There had been speculation that Kennedy might avoid surgery since the tumor is in a sensitive part of the brain that controls language, a crucial chunk of gray matter for a politician and orator. Bolstering that impression, early releases from Kennedy’s doctors discussed a treatment plan of radiation and chemotherapy, but didn’t mention surgery.
But after a weekend meeting with cancer experts from the National Institutes of Health and the National Cancer Institute, Kennedy apparently decided to take his chances with the scalpel. Now, as the nation waits for news, attention has shifted to the surgery’s risks and possible outcomes.
Experts say that the risk of damaging healthy brain tissue that controls speech and motor functions must have been outweighed by the possibility of extending Kennedy’s life slightly. “The treatment that has been shown to make the most difference as far as survival is removal of the tumor,” said Vivek Deshmukh, director of cerebrovascular and endovascular neurosurgery at George Washington University Medical Center. “Surgical removal carries the greatest benefit in terms of extending his survival.”
Even if the surgery and follow-up radiation and chemotherapy go well, however, Kennedy’s prognosis remains fairly grim. Most patients only survive about a year, although with surgery, survival can be extended by two or three years and in rare cases even longer [The Washington Post].
The Duke University neurosurgeon who will operate on Kennedy, Dr. Allan Friedman, may elect to keep the senator awake through parts of the delicate operation, in which Friedman will use a computer-guided system and a high-powered microscope to navigate in Kennedy’s brain tissue. Friedman and the Duke hospital are known for surgery called “motor mapping” in which doctors locate the areas of the brain responsible for things such as movement and speech and map these areas to ensure they are avoided.
Often during such operations, surgeons ask a patient to repeat certain words or make a movement such as squeezing a hand so they can identify areas of the brain involving speech and movement. They then attempt to remove as much of the tumor as they believe they can safely [CNN].
In related news that may be of intense interest to Kennedy, a new study by Duke researchers demonstrated a vaccine treatment that doubled the survival time of some brain cancer patients. The researchers tested a vaccine that created an immune response against the malignant cells, essentially teaching the brain to fight off its tumor.
It’s not yet clear if Kennedy could be a candidate for this experimental treatment, but with the nation’s best medical minds at his bedside, he’s certain to get the best advice.
Image: Duke Medical Center