Kennedy's Surgery Goes Well, Doctors Say
ROBERT SIEGEL, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.
MELISSA BLOCK, host:
And I'm Melissa Block.
Senator Edward Kennedy is out of brain surgery after a three and a half hour operation. The Massachusetts Democrat has a malignant brain tumor. The cancer was discovered last month after he had a seizure. Today's operation was performed in North Carolina at Duke University Medical Center by an expert in neurosurgery and brain tumors, Dr. Allan Friedman.
In a statement, Friedman said the surgery, quote, "accomplished our goals." But he did not elaborate on some outstanding questions about the kind of tumor the senator has.
We're joined by NPR health correspondent Richard Knox. And Richard, when Dr. Friedman says we accomplished our goals, what do you figure he means by that?
RICHARD KNOX: Well, I think he probably surely means that they have gotten out as much as possible of the malignant tumor, called a glioma, without causing damaged to areas nearby that cause - that control things like speech and thought and movement. The goal really is to reduce the tumor in size. The surgeons talked about debulking it. And that gives radiation and chemotherapy a better shot at controlling the remaining tumor. And it also, you know, worry - doctors worry about swelling in the brain from radiation, which he'll have later, and by reducing the tumor size. They may also lower the risk that swelling could cause problems later on.
BLOCK: Mm-hmm. I was surprised to learn this, although I've read since that this is standard procedure, that Senator Kennedy was awake during the brain surgery.
KNOX: Yeah, that's pretty usual these days in brain surgery, and it's important. It's because doctors want to map the limits of what's safe. You know, it's hard to distinguish by eye tumor tissue from normal tissue. And so the surgeon really wants to know what areas of the brain, you know, underneath his scalpel, controls speech and thinking and movement. And so to do that they stimulate the brain while the neurologist in the operating room or speech pathologists asks the patient to identify a picture or count or lift a finger or wiggle a toe. And you know, this tells the surgeon where not to cut.
BLOCK: So what kind of pain control is given then?
KNOX: Well, first, he wasn't awake the whole time. They undoubtedly put him to sleep during the incision. And then there's a point where the brain is exposed and they're ready to do this, they lighten up the anesthesia to wake him up. And the incision pain has been eliminated with local anesthesia while he's awake. And you know, it's interesting. It's really fascinating that the brain itself does not have pain nerves, so you know, the stimulation of the brain does not cause any pain itself. And I'm sure they put him back to sleep to close the incision.
BLOCK: Richard, is there any more clarity on where this tumor is and what the prognosis is for Senator Kennedy?
KNOX: Well, there's a lot we don't know, as you indicated earlier, and the most important is just what kind of glioma Kennedy has. Many speculate that it's - it's called a glioblastoma, which is the most aggressive type. It's probably no accident that - Dr. Friedman, his neurosurgeon, is an expert on glioblastoma.
With prognosis, it's really - I think we have to be careful. One doctor involved in his care tells me that the median survival for glioblastoma is a year and half. That means half of all people die within a year and a half and half don't. And some people can live for considerable periods because the trauma can be controlled.
BLOCK: Further treatments, Richard - you mentioned chemotherapy, radiation to come?
KNOX: Yeah, after he recovers from the surgery, which will take a week to 10 days probably, and healing is well underway, they'll start with radiation and chemotherapy, probably given together, for about six weeks. And then he'll have chemotherapy for at least a year after that.
BLOCK: Okay, Richard, thanks very much.
KNOX: You're welcome.
BLOCK: That's NPR health correspondent Richard Knox. Transcript provided by NPR, Copyright NPR.
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