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Medical records state McCain fit, cancer-free

Health disclosure meant to quell concerns of age

Email|Print|Single Page| Text size + By Susan Milligan and Stephen Smith
Globe Staff / May 24, 2008

WASHINGTON - Senator John McCain, hoping to become the oldest man inaugurated as president, is cancer-free and in general good health, according to medical records his campaign released yesterday and testimonials by his doctors.

McCain, who has survived four cases of melanoma, has not had a recurrence of the skin cancer since his last melanoma was removed in 2002, said his Mayo Clinic dermatologist, Dr. Suzanne M. Connolly.

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While McCain has minor ailments not uncommon for a 71-year-old man - such as a prior case of enlarged prostate - the senator is in good cardiovascular shape and is fit to contend with the rigors of the Oval Office, said Dr. John D. Eckstein, an internal medicine specialist at the Mayo Clinic in Arizona who has treated McCain for 16 years.

"While it is impossible to predict any person's future health, today I can find no medical reason or problems that would preclude Senator McCain from fulfilling all the duties and obligations of president of the United States," Eckstein said.

The release of eight years of McCain's medical history was meant to allay any fears among voters that he is not prepared to handle the physical de mands of the job. It is the most detail he has disclosed about his health since 1999, when during his first run for president he released 1,500 pages of medical and psychiatric records to address concerns about lasting damage from his 5 1/2 years as a prisoner of war in Vietnam.

The campaign choreographed the release of the records: it posted a summary online, organized a conference call with McCain's doctors, and gave a select group of reporters three hours to pore over records in Arizona, but not make photocopies.

The information disclosed yesterday indicated that McCain has no looming health problems. There is a "single digit" percentage chance that his cancer will return, Connolly said. His other health issues - such as elevated cholesterol levels, for which the senator takes medication - are minor, his doctors said

Eckstein described McCain as having "extraordinary energy" and rejected the notion that McCain's age could be a medical impediment. "Age should not be a limiting factor in this day and age," Eckstein told reporters.

But the senator's age - especially in comparison to the relative youth of his expected general election opponent, Senator Barack Obama, who turns 47 in August and plans to release his medical records next week - could be an issue in the campaign, according to political analysts. With Obama pushing the message of change, McCain's age may underscore his longevity in a Washington political system Obama pledges to shake up, they said.

"I do think when people see the two of them standing there [during a debate], there will be a striking contrast between the way Obama looks and the way McCain looks - for Obama talking about the future and looking like the future, and for McCain to talk any way about the past . . . will hurt him," said Tad Devine, a Democratic consultant not working for a presidential candidate.

Stephen Hess, a political analyst with the nonpartisan Brookings Institution, noted the powerful image in 1992 of Bill Clinton and Al Gore - then in their mid-40s - as they campaigned on a message of newness and youth. But McCain's maturity could also work as an advantage, he said.

"Change is not automatically a winning ticket," Hess said.

Candidates have come under increasing pressure to release detailed medical records to prove their fitness for office. Paul Tsongas, a former Massachusetts senator who had cancer, featured himself in a Speedo in a 1992 Democratic presidential campaign ad, and made his doctors available to convince reporters he was well. Tsongas died in 1997 of pneumonia.

Bob Dole, a former Republican Senate Majority Leader, also facing questions about his age when he ran for president in 1996, released his records to show he was physically able to handle the job.

The exercise is not without its share of humiliation and invasion of privacy. Reporters yesterday, for example, learned that McCain had "normal" urinary habits and freckles scattered across his backside.

But the documents, which Eckstein said reflected all of McCain's medical information, appeared to reinforce McCain's argument that he is fit.

On four separate occasions between 1993 and 2002, McCain was treated for a form of skin cancer called melanoma, which can prove lethal. But only once, in 2000, was the growth especially worrisome.

That year, doctors found an invasive form of the cancer on the senator's lower left temple and operated aggressively, removing a substantial amount of skin. Nearby lymph nodes were also excised as a preventive measure, but there was no evidence that the cancer had spread, McCain's doctors said. None of the four swatches of melanoma was related, his physicians said.

"Each of the melanomas was a new, primary melanoma and did not represent a recurrence of any previous melanoma," Eckstein said. "There was, and there is, no evidence of return."

That is an encouraging sign, said skin cancer specialists not involved in McCain's treatment. Patients generally are considered cured if they remain free of cancer for five years or longer after the removal of a serious melanoma.

"The first couple of years is the highest risk time," said Dr. Jeffrey E. Lee, medical director of the Melanoma & Skin Center at the M.D. Anderson Cancer Center in Houston. "Most patients who remain cancer-free for five years after a melanoma like this are cured, the overwhelming majority of patients."

A database of skin cancer patients at M.D. Anderson pegs the chance of recurrence at less than 10 percent.

More recently, McCain has been treated for more common - but vastly less dangerous - forms of skin cancer, known as basal cell or squamous cell. Those cancers are generally regarded as being highly curable. Earlier this month, doctors removed such a growth from one of McCain's legs.

The records released by McCain's campaign also show that when the senator underwent a routine screening for colon cancer this spring doctors discovered six polyps, fleshy growths on the inside of the large intestine. The polyps are described in the Mayo Clinic records as being adenomas - the kind of growths with the potential to become cancerous.

McCain's doctors said the polyps had not reached the cancerous stage, and a colon cancer specialist at M.D. Anderson said most adenomas in the colon never turn malignant.

The polyps were small, indicating that "they're quite early in their evolution," said Dr. Robert Bresalier of M.D. Anderson. "Assuming they did a good job taking them out, the risk of having an untoward event is pretty small."

Still, Bresalier said the discovery of so many polyps at once suggested that McCain's doctors will need to follow him closely.

"It just requires due diligence in screening," said Bresalier, adding that the senator should probably undergo another colonoscopy in three years. Typically, the interval between screenings is 10 years.

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