McCAIN'S CANCER

by Alexander Cockburn

Among the many travails of John McCain's faltering bid for the presidency is the semi-stifled suspicion that his chances of lasting through a four-year term are not rosy. Officially, the Obama campaign has distanced itself from allegations that McCain might be a lot sicker than he lets on. Supporters have been less restrained in suggesting that The Reaper is but a step behind the 72-year-old senator from Arizona.

In the past 15 years, John McCain has had four melanomas removed. The most dangerous was the one taken from his temple in 2000, classified by his doctors as an invasive melanoma, Stage IIA, on a standard scale that makes Stage IV the most serious. The 2000 surgery left McCain not only with a puffy jaw but also with a scar down his neck. Back in May, the McCain campaign sought to dispel concerns about McCain's health by permitting severely limited inspection of his medical records, plus a carefully controlled press conference with his doctors at the Mayo Clinic in Arizona. "Many questions," declared Dr. John Eckstein, "have been asked about the removal of the invasive melanoma from Sen. McCain's left lower temple in August 2000. To summarize, no evidence of metastasis or recurrence of the invasive melanoma as we approach the eighth anniversary of that operation." The press conference received relatively upbeat treatment. For Stage IIA melanoma, the survival rate 10 years after diagnosis is about 65 percent. But the outlook is much better, as McCain's doctors noted, for patients who have already survived more than seven years.

Reporters did note that two pathologists at the Armed Forces Institute of Pathology who examined the melanoma specimen from McCain's left temple in 2000 suggested there were two melanomas on his temple, not one, as his doctors had said publicly at the time. The two said it was unclear whether the melanoma on McCain's temple had metastasized from another or whether there was one new primary melanoma. For stage IIA melanoma, the survival rate 10 years after diagnosis is about 65 percent. But metastasis would mean a Stage III reclassification, which would nearly halve McCain's statistical odds for survival at 10 years.

"What people don't seem to get about this cancer," Lori Klaidman, a medical researcher into melanoma, tells me, "is that ... his chances of surviving to 10 years at Stage IIA were 64 percent. But nearly 10 years have past since the year 2000, since that diagnosis. It is much lower now. It might it be more like 50 percent survival to the end of his first potential term. Further, the minute those melanoma cells migrate to a lymph node, his chances for survival are anywhere from 15 to 63 percent." There have been an unconfirmed allegations of just such a metastasis, claiming that in a recent cancer checkup, which allegedly took place at John Wayne Cancer Institute in California, McCain was diagnosed with a melanoma recurrence, with a metastasis to the lymph node.

An East Coast oncologist says of John Wayne Cancer Institute in Santa Monica, Calif., "That would be the place he'd go because the world's expert surgeon for melanoma, Donald Morton, is there." Morton, while he was head of surgical oncology at UCLA, developed a technique that minimizes the number of lymph nodes that must be removed during biopsies.

A Los Angeles radiologist put the question of McCain being treated directly to two colleagues at John Wayne. "They said no, but I had the strong impression they weren't being forthright. I've known these guys 30 years, and I sensed from their tone that they weren't leveling with me."

In his last debate McCain did not look good. Commended last May by Eckstein for his "extraordinary energy," McCain has mostly limited himself in recent weeks to one event a day.

So, in the increasingly unlikely event of a McCain-Palin victory, the inexperienced governor of Alaska could face a 50-50 chance of succeeding McCain within four years. This prospect may be playing a role in some voters' decisions.

Though she has declined to release her health records, Gov. Sarah Palin appears to be in exuberant health. In May, Barack Obama released a one-page, undated statement by his doctor that he's in "excellent" health. On the Democratic ticket, it's the 65-year-old vice presidential candidate, Sen. Joseph Biden, whose health may be precarious.

Twenty years ago, Biden collapsed in a hotel room. He was rushed to a hospital, and a priest gave the last rites to the Roman Catholic senator. He had emergency surgery for an aneurysm in an artery that was leaking blood into his brain. A day later, he had elective surgery for a second aneurism. It's not known whether Biden has had any neuroscans in recent years.

The actual health of a presidential candidate, let alone a sitting president, usually remains secluded from journalistic inquiry. Often, the press is complicit in such cover-ups.

Examples in American history include President Woodrow Wilson's secret status as a stricken stroke victim, with his wife dispensing his supposed orders; the rapid decline of FDR in his final months; and Jack Kennedy's severely compromized physical condition, held secret till after his death.

In July 1985, President Ronald Reagan underwent an operation to remove a cancerous tissue from his colon. The existence of this condition was known but concealed during the 1984 election. We know now that Ronald Reagan was well into the foothills of senile dementia in his second term and his aides were secretly debating whether to activate the stipulations of the 25th Amendment and lead him away. At the time, members of the White House press corps were coy about alerting the public to the fact that the commander in chief was not firing evenly on all cylinders. To be fair, Reagan evinced confusion for many years, so it may have been hard to judge when he had conclusively retreated from the real world.