And me. Which is how I know McCain won’t be taking his diagnosis standing still.

GBM is a highly contingent disease. Survival depends on the size, location, genetic composition of the tumor, and a range of other factors related to the patient’s overall level of health. No two GBM patients are identical. The statistics about survival rates include elderly and young people, those with tumors that are inoperable, and those with genetic mutations that will be more or less responsive to existing therapies. Still, there is no escaping the reality that long-term survival is rare.

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If the doctors’ reports are accurate, McCain starts at an advantage, having already undergone surgery. “The tissue causing concern has been completely removed,” they told CNN. I struggled to come up with coherent words in the intensive care unit after my surgery, which lasted three times as long as McCain’s. I called a box of tissues “Led Zeppelin” four times in a row; the brain works in mysterious ways. By contrast, according to McCain’s medical team, he responded well after surgery, knew what year it was, and cracked jokes in the ICU; this week he returned to Washington and delivered a rousing 15-minute speech on the floor of the Senate when many patients struggle with language months after undergoing similar procedures. (Kennedy’s case was more complicated, and top national neurosurgeons were divided about whether to operate at all. His tumor was also located in a different part of the brain — another contingency.)

McCain, his family and his medical team are now reportedly considering his treatment options. The standard of care for GBM, as his doctors have explained, includes a combination of radiation and chemotherapy. The typical regimen includes six weeks of radiation, or 30 sessions. At the same time, patients take a low dose of an oral chemotherapy agent, temozolomide. This pill is usually tolerated more easily than intravenous chemo agents, though it, too, includes its own set of side effects.

There are two main obstacles to long-distance travel during this period: first, the cumulative effect of the radiation and chemo tends to cause fatigue. I had to slowly build up my endurance by walking around the neighborhood. Though he is more than four decades my senior, McCain has already tweeted photos of himself in the outdoors. He probably has the energy of someone used to the fast-paced schedule of a high-profile senator and the even more grueling presidential campaigns he ran. But beyond fatigue, plane travel will be a challenge. Chemo lowers the immune system’s ability to fight off illness so blood counts have to be monitored closely. Four-hour plane rides in close quarters with other people and their bacteria and viruses are not exactly ideal conditions for healing.

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If he follows the standard of care, McCain will likely get a few weeks off after radiation, then will start a new chemo-only routine that involves taking a higher dose of the oral agent five consecutive days a month for six months depending on his response and the recommendations of his oncologist. It is also possible McCain’s doctors will recommend a clinical trial, of which there are several for glioblastoma patients since the disease is an active research arena for scientists, especially in the burgeoning field of immunotherapy. McCain’s eligibility is likely to depend on the genetic makeup of his tumor and other specific criteria related to the precise circumstances of his health.

McCain has a rough road ahead but, he’s already endured worse. He’s blessed with two things needed to endure cancer: a first-class medical team and a tight-knit support network. The third pillar is a sense of purpose. Depression and anxiety commonly accompany cancer diagnoses. A commitment to family or another mission can exponentially help minimize the tedium and physical toll of treatments. A lifelong public servant has his mission at the ready.

McCain’s personal health crisis has arrived at the peak of the congressional debate over health care. Vice President Pence had to cast the deciding vote in a divided Senate just to allow the Republicans to introduce their various formulas for repealing the Affordable Care Act. After the vote to proceed, McCain lambasted his fellow senators for putting partisanship above the needs of the people and lauded a more constructive and bipartisan period in his 30-year Senate career: “The times when I was involved even in a modest way with working out a bipartisan response to a national problem or threat are the proudest moments of my career, and by far the most satisfying.” Still, he voted with the Republic Party line to open debate.

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