Years after McCain's surgery to remove skin cancer and lymph nodes, his left cheek still bears a visible seam.
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The sunburns that blistered McCain's skin as a child may prove far more of a threat to his longevity than his time as a prisoner. McCain's 2000 brush with melanoma wasn't his first and, experts say, may not be his last. He had a melanoma removed from his left shoulder in 1993 and had other noninvasive skin cancers removed from his upper left arm in 2000 and his nose in 2002. All were picked up and treated in the earliest stages of the disease, but because melanoma is one of the more unpredictable types of cancer, doctors say he remains at risk for not only spread from the excised cancers but new growths as well. "We know that there is a 40% risk of melanoma coming back with metastases even though the primary lesion is taken out," says Dr. Antoni Ribas, a cancer surgeon at UCLA Medical Center, who has not treated the Senator.
If either happens, McCain has several options. New lesions could be removed by surgery, as his previous ones were. Recurrent growths are trickier, since they are more likely to originate not on the skin but deeper in the body. Once melanoma spreads, it generally cannot be effectively treated with surgery or radiation, which are designed to target contained growths. Chemotherapy drugs and medications that stimulate the immune system are options, but some may not be suitable for McCain, doctors say, because of his age and the toxicity of the treatments.
As for his general health, McCain says he tries to get exercise when he can, like hiking with his wife and children in Arizona, including an August 2006 trek with his son 30 miles (48 km) through the Grand Canyon over three days. "In the Senate, I try to walk up the stairs most of the time," McCain says. "I don't take the subway." On occasion, he swims, and the old Navy captain still endeavors to do his sit-ups and push-ups, though the exact number is a matter of some discussion. "I can do at least 30 or 40," he said last spring of the push-ups, as his campaign bus crossed the countryside. "But it's pretty easy to cheat on a push-up." He paused, aware that he had grabbed the attention of his traveling press. "I would never do such a thing, of course," he added, smiling.