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Kennedy awake, active one day after surgery

Sen. Edward Kennedy was walking the halls and reading the news at Duke University Medical Center Tuesday morning.

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DURHAM, N.C. — Sen. Edward Kennedy continued his recovery Tuesday at Duke University Medical Center, a day after undergoing an aggressive surgery that experts said was designed to reduce his brain tumor and give chemotherapy and radiation treatments a chance to work.

A statement from the senator's office Tuesday morning said, "He is experiencing no complications, and has been walking the hallways, spending time with family and actively keeping up with the news of the day."

The 76-year-old senator was expected to stay at Duke for about a week before returning home to Massachusetts for further treatment.

Doctors gave few details about the surgery and did not say how much tumor was removed. The procedure lasted about three hours, and when Kennedy emerged, a family spokeswoman said he told his wife, Vicki, that he felt "like a million bucks."

Medical Center spokesman Mike Garrison said Tuesday there was no change in Kennedy's condition.

In the following days, Kennedy will likely be given drugs to prevent brain swelling and seizures, which are possible complications of the surgery.

The senator will also be closely watched for bleeding and blood clots because strokes are also a risk, though they are uncommon. (WRAL's Dr. Allen Mask discusses potential health problems for Kennedy as he recovers.)

"After a brief recuperation, he will begin targeted radiation at Massachusetts General Hospital and chemotherapy treatment," his doctor, Dr. Allan Friedman, said in a statement following Monday's procedure. "I hope that everyone will join us in praying for Sen. Kennedy to have an uneventful and robust recovery."

The sole surviving son of America's most glamorous and tragic political family was diagnosed last month with a malignant glioma, an often-lethal type of brain tumor discovered in about 9,000 Americans a year.

Details about Kennedy's exact type of tumor have not been disclosed, but some cancer specialists have said it likely is a glioblastoma multiforme – an especially deadly and tough-to-remove type – because other kinds are more common in younger people.

Cutting a tumor down to size – or "debulking" it – is extremely delicate because of the risk of harming healthy brain tissue that governs movement and speech. But Friedman, who is the top neurosurgeon at Duke and an internationally known tumor surgeon, said Kennedy should not experience any permanent neurological effects.

The outlook for patients with malignant gliomas is poor and depends on what type of glioma a patient has. Median survival for glioblastomas is 12 to 15 months, but the range is wide, said Dr. Mark Gilbert, a brain tumor expert at the University of Texas M.D. Anderson Cancer Center in Houston.

Dr. Henry Friedman, deputy director of the Preston Robert Tisch Brain Tumor Center at Duke, said research within the past five years is prolonging lives.

"There are survivors. You don't have to die with this tumor," he said.

Doctors have not revealed Kennedy's treatment plan, but typical radiation treatment is five days a week for a month, using 3D imaging techniques that narrowly deliver the beams to the tumor, affecting as little surrounding tissue as possible.

Kennedy also likely will receive the chemotherapy drug Temodar during and after radiation. It can cause typical chemo side effects – nausea, vomiting and fatigue – but treatments are much better for these than even a few years ago, doctors stressed.

He also may be treated with Avastin, a newer targeted drug to deprive the tumor of its blood supply, though this is still experimental as initial treatment, rather than after patients have relapsed.

Monday's operation "spells nothing but hope," Dr. John Sampson, associate deputy director of Duke's brain tumor center, said from Chicago, where he was attending a conference of 30,000 cancer specialists.

"What we're seeing with the surgery and this conference is that there's hope for patients with this kind of cancer."


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