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Republican presidential candidate Sen. John McCain has a 6 percent chance of dying of the skin cancer melanoma in each of the next two years, says a doctor who specializes in the design of medical trials.

McCain, 72, has battled melanoma four times, most recently in 2002. After his campaign released 1,200 pages of his medical records in May, his doctor said he had less than a 10 percent chance of the melanoma recurring.

Now, in a letter to the medical journal The Lancet, internist John Alam explains his analysis of those records, based on a predictive model for 10-year survival in melanoma patients. Alam is a biotech consultant in Massachusetts who's contributed money to the Democratic Party and its presidential nominee, Barack Obama.

The lesion doctors removed from McCain's left temple in 2000 was 2.2 millimeters thick, making it high risk, and it wasn't on an extremity — another risk factor. Two more strikes against McCain, according to the model: He's male and was older than 60 when the cancer occurred. All of those factors made his chance of surviving the melanoma just 24 percent when he was diagnosed.

Men with melanomas of the thickness of the one McCain had face an increased risk of dying of the cancer for 15 years after they're diagnosed, according to Alam's letter. That risk is highest seven years after the diagnosis, he writes, and it decreases slightly over the next eight years. That would give McCain a 12 percent chance of dying over the next two years from the disease, which is the deadliest form of skin cancer, he says.

But McCain's risk is cut in half, Alam writes, because biopsies of his lymph nodes were negative, meaning the cancer hadn't spread. "His prognosis should be better than for the overall population" in the prognostic model, Alam concludes. "If we assume that this trend is maintained long term, McCain's mortality risk due to melanoma is better but not eliminated, remaining at 6 percent per year."

A McCain spokeswoman, Jill Hazelbaker, disputed Alam's analysis. "This study is absurd," Hazelbaker said in an email. She cited comments made by McCain's doctors after the release of his medical records in May, characterizing him as being in "excellent health."

(Image of John McCain/U.S. Senate)

5 Comments

1. 1. Bradley 01:51 AM 10/25/08

   So what it is the probability for other people? We need selected examples to understand how significant McCain's case is. More interesting, what is the probability that McCain is either permanently brain damaged (like W) or is heading into cognitive decline at a significantly increasing rate? What is the probability that he has little more to offer us than the irrational and antisocial commentary he has delivered so far?

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2. 2. Fla2Mom in reply to Bradley 05:39 PM 10/25/08

   According to the American Joint Committee on Cancer's 2002 publication, with a Stage 2A without ulceration, McCain's survival prognosis is: 79% at 5 yrs and 64% at 10yrs. He was diagnosed in 2002, so he's obviously made it to the 5 year mark. While his odds certainly drop from the 5 to 10, let's all hope he makes it regardless of the election!

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3. 3. Fla2Mom in reply to Bradley 06:01 PM 10/25/08

   Oops! Sorry, Bradley. I reread the article. McCain's 2.2mm melanoma was removed in 2000. I had said 2002 earlier. According to the article, he had another melanoma removed in 2002, but I didn't see how deep it was...or even if they released that. Want to know more? Go to www.thedoctorsdoctor.com and search melanoma, then melanoma prognosis. Scroll down to "Site Results" and click on that, then scroll down to the actual prognosis numbers for all stages.

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4. 4. Bradley 12:07 AM 11/2/08

   Thanks, I put the link on my desktop.

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5. 5. Bradley 12:36 AM 11/2/08

   Thanks, I sent the link to my desktop. My question would be more concerned with demographics, not a particular prognosis for any one individual. As you can surmise from my remarks, it is far more a concern to me that Mr. McCain may be cognitively impaired, and possibly getting worse. This is not a trivial issue. There were plenty of signs that Ronald Reagan was mentally incompetent and deteriorating over time, yet he was elected twice. As it turned out, Ronnie was dying from Alzheimer's dementia. I do not know that this is the case with McCain, but it is clear to me from comments Mr. McCain has made that he lives in an unrealistic perceptual world. Besides McCain's personality driven perceptions, he has also bragged during a recent debate that Ronald Reagan is one of his heroes. That point of view if taken seriously (I do think McCain was telling the truth in this case) indicates a serious lack of critical thinking and a commitment to irrational emotionalism. McCain clearly missed the signs of Ronald Reagan's mental deterioration and irrational behavior if he looks to Ronnie as a role model. That's not a good sign if you are looking for wisdom and reason in a leader.

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