There was no point in treating: what is the disease that killed McCain

US Senator John McCain died of brain cancer, shortly before giving up treatment. What kind of tumor was found in McCain's brain, why does it arise and why is it so difficult to treat, understood Gazeta.Ru.

Photo: Twitter @SenJohnMcCain

Republican senator John McCain died exactly one year after he discovered a brain tumor, glioblastoma. Moreover, the disease was discovered almost by accident - after he had a blood clot over his left eye.

"A subsequent analysis of the tissue showed that the blood clot was associated with a brain tumor known as glioblastoma," the senator’s office said.

McCain was diagnosed 14 July 2017 of the year. He underwent a course of combined chemotherapy and radiation therapy, suffered complications such as pneumonia and diverticulitis, but remained at his post.

24 August he refused to continue treatment.

“Last summer, Senator John McCain shared with Americans the news our family already knew: he had been diagnosed with glioblastoma and the prognosis was bleak. John struggled for a year and his condition exceeded all expectations. But the progress of the disease and the inexorability of age delivered their terrible verdict,” the family’s statement said.

It is known that the senator had already been treated for cancer three times. Each time it was a different form of melanoma, or skin cancer.

Glioblastoma is considered to be the most dangerous form of oncological damage to the central nervous system, since with it the cells self-replicate at an enormous speed. According to statistics, patients with an established diagnosis of glioblastoma have a median survival of 14-14,5 months.

Only 5% of people with this diagnosis live for five or more years thanks to the existing new methods of treatment.

"This is a very difficult diagnosis," says Elizabeth Stoll, a researcher at the Institute of Neuroscience at the University of Newcastle.

Photo: Twitter @SenJohnMcCain

Glioblastoma is often the cause of death of famous people and politicians. Recently, Zhanna Friske and Mikhail Zadornov died from her in Russia. In the US, Senator Edward Kennedy and son of US Vice President Joseph "Bo" Biden.

Brain tumors annually affect about 250 thousand people, making up about 2% of all cancers.

Glioblastoma (malignant glioma) is the most common of them. It accounts for 52% of all primary brain tumors.

The five-year survival rate of patients with brain cancer over the past 40 years has grown from 22,4% to 35%.

“The main problem is that with this type of tumor, the tumor is the whole brain, and not a separate part of it, because genetic damage is everywhere. From such tumors as a neurinoma or meningioma or even metastasis of cancer that have a border, the difference between glioblastoma is that these tumors have no border either in the pictures or during the operation. Therefore, in essence, it is impossible to completely remove this tumor. Most often it occurs in the brain, sometimes in the spinal cord. This is the most common primary brain tumor, ”said a neurosurgeon doctor, candidate of medical sciences Alexey Kascheev.

Glioblastoma is more common in men, but the reasons for this are unclear. The causes of most tumors are also unknown, although in some cases it can be genetically determined. In March, 2017, 63 researchers from 20 institutes, based on 30 data, thousands of patients identified 13 new DNA loci associated with an increased risk of glioma, five of them - for glioblastomas. Previously, 13 loci were also detected. Such data allow using genetic analysis to establish how the patient is susceptible to the emergence of a particular type of tumor, and, through early diagnosis, significantly increase his chances of successful treatment.

Risk factors include Epstein-Barr virus infection, exposure to vinyl chloride gas and ionizing radiation, as well as neurofibromatosis, a hereditary disease characterized by the appearance of tumors of the skin and internal organs.

Another risk factor has become Higher education - in women who have studied at the university for at least three years, glioma develops by 23% more often than in those who are limited to schooling. In men, due to higher education, the risk of the appearance of a tumor increases slightly less - by 19%. In addition, in men with higher income levels, the tumor appeared on 14% more often. In women, however, such a correlation was not found. Also, glioma on 20% appeared more often in men working in senior and other high positions as compared to those who were engaged in manual labor - those on 50% were more often threatened with an acoustic neuroma.

Photo: Twitter @SenJohnMcCain

Researchers suggest that the development of brain tumors may be associated with some concomitant factors that have yet to be studied.

Combining several methods is considered the most effective method of treatment: radiation therapy or chemotherapy with surgical removal of the tumor (however, due to the location and size of the brain tumor, it is often impossible to remove it), as well as with immunotherapy, which may be aimed at strengthening the body’s own immune response to malignant tumors. and increasing the sensitivity of cancer cells to drugs.

Perhaps, if the tumor was not accidentally detected, McCain would have died even earlier.

“The most dangerous thing is when there are no symptoms at all,” says Gita Quatra, director of development for the glioblastoma fund, funding research into aggressive tumor therapy. Also, the treatment is complicated by the fact that the tumor can be detected only when it grows to such a size that it will be noticeable on an MRI.

Success in the treatment of glioblastoma is also due to the fact how well their relatives or carers take care of the patients. The brain controls the entire body, and its damage is often associated with impaired vision, the appearance of seizures, headaches and other additional health problems. Mood swings and personality changes may also occur, making it difficult to care for these patients.

However, care is important - an 2017 analysis of couples consisting of a patient and someone who took care of him in 88 showed that if the assistant did a good job with the situation, this reduced the risk of the patient dying by 16%.

“The impact of the family is enormous, and this is the part that is not covered,” said Dr. Susan Chang, director of the neuro-oncology department at the University of California at San Francisco. She founded a program to help families in which there are patients with a brain tumor. As part of the program, relatives and guardians visit support groups, receive counseling from psychologists and explain the ins and outs of medical insurance.

The problems may turn out to be completely unexpected - for example, McCain’s daughter admitted in February that she felt guilty that in such a situation she lives her usual life. She also stressed that many relatives of patients are experiencing similar difficulties.

In 2015, former US president Jimmy Carter announced successful cure for brain cancer. This difference in treatment outcomes in McCain and Carter was due to different baseline data — in Carter, the tumor was caused by metastasis of melanoma, which also affected the liver. The tumor in the liver was removed, and the ex-president of the United States was treated for a brain tumor using immunotherapy.

If earlier both metastatic melanoma of the brain and glioblastoma had an equally unfavorable prognosis, then today modern drugs can successfully treat the first disease.

“The results of treating metastatic melanoma due to immunotherapy today are the opposite of the results of glioblastoma treatment,” explains Dr. Ezra Cohen, director of the Moore Cancer Center at the University of California, San Diego.

The effectiveness of immunotope against melanoma is due to pronounced cell mutations, he says. These mutations allow the immune system to more likely find damaged cells and destroy them. And changes in cells with glibolastomy do not cause such a pronounced immune response.

In the long run, however, treatment can be found, Cohen encourages. According to him, very promising results show drugs based on viruses, as well as those that interact with specific receptors of gliobastomy cells.

Read also on ForumDaily:

Senator John McCain died: how was one of the most strong-willed politicians of our time

The White House fired an employee after a joke about McCain's disease

Cancer McCain relatives don't want to see Trump at the funeral

Senator John McCain diagnosed aggressive brain tumor

Do you want more important and interesting news about life in the USA and immigration to America? — support us donate! Also subscribe to our page Facebook. Select the “Priority in display” option and read us first. Also, don't forget to subscribe to our РєР ° РЅР ° Р »РІ Telegram  and Instagram- there is a lot of interesting things there. And join thousands of readers ForumDaily New York — there you will find a lot of interesting and positive information about life in the metropolis.