Despite his age, past encounters with skin cancer and history as a two-pack-per-day smoker for nearly 25 years, John McCain appears to have a clean enough bill of health for a White House run, according to medical records his campaign released to reporters today.
But some heart experts say the 71-year-old GOP senator must keep an eye on his cholesterol in order to protect his health.
"Were I to see him, I would be more aggressive with his cholesterol-lowering therapy," said Dan Rader, director of preventative cardiovascular medicine at the University of Pennsylvania School of Medicine.
Still, the nearly 1,200 pages of health records that cover all facets of McCain's health care since his last presidential run in 2000, along with the responses his Mayo Clinic Scottsdale doctors offered to reporters, painted a picture of a man healthier than average for his age.
McCain shows no evidence of the melanoma that he has battled on and off for the past 15 years, and he appears to have a relatively low risk of heart disease. Doctors continue to treat him for slightly elevated cholesterol and blood pressure and recurrent kidney stones. McCain also regularly receives total body skin examinations to screen for any new skin cancer and is up to date with all regular check-ups.
If elected, McCain would be the oldest person to start a first term in the White House.
McCain has slight elevations in certain risk factors for heart disease. But his most recent stress test, which measures the health of the heart, showed strong heart muscle without any evidence of poor blood circulation. He can exercise without any reported shortness of breath or chest pain.
Though his father died of a stroke at age 70, McCain does not show any signs of constriction of arteries in the neck and head. The circulation to his brain is normal, according to the records.
Still, the issue of his higher-than-desired cholesterol remains. And though he kicked the smoking habit in 1980, it is something he is not shy talking about on the stump.
"It used to be the thing that Navy pilots did, it was part of our image," McCain said recently in Allentown, Pa. "I'm happy to say that I quit many years ago. I'm also unhappy to tell you I still want a cigarette."
But, McCain said, he hasn't had one in nearly 30 years.
Despite his extensive smoking history, McCain doesn't appear to have the two most common complications associated with long-term smoking: chronic obstructive pulmonary disease, a disease in which the lungs have reduced lung capacity, and lung cancer.
In two separate lung imaging studies, most recently in March, McCain showed no signs of cancerous lesions in the lungs.
McCain does have a slightly enlarged prostate. While numerous tests indicate that he has never had prostate cancer, he did have a portion of his prostate removed to alleviate urinary symptoms in 2002.
He takes a pill to lower his calcium levels to prevent kidney stone formation.
No records were released today dealing with McCain's mental acuity, or psychological and emotional health. McCain spent more than five years as a prisoner of war in Vietnam, after which he was thoroughly examined for post-traumatic stress disorder and other psychiatric disorders. There has been no sign of any problems since that time.
For McCain, good health in his early 70s is a positive sign for his future medical well being.
Skin Cancer Concerns Remain
Most scrutinized in the medical records, however, was McCain's history of four previous melanomas, the most serious kind of skin cancer.
Doctors removed a melanoma in 2002 from his nose, two in 2000 from his upper arm and his left temple, and one in 1993 from his shoulder. The latter was previously reported by McCain's doctors as a non-invasive melanoma confined to the very top layer of skin. But today's review indicated that the lesion extended deeper into the skin than previously disclosed. But McCain is well past the critical period of time for that cancer to recur.
During his 2000 surgeries, which resulted in a prominent scar on the left side of his face and neck, surgeons performed an aggressive evaluation of his lymph nodes, which would have indicated if his cancer had spread. None of the more than 30 nodes removed showed the presence of cancer.
McCain has also had numerous non-melanoma skin cancers removed from various parts of his body, including his face, chest and legs.
Today, McCain is very careful about sun exposure, regularly applying a high SPF sunscreen, and wearing a hat. By 2007, his dermatologist had taken notice.
"Continues with his excellent habits of photo-protection," Dr. Suzanne Connolly wrote on McCain's chart. "He's doing a great job!"
The 10-year survival rate for Stage IIA melanoma, the kind McCain had, is about 65 percent. McCain is approaching eight years since his major cancer surgery. At 10 years, doctors consider the risk of a recurrence to be very minimal.
"He's eight years out, which I think is a very good prognostic sign for the future," said Dr. William Hanke, the president of the American Academy of Dermatology.
Other melanoma experts agree.
"Since he appears to be in good follow-up [care], and is taking care of himself, the probability of a new melanoma remains small," said Dr. Stuart Lessin, the director of Dermatology at the Fox Chase Cancer Center in Philadelphia. "Overall, his history of skin cancer doesn't impact his health situation or his ability to run for president."