Kara Kennedy was sitting in a doctor's office at Johns Hopkins Hospital with her father, Senator Edward M. Kennedy, when she got the news. Not only did she have cancer of the lung, it was inoperable. The doctor told her she might have less than a year to live.
For Senator Kennedy, the prognosis was unacceptable. Kennedy thanked the doctor and headed out the door. Over the next several days, he feverishly immersed himself in the subject of his daughter's cancer, and ultimately found a Boston surgeon who operated on her. Five years later, she is cancer-free and runs 5 miles a day, her mother said.
"He really saved her life," said Joan B. Kennedy, the senator's former wife and the mother of Kara. "I am so grateful that he is my children's father because he has always gotten them the best medical care."
Long before he was diagnosed with a malignant tumor on his brain, Kennedy had an extraordinary and intimate relationship with cancer. Two of his three children have faced severe forms of the disease, while a third had a noncancerous tumor on his spine. His former wife was also treated for breast cancer in 2005.
But Kennedy, 76, has met his children's cancers head on, arming himself with an arsenal of information and opinion that helped them to vanquish the disease. He has prayed and embraced experimental treatments and sought third opinions, and sometimes more. Many close to the family believe that the same tactics that he employed with his two children, both of whom faced possible death and are now cancer-free, will instruct and fortify him in his own battle against the disease.
"This family has had cancer laid in front of it and each time they have beat it," said Dr. David J. Sugarbaker, chief of thoracic surgery at Brigham and Woman's Hospital, who operated on Kara Kennedy. "They have an insatiable appetite for information and answers. They are looking for victory. That makes all the difference."
John V. Tunney, a former US senator and a close friend of Kennedy's, said that years of dealing with cancer doctors, both for his children and in his Senate work will also help him. "He knows that cancer can be beaten, because he's seen it in his own family time and again. We all hope that will help him in the days ahead."
For Kennedy's three children, cancer has shadowed their lives since Edward Kennedy Jr. lost a leg to bone cancer in 1973 when he was 12 years old. Patrick Kennedy, a Rhode Island congressman, was hospitalized for over a month in 1988, when he was 20, after his tumor was removed. Kara, 48, the oldest of the three children, has a "very good prognosis," according to Joan Kennedy, but she gets frequent check-ups to see that there is no recurrence.
Dr. David S. Rosenthal, former president of the American Cancer Society and the medical director of the Leonard P. Zakim Center for Integrated Therapies at the Dana-Farber Cancer Institute, said that while he is not familiar with the details of the Kennedys' medical history, he considers it "unlikely that the cancers are related." Given the young age at which some of the Kennedys' cancers occurred, and the fact that they were found in different organs, it is unlikely, but not impossible, that there is a common genetic thread linking them.
Kennedy was closely involved with virtually every aspect of his daughter's treatment, which included chemotherapy in Boston and Washington, D.C., according to family confidants. Kennedy and his wife, Victoria Reggie Kennedy, accompanied her to chemotherapy treatments in Washington in the morning. When Kennedy had to head off to the Senate, his wife would typically stay behind. During those days, the senator often stole away to attend Mass.
"The whole time she was in jeopardy, he went and prayed for her every day," said a close family friend who talked on the condition of anonymity.
And every day, he urged her to have faith that she would be all right.
"Kara was always calling me and telling me the great things he was doing for her," said Joan Kennedy, who remains close to her daughter and was with her at the hospital during the surgery. "He was always encouraging her."
Teddy Jr.'s cancer began with a small lump below his knee. The then-seventh-grader presumed it was a bruise from football, but doctors soon discovered that the boy had bone cancer of a sort that, at the time, few survived.
Kennedy Sr. plunged into action. He summoned a group of cancer specialists to his Virginia home where debate over how best to treat the boy went late into the night, according to family and friends. At the time, chemotherapy was still in rudimentary stages and the Kennedys anguished over whether to subject their son to an experimental medication. In the end, Teddy Jr.'s leg was amputated above the knee and he was placed on a two-year regimen of methotrexate, a drug that kills cancer cells. Each infusion was followed by a series of vitamin shots.
Every three weeks, the boy was taken to Boston from Virginia by one of his parents for treatments. The senator would often take his son to Bruins or Celtics games while the teams were in town. He learned how to give his son his shots so that they could leave the hospital earlier, according to Adam Clymer, author of the biography, "Edward M. Kennedy." And some believe Kennedy decided not to run for president in 1976 so that he could see his son through the disease.
"He organized his life to handle this," said Tunney, who is Teddy Jr.'s godfather. "It was the most important thing in his life, to help Teddy be saved. The medication that he got was very new and everyone was deeply, deeply concerned. But Kennedy was the field commander on this. He made up his mind and he never wavered. And he was right."
Ted Jr., now 46 and a healthcare attorney and advocate for the disabled, has been cancer-free ever since. He declined to be interviewed. Clymer said the senator and his son often visit Walter Reed Army Medical Center in Washington and talk to veterans about how to live despite missing limbs.
In Patrick's case, Kennedy took a similarly aggressive approach, according to family and friends. The young Kennedy, then a sophomore at Providence College, was admitted to the hospital after complaining of headaches and back pain. Several days later he underwent surgery to have a benign tumor pressing against his spine removed.
"In the case of each of his children, Kennedy has been completely stoic about it," said Gerard Doherty, former chairman of the state Democratic Party and a longtime friend of Kennedy. "He has a sense that you get good news and bad news in life, and when you get bad news you just go through the valley of tears and come through the other side."
The third diagnosis came in 2002. Kara Kennedy, then 42, was at a routine doctor's visit shortly before Christmas, when it was discovered that she had lung cancer. The family was shocked.
"It was just horrendous," said the family friend. "It was so devastating a diagnosis. In the case of both children, Ted and Kara, they were not given a lot of hope. But Senator Kennedy simply would not accept that they would not find a way to save them and cure them. He was going to beat this."
After considering a number of doctors, Kennedy and his daughter settled on Sugarbaker. In early January 2003, Kara had a portion of her right lung removed.
Two years later, in 2005, Joan Kennedy learned, through a routine mammogram, that she, too, had cancer. Kennedy, then 68, had a lumpectomy and said that her lymph nodes were not involved. She said that Kennedy, from whom she was divorced in 1982, did not help research her treatment options, but that he called her a couple of times to check up on her.
"I am doing great," said Kennedy. "I am really lucky."
Now, the subject of Kennedy's cancer research is himself. As he has in the past, Kennedy, according to those around him, is learning all he can about his tumor and how it might best be treated. He is believed to be researching novel protocols currently in clinical trials. He is expected to reach far and wide in the medical community in seeking opinions. And, as ever, he is reasurring those around him.
"Those of us who love him are having a very difficult time addressing this new reality," said Tunney. "If anybody is handling it well, it is him. He is very positive in his conversations about the future and how he will address the cancer. When you talk to him you just feel better."
Patricia Wen of the Globe Staff contributed to this report.