John McCain, 70 and scarred, cannot deny his age. So he jokes about it.
"I'm older than dirt, more scars than Frankenstein, but I learned a few things along the way," quips the Republican presidential candidate, who tries to play down the ravages of time for the wisdom acquired over seven decades.
His body is battered from torture in Vietnam. The scar along his left cheek is a reminder of a different battle, with skin cancer. Yet, McCain packs his work days so tight that aides grouse. And the man who could be the oldest first-term president hiked the Grand Canyon from "rim to rim" last summer.
Aging candidate troubles some
Despite McCain's high-energy lifestyle, getting older begets questions about health. The four-term Arizona senator no doubt will have to prove to voters that he is physically and mentally up to the demanding job of president.
For now, the issues are only background murmurs in the 2008 race for the GOP nomination. Neither Rudy Giuliani, the 62-year-old former New York City mayor who also is a cancer survivor, nor former Massachusetts Gov. Mitt Romney, a diet-and-exercise fanatic who just turned 60, has mentioned them publicly.
Still, an aging candidate troubles some voters.
Two recent surveys found that people are less likely to vote for a presidential candidate who is older than 72 than they would a candidate who has been divorced twice and a candidate who is Mormon. Giuliani is on his third marriage; Romney is a member of the Church of Jesus Christ of Latter-day Saints.
In Michigan, Jerry Roe, a Republican who is a former state GOP executive director, backed McCain in 2000 but supports Romney this time. "McCain's too old," said Roe, whose son is a deputy campaign manager for Romney.
"He looks tired. He looks like he's dragging," added Chip Felkel, a GOP strategist in South Carolina who says he is not aligned with a candidate.
Countering age concerns
McCain is determined to counter the notion that his age and health are hurdles, and he does not hide his distaste for the topic when questioned.
"I work seven days a week, 16-plus hours a day. I'm fine. I'm in great health," McCain tells anyone who asks.
To drive home the point, he talks about his Grand Canyon hike and notes that his spunky 95-year-old mother still drives and recently traveled through Europe. He does not mention that his father died in 1981 of heart failure at 70.
Campaigning, McCain seeks to counter skeptics who question his vigor.
On the first day of a two-day Iowa bus tour, he talked nonstop for hours to reporters traveling with him. He met with Iowa legislators. He hosted two question-and-answer sessions with hundreds of Iowans. He held several news conferences.
"He wears me out. I can't keep up with him," said his wife, Cindy, 52.
McCain told reporters that he exercises frequently, including sit-ups, push-ups and swimming when he can, and that he and his wife hike, camp and backpack often when they're in Arizona.
Still, despite McCain's best efforts, he cannot seem to escape the age questions.
"You had a birthday," late-night comedian David Letterman mentioned last month.
"Tragically," McCain said dryly.
Physically, McCain's body has withstood more trauma than those of most people his age.
As a Navy pilot in Vietnam, McCain broke both arms and severely injured his right knee when his fighter jet went down in Hanoi in 1967. When his captors tended to his injuries, they did so intermittently and never properly set his broken bones. They also exacerbated McCain's wounds when they tortured him during his 5 1/2 years in prison.
The results still show today. His hurried gait masks a slight limp. His oft-clenched fists hide the limited use of his arms. He cannot raise either arm above his head because of his war injuries. Arthritis also has set in.
Multiple skins cancer incidents
More recently, McCain had three bouts of melanoma, the most aggressive form of skin cancer. His aides say he has been cancer-free for at least five years. Still, because of his previous bouts, he is at a higher risk for a reoccurrence, as are all cancer survivors.
Hundreds of health records made available during McCain's first presidential run in 2000 consistently gave him a clean bill of mental health despite long periods in solitary confinement in Vietnam. He continues to be inquisitive and quick-witted judging by his exchanges on Capitol Hill with colleagues.
"He's as alert as he was 18 years ago when I went to work for him. He's as healthy as a horse," said Mark Salter, a longtime aide.
The campaign plans to release his updated health records to prove it. Aides are confident that voters will see it for themselves as the senator steps up his campaigning.
Running mate factor
Regardless of his current fitness, nobody knows how McCain would fare during his years in the Oval Office given his age and medical history. If he were nominated, his age would make his selection of a running mate even more critical.
Physicians unaffiliated with him say as people get into their 70s they face the increased risk of mental impairment, ranging from mild memory loss that doesn't affect judgment to full-blown dementia that inhibits a person's ability to function in daily life. They also have a higher chance of chronic physical ailments such as high blood pressure, diabetes, arthritis and cancer.
"If there is not clear evidence of serious progressive medical disabilities or cognitive impairment, I think age should not at all disqualify someone from being a candidate," said Dr. Eric De Jonge, chief of geriatrics at Washington Hospital Center.
Now 83, former presidential candidate and former Sen. Bob Dole, R-Kan., recently said McCain will face "constant questions about his fitness and ability to serve." The former Senate majority leader speaks from experience. Dole had suffered war wounds and was a cancer survivor when, at 73, he ran for the White House as the 1996 Republican presidential nominee challenging the then 50-year-old President Clinton.
A dozen years earlier, Ronald Reagan - who was 69 when he was first elected and 73 during his re-election race - neutralized the question of whether he may be too old for the job. In a debate with the 56-year-old Democrat Walter Mondale, a former vice president and senator, Reagan deftly quipped: "I am not going to exploit for political purposes my opponent's youth and inexperience."
Reagan was diagnosed with Alzheimer's disease just six years after leaving office.
For McCain, Republican strategists say, a release of health records as well as his appearance while campaigning will be the keys to deflecting suggestions that he may not be fit to serve.
"McCain has as much energy as he did six years ago and possibly more," said Scott Reed, a Republican consultant who ran Dole's campaign. But, he said, "The campaign will have to pace him properly to make sure he's not run down, doing too many events and looking tired because the camera doesn't lie."