Kennedy undergoes 'successful' surgery

Tuesday, June 3, 2008

DURHAM, N.C. -- Sen. Edward M. Kennedy underwent what his doctor called successful surgery Monday to treat his cancerous brain tumor, and told his wife shortly after that he felt "like a million bucks," a family spokeswoman said.

Kennedy was awake for the 3 1/2-hour procedure at Duke University Medical Center, his doctor said. The Massachusetts Democrat is expected to undergo chemotherapy and radiation in coming weeks, and will likely remain at the North Carolina facility for about a week.

The 76-year-old was diagnosed last month with a malignant glioma, a lethal type of brain tumor. Experts had said Dr. Allan Friedman -- the top neurosurgeon at Duke and an internationally known tumor and vascular surgeon -- would likely try to remove as much of the tumor as possible while balancing the risk of harming healthy brain tissue that affects movement and speech.

The hope is that the surgery will give future treatments a better chance of working.

"Almost no malignant gliomas are cured by surgery, but many of us believe that the more you get out, the next treatments, whether they be radiation or chemotherapy, have a better chance of working because there's less tumor there to fight," said Dr. Matthew Ewend, neurosurgery chief at the University of North Carolina at Chapel Hill.

Friedman said the surgery "was successful and accomplished our goals," and that Kennedy should not experience any permanent neurological effects.

"After a brief recuperation, he will begin targeted radiation at Massachusetts General Hospital and chemotherapy treatment," Friedman said. "I hope that everyone will join us in praying for Senator Kennedy to have an uneventful and robust recovery."

Family spokeswoman Stephanie Cutter said Kennedy spoke to his wife, Vicki, and told her: "I feel like a million bucks. I think I'll do that again tomorrow."

Kennedy was hospitalized May 17 at Massachusetts General Hospital after undergoing a seizure at his home on Cape Cod. Doctors later announced that he had a malignant glioma in his left parietal lobe, a brain region that governs sensation but also plays some role in movement and language. A malignant glioma is one of the worst kinds of brain cancer, and malignant gliomas are diagnosed in about 9,000 Americans a year.

Details about Kennedy's particular type of tumor have not been disclosed. The type of tumor plays a key role in determining survival odds. Some cancer specialists say it appears likely to be a glioblastoma multiforme -- a serious and tough-to-remove type -- because other kinds of brain tumors are more common in younger people.

In the following days, Kennedy likely will be given drugs to prevent brain swelling and seizures, which are possible complications of his surgery. He'll also be closely watched for bleeding as well as blood clots. Strokes are an uncommon, but still possible.

Typical radiation treatment is five days a week for a month, using 3-D imaging techniques that narrowly deliver the beams to the tumor, affecting as little surrounding tissue as possible.

Kennedy likely will receive the chemotherapy drug Temodar during and after radiation, said Dr. Otis Brawley, chief medical officer of the American Cancer Society. The pivotal study showing the drug's value for brain tumors was presented three years ago at the clinical oncology conference. Kennedy also may be treated with Avastin, a newer targeted drug to deprive the tumor of its blood supply, though this is still experimental at this stage of treatment.

Kennedy has a history of seeking top medical care available for his family. He pulled daughter Kara out of Johns Hopkins and brought her to a Boston hospital when he was not satisfied with the initial course of treatment she was getting for lung cancer five years ago.

Duke's brain tumor center was established in 1937 and has a staff of more than 250 who work only on the research and treatment of brain tumors. Doctors and staff there are currently following

the treatment of more than 2,000 patients from around the world.

One of Kennedy's closest friends, Sen. Chris Dodd, D-Conn., said he spoke on the phone with Kennedy on Sunday, the day before he went into surgery. The two talked about two bills he has been working on: a mental health parity bill and an education reauthorization bill.

"He wants to get them done and he expects to be here when they are done," Dodd said. "He plans on coming back as soon as the doctors will let him."

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