'Lion' of Senate has brain tumor

The Baltimore Sun

Edward Kennedy, the U.S. Senate's second-longest-serving member and one of the most powerful political figures of the past half-century, has been diagnosed with a type of brain cancer that usually proves fatal.

The diagnosis of malignant glioma was announced yesterday by his doctors at Massachusetts General Hospital, where the 76-year-old patriarch of the Kennedy family was taken by helicopter Saturday after suffering a seizure at his home on Cape Cod.

The Massachusetts Democrat will be treated with chemotherapy and radiation, his doctors said, standard treatment that normally slows or stops the growth of the brain tumor but seldom cures it. The senator will remain at the hospital "for the next couple days according to routine protocol," his doctors said in a prepared statement.

"Decisions regarding the best course of treatment for Senator Kennedy will be determined after further testing and analysis," said Dr. Lee Schwamm, vice chairmen of neurology, and Dr. Larry Ronan, the senator's primary care physician.

"He remains in good spirits and full of energy," they said.

In a statement, President Bush saluted Kennedy as "a man of tremendous courage, remarkable strength and powerful spirit." He added: "We join our fellow Americans in praying for his full recovery."

Senators of both parties heard about Kennedy's condition during their weekly, closed-door policy lunches.

Sen. Barbara A. Mikulski called Kennedy one of her oldest friends in Congress. She has been in touch with family members, and expressed hope for his recovery.

"No one knows how to fight harder and with more determination than Ted Kennedy," the Maryland Democrat said. "I know he will fight and beat this diagnosis."

Sen. John Kerry has visited Kennedy at Massachusetts General Hospital.

"He's in a fighting mood," the Massachusetts Democrat said. "He is asking questions about what the choices are for him and [is] deeply involved in making all the kinds of personal decisions that any of you would."

Sen. John McCain, the presumptive Republican presidential nominee, described Kennedy as "the last lion in the Senate."

Sen. Christopher J. Dodd, Kennedy's closest friend in the Senate, said Kennedy would return to work.

Doctors who treat brain cancer said patients generally tolerate treatment for this type of brain cancer well, and are often able to work and carry on daily activities. Though a small percentage of patients become long-term survivors, the majority succumb to the tumor within five years.

"It's a bad prognosis but not an absolute," said Dr. Henry Brem, chief of neurosurgery at the Johns Hopkins Medical Institutions. "At Hopkins, we operated on about 1,000 patients in the last decade, and the average survival for adults is about two years with malignant gliomas."

A brain scan revealed a tumor in Kennedy's left parietal lobe, a region in the top, rear portion of the head a part of the brain that helps govern sensation, movement and language. A biopsy revealed it to be cancerous.

Among other factors, his prognosis will depend on whether the tumor is stage III or IV, information that the hospital has not yet revealed.

Half of patients with a stage III tumor are alive three years after diagnosis, and about 20 percent survive five years, according to Dr. William Regine, chief of radiation oncology at the University of Maryland Medical Center.

The outlook for patients with stage IV cancer is worse: "Half pass away roughly within a year of diagnosis, and one in four are alive two years," Regine said. "Probably less than 5 percent are alive five years."

Some 20,000 cases of primary brain cancer are diagnosed each year, about 60 percent of which are malignant gliomas, Regine said. (Tumors classified as stage I or II are slow growing and not said to be malignant.).

Some patients have the tumor surgically removed. This rids the brain of the main body of the tumor but cannot eradicate small roots that grow into normal brain tissue, Brem said.

"You look at the MRI and there's a clean surface, but underneath are the roots," Brem said. Chemotherapy and radiation can stop the cancer's growth for a while, but in most cases the roots spawn new cancer cells and the disease progresses anew.

Kennedy's doctors have not publicly mentioned surgery as an option, which could mean that the tumor is large and in an area where surgery could cause paralysis or otherwise compromise his ability to function.

A typical course of radiation lasts about six weeks, doctors said. Chemotherapy comes in the form of a pill and is taken in cycles during several months.

Many patients are able to juggle work with their treatments.

"If he's feeling well, there's no reason he can't go back to work," Brem said. . "If he's going back to the Senate, he'd need to be getting radiation nearby."

"If he's getting treatment in Massachusetts, he'll just take the six weeks off."

Most patients tolerate the treatments well, experiencing hair loss where the radiation was aimed, Regine said. A small percentage feel fatigued.

"For a disease that's so lethal, people aren't going to accept the small chance of survival if they're going to pay the price of huge side effects," Regine said. "The nice things is that it's easy. It has very low side effects."

The youngest of nine children and the lone surviving son, Kennedy was first elected to the Senate in 1962 to the seat formerly occupied by his brother, John F. Kennedy, who had been elected president two years earlier.

Kennedy has left his stamp on a raft of health care, pension and immigration legislation during four decades in the Senate.

Kennedy's wife since 1992, Vicki, and his five children and stepchildren have been at his bedside.

"Obviously it's tough news for any son to hear," said Robin Costello, a spokeswoman for one of Kennedy's sons, Rep. Patrick Kennedy, a Rhode Island Democrat. "He's comforted by the fact that his dad is such a fighter, and if anyone can get through something as challenging as this, it would be his father."

Kennedy was re-elected in 2006 and is not up for election again until 2012. Were he to resign or die in office, state law requires a special election for the seat 145 to 160 days afterward.

The Kennedy family has been struck by tragedy over and over. Kennedy's eldest brother, Joseph, died in a World War II plane crash, sister Kathleen died in a plane crash in 1948, President Kennedy was assassinated in 1963 and Sen. Robert F. Kennedy was assassinated in 1968. The tragedies thrust "Uncle Teddy" into the role of surrogate parent to his brothers' children.

He is an uncle to former Maryland Lt. Gov. Kathleen Kennedy Townsend.

In 1980, Kennedy challenged Jimmy Carter for the Democratic presidential nomination. He eventually bowed out with a stirring speech in which he declared, "The cause endures, the hope still lives and the dream shall never die."

A low point in his life was 1969, when Kennedy drove a car off a bridge on Chappaquiddick Island on Martha's Vineyard. The accident killed aide Mary Jo Kopechne. Kennedy at the time was married to his first wife, Joan, whom he later divorced.

Kennedy has been active for his age, maintaining an aggressive schedule on Capitol Hill and across Massachusetts. He has made several campaign appearances for Sen. Barack Obama.


Sun reporter Matthew Hay Brown and the Associated Press contributed to this article.

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