Chemo for the Commander-in-Chief?
Should McCain be elected President and suffer a recurrence
within the next four years, his treatment would likely consist of the standard
menu of therapy—none of which offers a good chance of survival. Chemotherapy
and radiation often have little effect, leaving close monitoring and drug and
immunologic treatments as the best options—though the available drug treatments
also have limited success.
"The most useful course of action would be aggressive monitoring for recurrence," says Naylor. "If he has a recurrence, he might get interferon at that point. But there's not really any therapy that would make much difference." Interferon alfa-2b, a drug which mimics the proteins produced by the immune system, helps to extend overall survival in patients who have been surgically treated for melanoma. It is also the only drug that has been clinically shown to successfully decrease the risk of recurrence. Whether or not McCain is currently taking the drug has not been disclosed.
For more advanced melanomas, another option is leukine, a drug that activates the immune system to produce more white blood cells, thereby enhancing the body's ability to fight the tumor.
If McCain has no recurrence, it doesn't matter what stage of melanoma he previously had. "As long as he's asymptomatic," as he is now, "he'd be able to go along day to day as normal," says Naylor. But if the tumor removed in 2000 was in fact stage III, that would mean that any potential recurrence would be more likely to be serious than the recurrence of a stage IIA tumor.
"When the disease is absent, your quality of life is good, But when it comes back, that's when you usually crash and die very quickly," says Naylor. "It's an unassailable fact that someone with one of the worst prognoses of melanoma is apt to die very quickly if he has a recurrence."
