Sen. Edward M. Kennedy enjoyed "a restful night's sleep" and was walking hospital hallways on Tuesday, one day after undergoing an aggressive brain surgery aimed at slicing away at a cancerous tumor to give chemotherapy and radiation treatments a chance to work.
The 76-year-old senator, a brother of late President John F. Kennedy, is expected to stay at Duke University Medical Center in Durham for about a week before returning home to Massachusetts for further treatment. No further updates on Kennedy's condition were expected until Kennedy leaves the hospital, according to a statement his office issued to The Associated Press.
"Senator Kennedy had a restful night's sleep and is recuperating well from yesterday's procedure," the statement said. "He is experiencing no complications and has been walking the hallways, spending time with family and actively keeping up with the news of the day."
Kennedy was diagnosed with a malignant glioma in the left parietal lobe of his brain after suffering a seizure on May 17 at his home in Hyannis Port, Massachusetts. He underwent 3 1/2 hours of surgery on Monday at Duke, where doctors provided few details about the surgery, including how much of the tumor was removed.
But Kennedy's doctor deemed the procedure a success that "accomplished our goals." When Kennedy emerged, a family spokeswoman said he told his wife, Vicki, that he felt "like a million bucks."
In the following days, Kennedy will probably be given drugs to prevent brain swelling and seizures, which are possible complications of the surgery. The senator also will be closely watched for bleeding and blood clots, because strokes are also a risk, though they are uncommon.
"After a brief recuperation, he will begin targeted radiation at Massachusetts General Hospital and chemotherapy treatment," his doctor, Dr. Allan Friedman, said in a statement following Monday's procedure. "I hope that everyone will join us in praying for Sen. Kennedy to have an uneventful and robust recovery."
The sole surviving son of America's most glamorous and tragic political family was diagnosed last month with a malignant glioma, an often lethal type of brain tumor discovered in about 9,000 Americans a year.
Delicate procedure
Details about Kennedy's exact type of tumor have not been disclosed, but some cancer specialists have said it likely is a glioblastoma multiforme — an especially deadly and tough-to-remove type — because other kinds are more common in younger people.
Cutting a tumor down to size — or "debulking" it — is extremely delicate because of the risk of harming healthy brain tissue that governs movement and speech. But Friedman, who is the top neurosurgeon at Duke and an internationally known tumor surgeon, said Kennedy should not experience any permanent neurological effects.
The outlook for patients with malignant gliomas is poor, and depends on what type of glioma a patient has. Median survival for glioblastomas is 12 to 15 months, but the range is wide, said Dr. Mark Gilbert, a brain tumor expert at the University of Texas M.D. Anderson Cancer Center in Houston.
Doctors have not revealed Kennedy's treatment plan, but typical radiation treatment is five days a week for a month, using 3D imaging techniques that narrowly deliver the beams to the tumor, affecting as little surrounding tissue as possible.
Kennedy also likely will receive the chemotherapy drug Temodar during and after radiation. It can cause typical chemo side effects — nausea, vomiting and fatigue — but treatments are much better for these than even a few years ago, doctors stressed.
He also may be treated with Avastin, a newer targeted drug to deprive the tumor of its blood supply, though this is still experimental as initial treatment, rather than after patients have relapsed.
Monday's operation "spells nothing but hope," Dr. John Sampson, associate deputy director of Duke's brain tumor center, said from Chicago, where he was attending a conference of 30,000 cancer specialists. "What we're seeing with the surgery and this conference is that there's hope for patients with this kind of cancer."
Doctors found the tumor last month after Kennedy suffered a seizure at his home on Cape Cod.
Rep. William Delahunt, D-Mass., a longtime friend of Kennedy’s, said Kennedy threw himself into helping find treatment options in much the same way he searched for cures when son Edward Jr. faced bone cancer at age 12 and daughter Kara had lung cancer five years ago.
He went so far was to pull Kara out of Johns Hopkins and brought her to a Boston hospital when he was not satisfied with her initial course of treatment. In his own case, he met on Friday with family and doctors at Mass General and decided then to head to Duke for treatment, Delahunt said.
The outlook for patients with malignant gliomas is poor. Median survival for patients with moderately severe ones is three to five years, and less than a year those with the most severe type.
Surgery is rarely a cure but is considered the best option for extending life. But because of the risks, especially in someone as old as Kennedy, doctors sometimes advise against it.
In Friedman, Kennedy picked “one of the thought leaders” in the field of neuro-oncology, said Dr. Otis Brawley, the top doctor at the American Cancer Society. Dr. Matthew Ewend, chief of neurosurgery at the University of North Carolina, said: “He’s an excellent surgeon. His patients are in very good hands.”
Next: radiation
Typical radiation treatment is five days a week for a month, using 3-D imaging techniques that narrowly deliver the beams to the tumor, affecting as little surrounding tissue as possible.
“After completing treatment, I look forward to returning to the United States Senate and to doing everything I can to help elect Barack Obama as our next president,” Kennedy said is a statement issued before the surgery.
Kennedy spoke on Sunday with Connecticut Democratic Sen. Christopher Dodd, one of his closest friends. But in his typical fighter’s style, there was little talk about the cancer or his impending surgery. Instead, it was all about a pair of legislative measures — on mental health care and education — that Kennedy has been working on for months.
“He wants to get them done and he expects to be here when they are done,” Dodd said. “He plans on coming back as soon as the doctors will let him.”