USA TODAY International Edition
After year with cancer, what’s next for McCain?
Return to Senate seems unlikely as he endures treatment
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 anniversary suggests he may have a lessaggressive form of this deadly cancer, known as glioblastoma.
But it also could mean he is approaching the outer limits those with more serious forms can live.
McCain, 81, and those closest to him have not publicly revealed his longterm medical prognosis. His wife, Cindy McCain, in a statement to The Arizona Republic, thanked the medical professionals at Mayo Clinic in Arizona and the National Institutes of Health and Walter Reed National Military Medical Center, 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.”
McCain had emergency surgery on July 14, 2017, to remove a brain tumor. Five days later, his office said 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. There, he occasionally weighs in on policy and media reports via Twitter, issues statements and receives staff briefings. However, McCain cannot cast Senate votes by proxy or in absentia.
McCain’s prolonged absence has not doomed the Republican agenda, but has complicated the party’s path for a reliable majority. His extended absence also has put front-and-center the question of whether he even could return to the floor given his age, frailty, and the cold, hard reality of his illness. 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.
But 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 terms of what’s behind them and what’s ahead of them.”
It is unclear what type of medical care McCain is receiving.
The last health update from McCain’s office was in April, when he had surgery at the Mayo Clinic to treat an intestinal infection related to diverticulitis. At the time, his office said he was in stable condition and undergoing physical therapy at home as he recovered from the side effects of cancer treatment.
Since then, his daughter Meghan McCain has said he is doing well and has offered glimpses into his life through social media posts, talk-show commentary and interviews.
When he is up to it, McCain greets old friends who travel to see him. Visitors have included longtime local friends, current and former U.S. senators, former Vice President Joe Biden and various staffers from his decades of public service.
Experts say it is common for people with brain cancer, and their families, to reassess priorities and how they spend their days.
“They are more thoughtful about the time they spend with each other,” said Leticia Terry, the American Brain Tumor Association’s director of programs and outreach.
In his own words, McCain seems to be coming to terms with what lies ahead. “
My predicament is, well, rather unpredictable,” McCain wrote in his political memoir this year. “A fight not joined is a fight not enjoyed, and I wouldn’t mind another scrap or two for a good cause before I’m a memory.
“Who knows, maybe I’ll get another round. And maybe I won’t. So be it.”
“I don’t know if he’ll return to the Senate. The odds seem to be against it.”
J. “Jack” Pitney Jr. Claremont McKenna College political scientist