McCain Recovers From Skin Cancer Surgery
Leffell, author of the book Total Skin, says thickness is an important consideration when a patient has been sent to him with melanoma. "The No. 1 thing I ask," Leffell says, "is, 'What is the thickness of the melanoma?'"
Leffell explains that when a melanoma has not spread more than a millimeter's thickness below the skin, there is a 96% to 99% cure rate. Once the melanoma becomes thicker than a millimeter, or about the thickness of a dime, it translates into lower survival rates.
Leffell says a melanoma bigger than a millimeter and up to 2 mm has a 94% cure rate. Just over 2 mm and under 4 mm has a 78% cure rate. And if a melanoma is thicker than 4 mm, the cure rate plummets to 42%.
Leffell tells WebMD that, although it is a very good indicator, there is more to determining cure than melanoma thickness. The amount of lymph node involvement is important in prognosis.
Leffell says part of the doctors' decision to remove McCain's lymph nodes for testing is associated with the thickness of the melanoma. If the cancer is thicker than a millimeter, then doctors often want to look at the lymph nodes.
But there may have been other reasons why the doctors wanted to look at them, he says. They may have felt swollen lymph nodes by hand or seen that they looked swollen on the MRI.
At a press conference Friday afternoon, McCain said he had earlier had a growth at the same site on his temple tested, but that it was benign. White House medical staff recently urged him to have it checked again, he said, and last week, physicians in Bethesda, Md., diagnosed him with melanoma.
The results of Thursday's tests indicated that it was unlikely the skin cancer had spread to the major organs of his body, greatly increasing his chances of winning his second battle with the disease. McCain's doctors have said his two latest melanomas are not related to the one McCain had on his shoulder in 1993.
"I've been in a number of fights in my life and this is just another one, and I'm sure I will prevail," said McCain on Friday.
The outlook would have been much worse if the cancer had spread, since that stage of melanoma is much more difficult to treat, said John Glaspy, MD, MPH, a researcher at UCLA's Jonsson Cancer Center.
Glaspy said the kind of surgery McCain had requires one to two weeks for recovery.
"Having an inch divot missing from your skin is not nothing, but you can hurt yourself worse falling off a bicycle," Glaspy said. "It's not like you're removing organs. It's not a major surgery."