McCain Receives Good News About His Cancer

An upbeat John McCain emerged from a meeting with his doctors here Friday and pronounced himself confident that surgery today to remove two malignant melanomas will help him overcome his latest bout with skin cancer.

After a battery of tests Thursday, the Arizona senator’s physicians at the Mayo Clinic in nearby Scottsdale reported that the lesions found on McCain’s upper left arm and left temple were unrelated to a malignancy removed from his left shoulder in 1993.

They will remove both of the new tumors today and said they will perform a lymph node dissection on the mass in his left temple, a procedure that will indicate if the cancer has spread.

“I’ve been in a number of fights in my life,” said the former Navy pilot, who was characteristically buoyant, even cracking jokes to reporters gathered in front of his home in north-central Phoenix. “This is just another one. I’m sure we will prevail.”

Cancer experts say it is not unusual for people who spend a lot of time in the sun to develop multiple melanomas. “We see that all the time,” said Dr. David Leffel of Yale Medical School.

The surgery today will give physicians definitive information about the possible spread of the melanoma, the most aggressive and deadly form of skin cancer. McCain, a recent GOP presidential candidate, said he would undergo general anesthesia and would likely remain hospitalized overnight.

The decision on whether to biopsy lymph nodes normally depends on the thickness of the melanoma. Thin melanomas “can have a 96% to 97% cure rate with a simple excision,” said David Leffell, professor of dermatology and surgery at Yale Medical School.

If the melanoma is thicker, there is a greater chance of spread and surgeons will examine the nearest lymph nodes to look for the presence of cancer cells.

In the case of a tumor on the temple, the nearest nodes are under the jawbone in the neck.

If the team finds no cancer cells there, they can be fairly sure the tumor has not spread. Dr. Stanley Leong of UC San Francisco also said there are no cancer cells discovered in about 80% of these types of cases.

Lymph Node Cancer Cuts Survival Rate

If they do find cancer cells in the lymph nodes, the survival rate drops by 40% to 50%, according to Dr. Vincent DeVita Jr., director of the Yale Cancer Center. At that point, doctors have few options. Chemotherapy has only “marginal” benefits, he said. The most likely course of treatment would be an experimental melanoma vaccine, which has shown some benefit.

McCain has a history of melanoma and carcinoma, a less serious form of skin cancer. He said he has been getting his skin checked every three months “for years,” but it wasn’t until a physician in Washington noticed the spots on his temple three weeks ago that McCain sought a biopsy at Bethesda Naval Hospital. McCain was notified more than a week ago that the biopsy showed a malignancy, but wanted to wait until doctors gave him a prognosis until speaking publicly.

The senator apologized that information about his condition had been leaked on the day Sen. Joseph I. Lieberman gave his acceptance speech as the Democratic vice presidential nominee. McCain called Lieberman a “dear friend,” said he was not the source of the leak and called it inappropriate.

McCain’s sense of humor appeared to have remained intact after more than a week of strain.

Will Resume Stumping by Labor Day

McCain, who joined his wife in passing out water bottles and sunscreen to reporters, wore a purple Arizona Diamondbacks cap and joked that he was becoming a commercial for the medical benefits of wearing hats and sunscreen.

The senator joked that while his wife appears confident and unruffled, the opposite is the truth. “Last night I got up and I saw her thumbing through the insurance policies,” McCain said.

Although McCain has canceled more than a dozen campaign and fund-raising appearances since his diagnosis, he vowed to return to the stump on behalf of Republican presidential nominee George W. Bush by Labor Day.

Asked if his medical history would have any effect on voters if he wage another presidential bid, McCain guffawed.

“It would be a cold day in Gila Bend, Ariz., if I ever run for president again,” he said, referring to the state’s perennial hottest spot.

McCain underwent a battery of preoperative tests Thursday, which his doctors pronounced normal. Most of the tests were designed to look for the presence of large metastases, but, experts say, such tests could miss smaller tumors.

While the tests apparently showed no large growths elsewhere in his body, McCain acknowledged, “There’s always that possibility.”

The 63-year-old betrayed no reservations about the course of his treatment and also gave no hint of specific information his doctors had given him. But, with his birthday coming up, McCain made clear his birthday wish: “I think it’s pretty obvious that I’d like to have a clean bill of health.”

He debunked reports that he was exposed to the sun for long periods during the 5 1/2 years he spent as a POW in Vietnam, saying he was kept indoors and longed to see the sun.

McCain shrugged when asked about the cause of the disease.

“It’s the curse of the Irish,” said the pale politician. “People say its drinking, but it’s really the light skin.”

* Times staff writer Thomas H. Maugh II contributed to this story.