McCain Flies Back to Senate. Is It Too Soon After Surgery?

Image: FILE - JULY 19, 2017:  U.S. Sen. John McCain (R-AZ), who last Friday had surgery to remove a blood clot above his left eye, has been diagnosed with brain cancer, according to published reports today. Sarah Palin Campaigns With Senator John McCain
Sen. John McCain at a campaign rally in Tucson, Arizona, in on March 2010.Darren Hauck / Getty Images

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By Jane Weaver and Shamard Charles, M.D.

Sen. John McCain returned to the U.S. Senate on Tuesday, 10 days after recovering from surgery to remove a malignant brain tumor. The Republican senator from Arizona is back in Washington to work on health care reform after undergoing minimally invasive surgery for an aggressive glioblastoma, a quick return after spending the past week outdoors and hiking with his daughter Meghan and friends.

McCain was in the Senate on Tuesday afternoon, in time for a critical vote on health care. But is the 80-year-old senator risking his health by getting on a plane or returning to work too soon?

"It is possible to fly cross country safely, but it needs to be done carefully," said NBC News medical correspondent Dr. John Torres. "Having a trained flight crew and medical team that fully understands how flying can stress the body and worsen the medical condition is key."

Sen. John McCain, R-Ariz., and Joe Harper sit on a rock at Zebra Falls in Oak Creek, Arizona in a photo shared on Twitter on July 23, 2017.John McCain / via Twitter

McCain is still in the "honeymoon" phase of his medical care, meaning he’s in the pre-chemotherapy and pre-radiation stages of care when fatigue and side effects are more likely to happen. But he is at higher risk of developing a deep vein thrombosis during the flight, according to Dr. Steven Kalkanis, chairman of the department of neurosurgery at the Henry Ford Health System, one of the most respected cancer centers in the U.S.

Cancer, which often causes a person's blood to clot more easily, places patients at high risk for developing clots in the legs where blood flow is more stagnant. If the clot dislodges and travels to the lungs, causing a pulmonary embolus or the blocking of air and blood flow in the lungs, the results could be deadly. "Cramped quarters, lack of movement, dehydration, and the hypercoagulability of brain tumor patients definitely increases the risks of these complications occurring, but they can be mitigated by moving about the cabin and staying hydrated,” said Dr. Lynne Taylor, neuro-oncologist and co-director of the Alvord Brain Tumor Center at University of Washington.

"Still, the risk of DVT in brain tumor patients is high and the risk does not end when the flight ends."

Related: What is Glioblastoma? McCain's Brain Tumor an Aggressive Type of Cancer

Doctors are likely monitoring McCain closely and following standard protocol, which often includes placing cancer patients on a blood thinner.

McCain, who was treated by doctors at the Mayo Clinic in Phoenix, had a malignant tumor associated with a blood clot removed from behind his left eye. The Mayo Clinic could not be reached by NBC News for comment.

"Complications such as air in the brain or swelling of the brain are nearly zero 7-10 days after surgery. It would take a very compelling argument for me to disallow Senator McCain on that plane if he were my patient. Sen. McCain is a well-documented fighter and adhering to goals is part of the therapeutic process," Kalkanis told NBC News.

Following the surgery earlier this month, McCain recuperated at his home in Arizona. It has not yet been disclosed when the senator will begin treatment, which will likely include a combination of chemotherapy drugs to attack the malignant cells and radiation.

His colleagues say it's not surprising McCain would hurry back to the Senate.

"Is it surprising that he would get out of a hospital bed and go to work? No," said, McCain’s friend and colleague, Sen. Lindsey Graham, R-SC, on Tuesday. "It's surprising he's been in the hospital this long."

The Associated Press contributed to this report