May 7, 2007

Presidential candidates with cancer

We have so many candidates for President, declared and undeclared, that they follow fairly conventional distributions on many traits. For example, how many have had cancer? Sen. John McCain was diagnosed with malignant melanoma in 2000 (Celtic ancestry and Arizona sunshine can be a bad combination).

Actor and undeclared candidate Fred Thompson has a (currently) incurable form of slow-acting (or "indolent") lymphoma (cancer of the lymphatic system), in contrast to the more aggressive lymphomas which offer more of a high stakes gamble -- they can kill you quick or be cured. (I was treated for intermediate grade lymphoma in 1997.)


When a tumor showed up under his jaw in 2004, Thompson had it treated first with radiation, which often doesn't work as well with lymphoma as with other cancers because lymphoma tends to be diffused rather than just in one place where you can zap it.

Then he was treated with Rituxan, a monoclonal antibody that inspires the body's own immune system to target the cancer cells. It's often compared to smart bombs, while standard chemotherapy is compared to Dresden-style carpet bombing in which you try to kill everything that's growing in you in the hope that you can kill the cancer before you kill yourself.

(In 1997, I was, I believe, the first person in the world with intermediate-grade [moderately fast growing] lymphoma to be treated with Rituxan. I'm still here and Rituxan had sales of $1.6 billion in 2004 in the U.S. alone. The standard treatment for aggressive lymphoma is today CHOP chemotherapy and Rituxan, which I was fortunate enough to get a decade ago. I'm now almost ten years out, so the odds of avoiding a relapse look good for me, knock on wood.)

Thompson is currently in remission. Many people his age, 64, will die of old age before his slow-acting kind of lymphoma kills them. He is fairly likely to relapse, however, if he otherwise stays in good health. He claims that another round of treatment, if it became necessary, wouldn't be "debilitating."

Oncologists are fairly open-minded about how to treat relapsed indolent lymphoma, with options ranging from (not a comprehensive list):

- doing nothing until the pain gets bad (watch-and-wait)

- to radiation therapy

- to more Rituxan, which doesn't have many side effects

- to the two second-generation monoclonal antibodies for lymphoma, Zevalin and Bexxar, that come loaded with radioactive substances to deliver radiation right to the cancer cells. These have more side effects, but still aren't as bad as chemotherapy.

- to traditional chemotherapy (which many people, including me, find debilitating -- I didn't suffer much nausea, but slept 12 hours per day during my 18 weeks of treatment and suffered anemia for about a year afterwards)

- to intensive chemotherapy, which is usually called a stem-cell transplant or bone marrow transplant. It's no fun.

It would be useful if an oncologist would calculate the odds for us that Thompson could get through both one and two four-year terms as President without having to resort to debilitating treatments for relapses. I would guess that he'd probably get through a single term okay, but I wouldn't begin to guess about two terms. And don't listen to me, anyway.

In general, the U.S. has been lucky with the health of its Presidents, even though the press wasn't very responsible about reporting the facts to voters. FDR managed to survive long enough until Harry Truman had replaced Stalin-fan Henry Wallace as Vice-President, and Reagan's old-age deterioration didn't come with major costs. Oddly, the most nearly disastrous health problems were those of the youngest elected President, JFK, who was in a lot of pain much of his life. He was so pilled-up and unimpressive when he first met Khrushchev in Vienna in 1961 that the Soviet supremo thought he could push the playboy around over missiles in Cuba.


My published articles are archived at iSteve.com -- Steve Sailer

16 comments:

Nimrod said...

I saw an interesting segment on Sky News, yesterday, about the development in a London hospital of a new treatment for some types of lung cancer. They feed a tube down the mouth/nose into the stomach and freeze sections of cancerous cells with liquid nitrogen.

That said, I'm sure the Americans are way ahead of us on this.

Ian Lewis said...

Hi Steve, what is CHOP? As in, "The standard treatment for aggressive lymphoma is today CHOP chemotherapy and Rituxan..."

Around my area, CHOP stands for Children's Hospital Of Philadelphia.

Anonymous said...

why does the media care about HIV so much more than cancer? cancer is certainly more dangerous to humans.

i don't know what the research spending is on cancer versus HIV, but it should be about 10 to 1. probably more.

Big Steve said...

Media full of homos.

Anonymous said...

CHOP chemotherapy is cyclophosphamide, doxorubicin, vincristine, and prednisone.

Ian Lewis said...

"CHOP chemotherapy is cyclophosphamide, doxorubicin, vincristine, and prednisone."

Thanks.

Anonymous said...

Steve:

You forget to mention Giuliani, who had prostate cancer. That would make at least three of the presidential candidates to had cancer.

tggp said...

Cancer kills more people, but they're old people. HIV tends to kill younger people, and we're more upset about the deaths of the young (perhaps we are attempting to minimize the expected number of life-years lost). Also, people with cancer or at-risk haven't formed the sort of activist groups that were formed for HIV. I agree that the funding is lopsided, although I'm also opposed to all government funding of pretty much anything other than defense.

Steve Sailer said...

Lymphoma, in particular, is a disease that strikes extraordinarily at random, which makes it hard to put together a political coalition to get funds to fight it. Breast cancer strikes your mom, prostate cancer your rich uncle (it's a disease of high-testosterone hard-chargers like Giuliani, Norman Schwarzkopf, Bob Dole, Michael Milken, and Arnold Palmer). AIDS, of course, has the most tight knit political coalition of all. But lymphoma victims are as random as people born on Thursday.

Udolpho said...

Little did Khrushchev know that a combination of speed and steroids would make JFK wildly hyper-reactive when pushed. Thank God his grandstanding didn't wipe out both countries.

Anonymous said...

Good point about JFK Steve. I have never understood the hagiography of JFK among liberal and dem circles much less the conspiracy theory idiots. Oswald did it, because he was a lunatic Communist. The forerunner of the Daily Kos idiots.

SFG said...

prostate cancer your rich uncle (it's a disease of high-testosterone hard-chargers like Giuliani, Norman Schwarzkopf, Bob Dole, Michael Milken, and Arnold Palmer).
Hmmm...what an interesting observation. I wonder if there really is some sort of correlation between testosterone levels within normal levels and prostate cancer?

ricpic said...

If Thompson is the Republican candidate how big a factor will his cancer, albeit of the slow growth variety, be in the campaign? How will he finesse it? How will Hillary or Obama keep it front and center, all the while making protestations about the high road?

Sean said...

does HIV really kill more young people than cancer? i don't have the research but i bet even at age 30, they are equal killers. in straight men and women, i bet cancer has the lead at every age.

by age 45 cancer in a landslide. just at the time when many people assume leadership positions in society and can least afford to die from cancer.

Richie Fleiger said...

Oddly, the most nearly disastrous health problems were those of the youngest elected President, JFK, who was in a lot of pain much of his life. He was so pilled-up and unimpressive when he first met Khrushchev in Vienna in 1961 that the Soviet supremo thought he could push the playboy around over missiles in Cuba.

Didn't keep him from getting on top of Marilyn Monroe, did it?

dearieme said...

Don't overlook cancer of the personality. I'm thinking of Little Madam Cattle-Futures.