Glioblastoma: Sen. John McCain's Brain Tumor
As many of our patients are aware, on July 19th, 2017 Senator John McCain’s office announced that the Senator had been diagnosed with a glioblastoma. Yesterday, I found myself answering patients who were as curious about what that meant as they were about their own condition.
Here’s what I told them.
I haven’t treated Senator McCain nor have I seen his medical records so the following is what seems to be the most likely situation and treatment plan.
As described in the news, Senator McCain underwent a routine CT scan of the brain last week to assess the symptoms of fatigue and double vision that he was attributing to the stress of extensive travel. Upon review of the scans his doctors found a 2 inch blood clot in the left frontal lobe of his brain that appeared to be about a week old. Given Senator McCain’s history of malignant skin cancer (surgical removal from his temple in August 2000) the doctors were suspicious of tumor and recommended an urgent MRI. This is prudent medicine and undoubtedly what I would have done within my own practice.
Senator McCain then underwent a minimally invasive surgery where an incision was made along the left eyebrow to gain access to, and remove the clot. In other words, they performed a craniotomy. After surgery, pathologists discovered abnormal cells that are consistent with a condition known as Glioblastoma Multiforme (GBM). This is the same type of tumor that lead to the death of Senator Ted Kennedy in August 2009.
GBM is an extremely aggressive type of cancer that arises from the cells called glia which support and nourish the nerve cells that are responsible for thought, movement and sensation. Although GBM represents only 2% of all adult tumors, it is responsible for almost half of all brain tumors and has an average survival of 15 months.
It is a tough diagnosis, and one that no neurosurgeon wants to deliver to a patient. Sen. McCain’s doctors will have described to him his diagnosis, probable progress of the condition, and his available treatment options.
GBM is a “diffuse” tumor which means there are no defined borders so it is very difficult to remove by surgery without injuring important nearby brain structures. Treatment typically consists of surgery to debulk the tumor followed by radiation treatment and chemotherapy.
This type of tumor is not typically considered an inherited family condition but risk factors include Caucasian ethnicity and older age. Men are slightly more likely to be affected. 64 is the mean age of occurrence and the highest numbers of people are diagnosed between ages 75 – 84. Senator McCain is 80 and accordingly in the group that is most likely to be diagnosed with glioblastoma.
Survival rates are affected by the location of the tumor and by how early it is detected. Symptoms most commonly experienced are headaches, changes in vision, strength and sensation as well as seizures. You should definitely contact your doctor if you have been experiencing any of these symptoms.
We extend our hopes that Sen. McCain’s treatment will go well. Fortunately, we know that his care will be top level and provide him with the best possible chance of successful treatment.
You can learn more about glioblastoma
Glioblastoma on WebMD