Skin Cancer, McCain, and The Upcoming Election

Dr. Hema Sundaram Health Guide
  • Back in the days of Franklin Roosevelt, media discussion of a President's health problems was distinctly off-limits.  Although FDR was paralyzed from the waist down due to polio, he was rarely photographed in public in his wheelchair or wearing his leg braces. Decades later, President Kennedy was afforded almost the same media blackout in regards to his colitis and the severe side effects that resulted from his chronic treatment with steroids.

    It's a different story these days, when anyone in the public eye - Presidents included - has long since lost the aura of infallibility. Ronald Reagan's brush with basal cell carcinoma during his presidency received widespread press coverage, and now presidential candidate, John McCain, has been dogged by media speculation almost since the start of his campaign regarding his history of the more serious skin cancer, melanoma. This speculation is in part fueled by McCain's age; at 71, he would be the oldest first-term President of the United States if he were to win the upcoming election. McCain's first melanoma, on his left shoulder, was surgically removed in 1993. The second, on his left temple, was diagnosed eight years ago and, since then, McCain has reportedly had other non-melanoma skin cancers removed.

    The positive aspect of the media attention on McCain's medical history is that it has raised awareness of melanoma specifically, and skin cancer in general. And that's a good thing, given that skin cancer is now the most common cancer in the United States, according to the National Cancer Institute and the Centers for Disease Control and Prevention (CDC), with more than one million cases being diagnosed annually. That translates to a 1 in 5 chance of anyone in the U.S. developing skin cancer, and a 1 in 3 chance for a fair-complected Caucasian like McCain. 

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     Melanoma is due to the uncontrolled growth of melanocytes (pigment cells) in the skin or, less commonly, in the eye or intestines. Although melanoma is less common than other types of skin cancer, it causes about 75% of skin cancer-related deaths. The World Health Organization reports about 48,000 people die throughout the world every year from melanoma [1]. In general, a melanoma is completely curable if is less than 1mm thick when surgically removed. McCain's second melanoma had not spread to local lymph nodes when it was diagnosed, but it was sufficiently advanced to be classified as an invasive form, stage 2A. Up to one-third of up to 34% of those diagnosed with this stage of melanoma die within 10 years.

    McCain's well-documented adherence to sun safety precautions serves as an excellent example to the general public. He protects his skin religiously from the sun's damaging ultraviolet rays with clothing and sunscreen and has regular skin check-ups every few months. But, in an era when a news story can circumnavigate the globe in a matter of minutes via the internet, it seems inevitable that any further skin cancers he develops will become the subject of intense media attention, and could even influence the outcome of the 56th presidential election.   
     [1] Lucas, R. Global Burden of Disease of Solar Ultraviolet Radiation, Environmental Burden of Disease Series, July 25, 2006; No. 13. News release, World Health Organization
Published On: May 19, 2008