Sen. Ted Kennedy
DURHAM -- After investigating all his options with his trademark intensity, Sen. Edward M. Kennedy underwent 3 1/2 hours of risky and exquisitely delicate surgery Monday to cut out as much of his cancerous brain tumor as possible.
"I feel like a million bucks. I think I'll do that again tomorrow," the 76-year-old Massachusetts Democrat was quoted by a family spokeswoman as telling his wife immediately afterward.
Dr. Allan Friedman, who performed the surgery at Duke University Medical Center, pronounced the operation a success and said it "accomplished our goals." Up next: chemotherapy and radiation, aimed at shrinking whatever is left of the tumor.
"The main goal is to remove as much of the tumor as possible to give any other therapy that we do a better chance of working," said Dr. John Sampson, associate deputy director of Duke's brain tumor center.
The sole surviving son of America's most glamorous and tragic political family was diagnosed last month with a malignant glioma, an often lethal type of brain tumor discovered in about 9,000 Americans a year.
Details about Kennedy's exact type of tumor have not been disclosed, but some cancer specialists said it might be a glioblastoma multiforme — an especially deadly and tough-to-remove type — because other kinds are more common in younger people.
Cutting a tumor down to size — or "debulking" it — is especially delicate because of the risk of harming healthy brain tissue that governs movement and speech. But Friedman — the top neurosurgeon at Duke and an internationally known tumor and vascular surgeon — said Kennedy should not experience any permanent neurological effects.
News 14 Carolina's Ilin Chen is at Duke University Medical Center, where media from around the country flocked to cover the senator's surgery.
News 14 Carolina's Tracey Early looks back at the events leading up to Monday's surgery.
News 14 Carolina's Johnny Chappell has more on the procedure the 76-year-old Massachusetts senator underwent.
Doctors said Kennedy was awake for much of the surgery, which begins with opening the scalp and removing a piece of the skull to expose the brain. Sometimes, to avoid damaging areas that control speech, surgeons use a probe to stimulate parts of the brain, then hold a conversation with the patient.
In the following days, Kennedy will probably be given drugs to prevent brain swelling and seizures, which are possible complications of his surgery. The senator will also be closely watched for bleeding as well as blood clots, because strokes are also a risk, though they are uncommon. He is expected to return to Boston in about a week.
"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 Sen. Kennedy to have an uneventful and robust recovery."
Doctors found the tumor last month after Kennedy suffered a seizure at his home on Cape Cod.
Rep. William Delahunt, D-Mass., a longtime friend of Kennedy's, said Kennedy threw himself into helping find treatment options in much the same way he searched for cures when son Edward Jr. faced bone cancer at age 12 and daughter Kara had lung cancer five years ago.
He went so far was to pull Kara out of Johns Hopkins University and brought her to a Boston hospital when he was not satisfied with her initial course of treatment. In his own case, he met on Friday with family and doctors at Mass General and decided then to head to Duke for treatment, Delahunt said.
In Friedman, Kennedy picked "one of the thought leaders" in the field of neuro-oncology as his surgeon, said Dr. Otis Brawley, the top doctor at the American Cancer Society.
"He's an excellent surgeon. His patients are in very good hands," said Dr. Matthew Ewend, the neurosurgery chief at the nearby University of North Carolina at Chapel Hill.
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.
"After completing treatment, I look forward to returning to the United States Senate and to doing everything I can to help elect Barack Obama as our next president," Kennedy said is a statement issued before the surgery.
The outlook for patients with malignant gliomas is poor. Median survival for patients with moderately severe malignant gliomas is three to five years, and less than a year those with the most severe type.
Nevertheless, Monday's operation "spells nothing but hope," Duke's Sampson said from Chicago, where he was attending a conference of 30,000 cancer specialists. "What we're seeing with the surgery and this conference is that there's hope for patients with this kind of cancer."
Kennedy spoke on Sunday with Connecticut Democratic Sen. Christopher Dodd, one of his closest friends. But in his typical fighter's style, there was little talk about the cancer or his impending surgery. Instead, it was all about a pair of legislative measures — on mental health care and education — that Kennedy has been working on for months.
"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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"I am deeply grateful to the people of Massachusetts and to my friends, colleagues and so many others across the country and around the world who have expressed their support and good wishes as I tackle this new and unexpected health challenge.
"I am humbled by the outpouring and am strengthened by your prayers and kindness. Over the past several days, Vicki and I, along with my outstanding team of doctors at Massachusetts General Hospital, have consulted with experts from around the country and have decided that the best course of action for my brain tumor is targeted surgery followed by chemotherapy and radiation.
"This morning, I will be undergoing surgery with Dr. Allan Friedman at Duke University Medical Center and expect to remain there to recuperate for approximately one week. Shortly thereafter, I will start radiation treatments at Massachusetts General Hospital and begin chemotherapy.
"After completing treatment, I look forward to returning to the United States Senate and to doing everything I can to help elect Barack Obama as our next president."