Kennedy Well After Undergoing Surgery for Brain Tumor
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Senator Kennedy was recovering last night after undergoing brain surgery to remove a malignant tumor, a risky and delicate procedure that offers the 76-year-old Democratic icon the best chance of extending his survival.
After spending a night in intensive care and then about a week at the hospital, Mr. Kennedy plans to return to his home state to undergo the next stage of his treatment: chemotherapy and radiation at Massachusetts General Hospital.
“I feel like a million bucks. I think I’ll do that again tomorrow,” Mr. Kennedy quipped to his wife, Victoria, after the 3 1/2-hour surgery, a family spokeswoman, Stephanie Cutter, said.
The surgery was “successful and accomplished our goals,” the neurosurgeon who performed the operation at Duke University Medical Center in Durham, N.C., Allan H. Friedman, said in a statement.
Mr. Kennedy was partly anesthetized but awake through most the procedure as surgeons monitored his responses to ensure that no crucial brain tissue was removed, and Dr. Friedman said he should “experience no permanent neurological effects from the surgery.”
No additional details were released about the senator’s treatment, condition or prognosis. But experts who were not involved in his care said the decision to undergo surgery indicated that he and his doctors had opted for the most aggressive treatment, and that the surgeons thought they could safely remove a significant proportion of the tumor.
“It’s a sign that there’s hope that something could be done,” a neurosurgeon who works with Dr. Friedman, John H. Sampson, said. “It almost certainly won’t be curative, but it should enhance the chances that additional treatment will be effective.”
A successful surgery would be the removal of at least 90% of the tumor without major neurological damage, several experts said.
“If you are going to operate, you have to get 90% or 95%, otherwise you haven’t made a difference in terms of survival,” the director of cerebrovascular and endovascular neurosurgery at George Washington University Medical Center, Vivek Deshmukh, said.
Even after successful surgery and follow-up radiation and chemotherapy, Mr. Kennedy’s prognosis remains fairly grim, experts said. Most patients with his type of tumor do not survive more than a year or two after diagnosis.
“If you didn’t do the surgery, you’re looking at a much shorter survival period — on the order of a matter of months,” Dr. Deshmukh said. “If you can go from three to six months of survival to a year or a year and a half, I think that’s making a difference, particularly if he’s not injured from it.”
Others noted that some people with similar tumors have survived for years.
“Every patient is different. We have a bunch of new treatments that are looking pretty good,” the chief of neurosurgery at the University of North Carolina at Chapel Hill, Matthew G. Ewend, said. “You just have to keep fighting year by year.”
Mr. Kennedy found out last month that he has a malignant glioma, a common and often lethal brain tumor, after having a seizure May 17 at his home in Hyannis Port, Mass., on Cape Cod. The tumor is in a part of his brain known as the left parietal lobe, which is involved in aspects of speech, sensation, and motor control.
The decision to operate was made on Friday, after a meeting in Boston of experts from around the country, a Kennedy aide, Anthony Coley, said. The senator flew to Duke over the weekend with his wife; his son Patrick J. Kennedy, a Democratic congressman from Rhode Island, and his sister Jean Kennedy Smith, Mr. Coley said.
Although the senator’s medical team released no details about the procedure, other experts described the typical course it would follow:
After undergoing an MRI brain scan to provide Dr. Friedman with a detailed image of the size and location of the tumor, Mr. Kennedy would have a small part of the left side of his head shaved and then would be sedated. Dr. Friedman would make an incision probably about 4 to 6 inches long to pull back the scalp so he could drill one or more pea-size holes in the skull to insert a second drill bit to cut out a larger piece of bone, probably about three inches in diameter. Dr. Friedman would then use a scalpel to cut through the dura, the layer of tissue covering the brain.
Because the brain has no nerve endings, the process is painless.
Mr. Kennedy was expected to be kept in intensive care for at least one night. In addition to bleeding, brain surgery patients also face risks of infections and seizures.