona; the National Institutes of Health and Walter Reed National Military Medical Center in the Washington, D.C., area; and the caregivers working with McCain at his family’s Cornville retreat “for their superb care of John, and their amazing efforts
to treat this terrible disease and its effects.”
“That he is still with us one eventful year later, still working at getting stronger, still engaged in the life of his family and our country, is as much a testament to their dedication, skill, and compassion as it is to his fighting spirit,” Cindy McCain said. “Thank you from the bottom of our hearts.”
Cindy McCain went on to praise those “working diligently on many fronts and with encouraging results to find a cure for this disease” and to thank “our friends, John’s colleagues, and the thousands and thousands of Arizonans, Americans and people of good will on every continent, who have called and written to offer their assistance, their encouragement and their love for John.”
To those “many generous souls, many of them strangers to us” who have shown the McCain family “such concern and decency,” she added: “Thank you. You are in our hearts forever.”
McCain had emergency surgery on July 14, 2017, to remove a brain tumor. On July 19, 2017, his office revealed that the tumor was associated with glioblastoma.
McCain has not set foot in Washington, D.C., since December. He continues his Senate duties as much as he can from his family home in northern Arizona, 2,200 miles away from Washington, Cindy McCain watches her husband, Sen. John McCain, as he meets with the editorial board of The Arizona Republic in downtown Phoenix on Aug. 3, 2017. D.C. There, he occasionally weighs in on policy and media reports via Twitter, issues official written statements as he deems necessary, and receives staff briefings. However, McCain cannot cast Senate votes by proxy or in absentia.
McCain’s prolonged absence from Capitol Hill has not ultimately doomed the Republican agenda, but it has complicated the party’s path for a reliable majority. His extended absence has also put front and center the question of whether he even could return to the floor given his age, his frailty and the cold, hard reality of the illness that he has battled.
The median survival time for glioblastoma patients who have surgery and standard treatment is 15 to 16 months.
“Most people, on the one hand, pray for a miracle, (but) on the other hand, know that miracles are rare,” said John J. “Jack” Pitney Jr., a political scientist at Claremont McKenna College in Southern California. “I don’t know if he’ll return to the Senate. The odds seem to be against it.”
And most politicians “don’t act like they believe in miracles. There’s a lot of maneuvering going on in the expectation that he won’t return,” Pitney added, particularly during vote counts. “They’re assuming he is going to be absent from the Senate.”
Medically speaking, it is positive for any glioblastoma patient to survive a year, said Nader Sanai, a neurosurgeon at Barrow Neurological Institute.
“When you reach that threshold, it suggests the tumor itself is not amongst the most aggressive subtypes of glioblastoma that we see,” he said.
Brain-cancer patients face many challenges when they embark on their second year of treatment.
Drugs that worked during the first months or year may become less effective as malignant cells adapt and attack.
Aside from the tumor, patients must withstand the ravaging side effects of treatment, which leaves them, among other things, emotionally and physically fatigued.
“In our experience, different patients engage the challenge in different ways,” Sanai said. “For some patients, the logical step is to not change anything in their lifestyle.
“For other patients, it’s really a pivot point where a lot is changed deliberately to enhance quality of life. … Everyone is different in where they are at in life, in