Image: Tony Snow
Jim Watson  /  AFP - Getty Images file
White House press secretary Tony Snow announced that cancer has spread to his liver.
updated 3/27/2007 8:07:50 PM ET 2007-03-28T00:07:50

A powerful podium like Tony Snow's and wealth like Elizabeth Edwards' mean nothing to cancer cells. A disease that afflicts the comfortable along with everyone else, cancer casts a large shadow in this presidential campaign, and now in the White House.

The back-to-back revelations that President Bush's spokesman and the wife of Democratic presidential candidate John Edwards are battling recurrences of cancer have resonated not just in living rooms, but high places, too.

GOP presidential candidates Rudy Giuliani and John McCain have had the disease, in serious form. The last three presidents were touched by cancer, both personally and in their families, and the last chief justice died of it. Members of Congress mourned one of their own last month, killed by it.

Partisan opposites, Edwards and Snow share a struggle against a disease that kills more than 500,000 Americans a year and leaves no one of extraordinary or common means immune.

"Disease in general and cancer in particular is a great equalizer," Dr. Durado Brooks, director of prostate and colon cancer programs for the American Cancer Society, said in an interview. "Any disease, including cancer, will quickly humanize you and equalize you."

It was Snow who offered best wishes from the White House last week when the Edwardses announced a return of her cancer and their decision to press forward in the Democratic presidential race. "Good going, our prayers are with you," he said.

On Tuesday, John and Elizabeth Edwards were quick to offer praise and prayers for him.

Snow, 51, had his colon removed in 2005 and underwent six months of chemotherapy after being diagnosed with colon cancer at an advanced stage. On Monday, doctors removed a malignant growth from his lower right pelvic area and discovered cancer had spread to his liver and more parts of his body.

Better quality of care
Elizabeth Edwards probably faces chemotherapy for the rest of her life, now that cancer found in her breast in 2004 has come back, in her rib and possibly elsewhere. In disclosing her incurable condition, she acknowledged she will get a quality of care that many others with breast cancer do not.

Image: Elizabeth Edwards
Mark Duncan  /  AP
Elizabeth Edwards, wife of Democratic presidential hopeful John Edwards, announced last week that her cancer has returned.

"You know, is this a hardship for us?" she asked. "Yes, it's yet another hurdle. But I've seen people who are in real desperate shape who don't, first of all, have the wonderful support that I have, and have no place to turn."

Heart disease — the leading killer — appears more sensitive than cancer to income disparities, with one new Duke University Medical Center study finding that the poorest Americans were more than twice as likely to die from it than patients with more money.

An American Cancer Society study found less dramatic but still marked differences among cancer patients — a five-year survival rate that was 10 percentage points lower for people in the poorest counties studied, compared with those on the next rung up. Such disparities vary widely according to cancer type.

"One's likelihood of dying from cancer is definitely significantly higher if you live in poverty," Brooks said.

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Cancer is generally more curable when detected early, meaning those with good insurance and the means — not just money but the time and education — to develop a good doctor relationship are more likely to get that early testing.

Snow is assured the best treatment, at a hospital he wished not to disclose. "Tony Snow is paid the salary that he's paid, and he has health insurance," said Dana Perino, filling in for him at the White House. "And I'm sure he's taken care of that way."

An inspiration to others
When VIPs get terribly sick, the hope is that their illness will inspire others to take the steps necessary to protect their own health. After her husband died from colon cancer, Katie Couric had a colonoscopy live on the "Today" show, a "Katie effect" that one study found spurred colonoscopy rates by 20 percent.

Back in 1974, the year Gerald Ford became president, his wife Betty announced she had breast cancer and would undergo a mastectomy. At the time, the illness, and the operation, were rarely discussed in public. Her disclosure prompted a surge in breast-cancer screenings.

Colon cancer is highly preventable through screening and very curable when caught early, yet only a little more than half of people with health insurance get the recommended tests and only about 20 percent without health insurance do.

Giuliani called off his New York Senate run in 2000 in large part because of a diagnosis of prostate cancer. Now 62, the former mayor was treated with the implantation of radioactive "seeds" in the prostate to zap cancer cells, and he has been cancer-free since.

McCain also has been cancer-free for more than five years. The Arizona senator, 70, carries scars after three episodes of melanoma, the most aggressive form of skin cancer. Both men, like cancer survivors generally, are at an elevated risk of having it come back.

Among recent presidents:

Ronald Reagan had surgeries for colon and skin cancer and for an enlarged prostate in his second term; his daughter Maureen died from cancer in 2001.

The elder George Bush, had a basal cell cancer removed from his face when he was vice president, and more than 50 years ago lost his daughter, Robin, to leukemia.

Bill Clinton had a precancerous lesion removed from his nose in 1996 and a cancerous growth taken from his back after leaving office — a time marked most dramatically by heart bypass surgery. Clinton's mother, Virginia, died of breast cancer in 1994, two years into her son's presidency.

President Bush had three small potentially cancer-causing lesions removed from his face in 2001. His wife Laura had a nickel-sized skin cancer tumor removed from her shin last fall.

Vice President Dick Cheney, who has a history of heart problems, had skin cancer many years ago.

Copyright 2007 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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