John McCain’s Melanoma in Perspective

[tekisui]

Bill Jempty | Tuesday, March 11, 2008

Senator John McCain, the presumptive Republican nominee for President, and I have a similar medical history. In a recent NY Times article, Lawrence K. Altman, M.D reported, “Mr. McCain has had four (malignant) melanomas.”

Until 2007 I was tied with the Senator. I had four of these deadly skin cancers diagnosed in 1993-94. A fifth was located on me and biopsied in 2007.

Around 150,000 a year world-wide are diagnosed with melanoma. A little under 50,000 die of the disease every year. It is the most common cancer for women under the age of 30, second most common for women age 34 and under.

Multiple melanoma survivors aren’t that common. I’ve been an active participant in MM support groups for 12 years. I can count the people I know who have had more than one of these skin cancers diagnosed. Senator McCain is the only one I know to have a total equal to mine.

In 1993, he waited more than six months before seeking care after a Navy doctor recommended that he consult a dermatologist for a lesion on his left shoulder that turned out to be his first melanoma. It was excised and has not recurred.

Pathology tests showed that the two other melanomas — detected on his upper left arm in 2000 and on his nose in 2002 — were of the least dangerous kind, in situ. In that type the malignant cells are confined to the outer layer of skin.

The most serious melanoma was spotted on his temple in 2000 by the attending physician at the United States Capitol after it had escaped the eye of Mr. McCain’s personal physician at Mayo Clinic Scottsdale. (The Capitol physician also spotted another melanoma that was in situ.)

The melanoma on Mr. McCain’s left temple was 2 centimeters in diameter and 0.22 centimeters deep, and was fully excised with wide margins, 2 centimeters in each direction, his campaign staff said.

(snip)

Dr. Altman’s article is most concerned with the 2000 melanoma. At 0.22 depth, it is a Clark Level II. Clark Levels are used for the degree of invasion of the MM into the patient’s skin. So far as Clarks go, .22 only penetrates into the second layer of skin. Of my five melanoma, three were .26 or less. What are the survival rates for this type of melanoma?

For patients with a melanoma like Mr. McCain’s who remained free of the disease for the first five years after diagnosis, the probability of recurrence during the next five years was 14 percent and death 9 percent, a study published in 1992 found.

The melanoma is almost eight years old. In 2000 Sen. McCain had surgery to have lymph nodes removed(This resulted in noticeable puffiness and scarring on his face still seen today), they tested negative.

Any oncologist will tell you, that a MM patient is never totally free or safe from having the disease come back.

more at link: http://www.outsidethebeltway.com/archives/2008/03/mccain_nyt_and_melanoma/

[Horse with no Name]

1. A very fine nurse that I had the pleasure of working with many years

ago was diagnosed with MM at the age of 31.
When she died, she was 35 and had 3 small kids.

[beachmom]

3. From the same one or did she get another instance of melanoma?

I have had melanoma, and I plan to live a long, long time with regular skin checks, of course.

[Horse with no Name]

4. It came back in her lungs

There was not a good prognosis for her from the start.

[beachmom]

2. I am confused. By definition melanoma is malignant. It is cancer.

I have never heard of the term MM.

[tekisui]

5. I think it is referring to "Multiple Melanoma", as in recurrence.

[uppityperson]

16. There are pre-malignant skin tumors, perhaps it used to be less definintive, or more, or something

There used to be "pre-malignant melanomas" which were suspicious areas that weren't melanomas but needed to be monitored so they didn't turn into malignant melanomas. I think they may now be called different things, rather like "schizophrenia" used to be a catchall and now has a more specific set of things needed for diagnoses.

http://www.skin-disorders.net/diseases/premalignant-and-malignant-skin-tumors.html
http://www.pathology-skin-rjreed.com/index3.html

[trof]

6. Why doesn't he wear a hat?

Miz t. had a melanoma on her neck 5 years ago.
Surgical removal and lymphectomy.
Doc said wear a hat when you go out.

I've had several precancerous bumps frozen off my bald head. Had one small basal cell cancer removed from my eyelid. Recently did a chemo process (lotion) on my head to root out little precancers.
Doc said wear a hat when you're outside.

Why not McCain?

[tekisui]

7. I've read he does wear a baseball hat when outside, stays in the shade

and uses strong sunscreen.

[MidwestTransplant]

8. I guess our candidate will have the better tan.

[tekisui]

9. Indeed.

Ours grew up in Hawaii.

And his dad was Black.

:)

[trof]

10. Need something wide brimmed.

[Berry Cool]

11. It's true that an MM patient is never totally free or safe from having the disease come back

yet the same is true of breast cancer patients, and there are still people who thought Elizabeth Edwards was "cured" of her cancer until the recent recurrence.

If McCain has made it eight years out from the diagnosis of his worst melanoma, he beat the 14 percent chance of recurrence and the 9 percent chance of death within that time. The negative tests on his lymph nodes also bode well.

In short, chances are excellent that he will live for quite some time, and eventually die of something else.

Not that I want him to be president or anything, but the odds of his keeling over dead from this, while they will never completely go away, are pretty small.

[tekisui]

12. I searched for info on this because of a photo released today.

He had a bandage over his left temple, where his melanoma was. I made me wonder what was going on.

[OhioChick]

13. I spoke with one of my kid's doctors about this

last week. She didn't know that he had 4 occurrences, only 2. She was very surprised that the Repubs would have him as their nominee as she said that 4 occurrences (in such such a short span of time) near the brain is not a good sign.

[asdjrocky]

14. My nephew died of this-

Way, way too young.

[undeterred]

15. Strangely enough, sometimes people ignore things on their skin.

When I worked in a cancer resource room, I remember talking to a woman in her fifties. Her husband had a melanoma on his back, and naturally she was the first to see it. He refused to go to the doctor for a year, saying it was nothing. I don't remember what kind it was.

During that year, it metastasized. By the time he was seen at a comprehensive cancer center it had spread to other organs in his body. If he had gone in for diagnosis and treatment right away it would have been no big deal. I felt so bad for her- and for him. They were desperately trying to find a cure but they couldn't make time go backward.

[uppityperson]

17. Worked in a care center and saw a person eaten by basal cell ca

Didn't want to get it checked because was afraid. Finally (grown) kids noticed there was a smell, so took parent to doctor to find a huge chunk erroded out of torso. It was nasty. Got to see ribs exposed before died. It was nasty. Just was scared to get it checked out. It was incredible.

[undeterred]

18. No medical procedure is scarier than the disease.

I know medical students who saw people with stage 3 and 4 cancers who came in to the ER because they had no insurance. This is the heartbreaking reality of America. But there was also a woman who worked for a breast cancer surgeon (female) who would not have a lump in her breast checked because she was afraid. By the time she did it was too late. She died at age 38. And working at the hospital she had good insurance, and could have been seen by an excellent doctor immediately.