In July of this year, Senator John McCain announced to the nation that he had brain cancer — specifically, glioblastoma.
The tumor was discovered when the 80-year old Arizona senator went in for a routine physical exam and a blood clot was discovered above his left eye. During the procedure to remove the blood clot, tissue pathology revealed that a glioblastoma was associated with the clot. Unrelated to this diagnosis, McCain has had several melanoma skin cancers removed since 1993.
What is glioblastoma?
Glioblastoma is the most aggressive type of brain tumor. It originates in the brain, but does not spread there from another part of the body and rarely spreads to other parts of the body.
Glioblastomas are tumors that develop in the supportive tissue of the brain. These tumors are typically cancerous because the cells there reproduce quickly and are supported by a large network of blood vessels.
There are two types of glioblastomas:
Primary, or de novo (McCain’s type): These tumors tend to form and make their presence known quickly. This is the most common form of glioblastoma; it is very aggressive.
Secondary: These tumors have a longer, somewhat slower growth history, but still are very aggressive. They may begin as lower-grade tumors which eventually become higher grade. They tend to be found in people 45 and younger, and represent about 10% of glioblastomas.
Glioblastoma represent 14.9% of all primary brain tumors. An estimated 12,390 new cases are expected in 2017. The risk that it will develop increases with age.
Were McCain’s symptoms typical?
Prior to diagnosis, McCain reported to his doctor that he felt fatigued (not surprising with the senior’s rigorous travel schedule), of feeling “foggy” at times and having intermittent double vision.
People with brain tumors often experience these symptoms:
- Sensory (touch) and motor (movement control) loss
- Deep venous thrombosis (DVT, or blood clot)
- Hearing loss
- Vision loss
- Behavioral and cognitive (thinking) changes
- Endocrine dysfunction (hormone/gland changes)
McCain’s treatment options
Like most cancers, glioblastoma is treated with surgery to remove as much of the tumor as possible, then radiation and chemotherapy. McCain had surgery right away — a minimally invasive craniotomy with an eyebrow incision — a procedure that took about three hours. Because glioblastomas have finger-like tentacles, they are very difficult to completely remove. This is particularly true when they are growing near the parts of the brain that control important functions such as language and coordination.
Radiation and chemotherapy may be used to slow the growth of tumors that cannot be removed with surgery. Since the surgery, and the healing of the incision, McCain has undergone radiation and chemotherapy.
RELATED: Local cancer support groups
What are the survival rates for glioblastoma?
After surgical removal, the tumor almost always grows back in less than a year. When it recurs, surgeons usually operate again. Because they keep returning, glioblastomas are almost never cured, and the prognosis is poor. With treatment, the median survival (which means half of patients live longer than this, and half die sooner) is 14.6 months and the two-year survival is 30%. However, 10% of patients have lived longer than five years.
Senator Edward M. Kennedy died of glioblastoma in 2009, 15 months after it was diagnosed. Beau Biden, son of former Vice President Joseph R. Biden Jr., died of the same cancer in 2015, nearly two years after diagnosis.
John McCain has vowed to fight his cancer with an appreciation for the life he has lived. “Now we're going to do what we can, get the best doctors we can find and do the best we can. And at the same time celebrate with gratitude a life well lived."
If you or a loved one are diagnosed with brain cancer, get the skilled, compassionate care you need and deserve. Dr. Perez of Sierra Nevada Cancer Center was trained at the MD Anderson Cancer Center in Houston and has been in practice in northern Nevada for 15 years. To make an appointment with Dr. Perez at any of our four northern Nevada locations, call 775-883-3336.