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What about McCain's melanomas?

Mr. McCain's cancer history dates back to 1993, when surgeons removed a melanoma from his left shoulder. McCain's 2000 presidential bid ended after doctors diagnosed two more melanomas. The cancer on his left arm was considered low risk; however, the lesion on his left temple required extensive surgical treatment, removing both the melanoma and 30 lymph nodes. Pathologists graded the tumor as Stage IIA based on the tumor thickness of 2.2 mm and no evidence of cancer found in the lymph nodes. The most advanced melanoma stage is IV, and the risk of bad outcomes increases with increased stage. In 2002 McCain had a early stage melanoma removed from the left side of his nose.  The public was told that all four melanomas were primary, or new, and that there was no evidence that any had spread. . 

 

However, a reporter's summary of McCain's medical records includes a report from an Armed Force pathologist suggesting that the left temple melanoma may have spread from another melanoma. This raises questions about whether a skin lesion removed from McCain's left temple 1996 was really a benign lesion, as the pathologists reported, or a missed melanoma. If that were the case, Mr. McCain's left temple cancer was not Stage IIA but rather Stage III. If you look at 100 patients with Stage IIA melanoma, 60 are alive at ten years; only 36 out of 100 patients with Stage III are alive 10 years after diagnosis.

 

It has been eight years since Mr. McCain's treatment for his riskiest melanoma. While we hope for the best for him, the risk of recurrence is greater than it would be if he were younger, if the cancer had been on some other part of his body other than his face, or he were female.

 

I will leave the question of the medical experts' limited access to Mr. McCain's medical records and the timing of this disclosure of this information to the political pundits.   While a vote for president always includes the possibility that the vice presidential candidate may some day serve as our president, this medical news released a mere fifteen days before the election has sobering implications. In my opinion as a physician, a vote for McCain now comes with increased odds that Governor Palin will function as our president in the next four years.