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What We Can Learn From John McCain’s Brain Cancer Death

What brain cancer is and how new treatments are improving the prognosis


(Editor’s note: Sen. John McCain  died of brain cancer on Saturday at age 81. Below is a previously-published Next Avenue article about McCain and brain cancer.)

McCain had a highly malignant form of brain cancer, which is associated with the blood clot that doctors removed. Here’s a brief explanation of brain cancer and how new treatments are improving the prognosis for patients; this story is an updated version of the 2015 Next Avenue article published after President Jimmy Carter was diagnosed with brain cancer due to melanoma.

McCain’s brain tumor is known as a “primary glioblastoma” — an aggressive type that forms in the tissue of the brain and spinal cord. The median survival rates for this type of brain cancer range from 14 months to three years. But the American Brain Tumor Association noted that a 2009 study found almost 10 percent of patients with glioblastoma may live five years or longer, according to CNN.

Brain Cancer of Kennedy and McCain

Sen. Ted Kennedy had the same type of tumor and survived about 15 months after being diagnosed. About three in 10 brain tumors are glioblastomas, according to the American Cancer Society.

There are two main types of brain cancer, said Dr. Henry Brem, director of the department of neurosurgery at Johns Hopkins Hospital:

Primary brain cancer  This type affects about 20,000 new patients per year in the U.S., refers to cancer that begins in the brain. About half of these are malignant — a group that includes the particularly deadly glioblastomas.

Secondary, or metastatic, brain cancer This much more common type is cancer that appears in the brain after having spread from another part of the body. The number of people with new cases of metastatic brain cancer each year is harder to estimate, Brem said, but it exceeds 150,000. The prognosis for an adult with secondary brain cancer is variable, Brem said. “It’s not unusual to live 20, 30 years, or they might die in a few months,” he said.

At What Age Does It Appear?

Primary brain cancer shows up in two age “bumps,” Brem said. One is during childhood. The other is in the 50s.

Metastatic brain cancer is most often seen in people in their 50s or 60s, sometimes older, Brem said.

Exciting Advances in Treatment

Brem said that surgical improvements, the targeting of radiation to very specific points where it’s needed and chemotherapy at the time of surgery have helped physicians make great strides with primary brain tumors.

“I would say that for primary brain tumors, we’ve seen tremendous progress in the past decade,” Brem said. “When you’re on the front lines, the fact that we’ve seen a doubling of the median survival rate (from nine to 20 months) is very significant. It’s still a pretty grim disease, obviously.”

Symptoms of a Brain Tumor

Brem cautions that most of the symptoms of a brain tumor can be attributed to other causes. Headaches, for instance, are rarely caused by tumors.

“Ninety-nine percent of headaches have nothing to do with brain cancer,” he said.

One of the more meaningful early warning signs, on the other hand, is seizures. People will get medical attention for a seizure, and appropriately so, Brem said.

People with brain cancer may also experience a diffuse pressure in the head, personality changes, nausea, vomiting, speech impairment, visual problems and weakness on one side of the body.

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