en. John McCain’s decision to return to Washington for Tuesday’s vote on health care legislation came less than two weeks after surgery to remove a blood clot in his head — and shortly after he was diagnosed with an aggressive form of brain cancer.

His quick return came as a surprise to much of Washington. When he received his diagnosis of glioblastoma on July 14, he announced that he would stay in Arizona for a week to recover. And in a speech after Tuesday’s vote, McCain announced that he’ll be returning to Arizona to continue treatment after a few days in D.C.

Dr. Fred Barker, a neurosurgeon at Massachusetts General Hospital, said people who are diagnosed with glioblastoma and who go through an initial surgery generally take four to six weeks before returning to work. “Others go back part time part time for a week or two,” he said.


Barker said there’s no reason to think McCain isn’t capable of doing his job.

“If it’s a question of something like this, where another person really can’t stand in for you, there’s no reason to believe his judgment would be impaired,” he said.

Indeed, during his speech from the Senate floor, McCain, who had an incision from his surgery just over his left eye, didn’t appear to struggle to remain standing or to deliver his remarks. And he promised he would eventually return to the Senate again.

Medical experts, however, say the senator’s condition may come with challenges if he continues to try to work, particularly fatigue. It’s also likely he’ll need more treatment.

Though imaging showed that all visible parts of McCain’s tumor was removed, glioblastomas often send tiny “fingers” out into normal brain tissue — which makes it very likely that some cancerous cells were still left behind.

According to a statement from McCain’s office announcing the diagnosis, he and his family are discussing more treatment options. Chemotherapy and radiation are among the possibilities being weighed, though there are other options, too. At least 87 clinical trials to treat glioblastoma are ongoing.

McCain may also have other symptoms from the tumor; issues with language and words are possible, as is some physical weakness or swelling in his brain.

Could the flight to Washington have affected his health? Probably not.

“Flying in a pressurized cabin, he should be fine,” said Dr. Michael DeGeorgia, the director of the neurocritical care unit at University Hospitals, Cleveland Medical Center. “My advice to the patient would be, ‘If you need to travel to some event, and you’re otherwise fine, you’re home and walking about, it’s fine as long as you’re not going off into the wilderness or some place where there’s not access to medical care.’”


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Most publicly available medical guidelines for air travel suggest waiting seven days after neurosurgery, including the Aerospace Medical Association and the Civil Aviation Authority, the United Kingdom’s aviation regulator. The biggest concern for neurosurgical patients cited in those guidelines is air trapped in the skull, because at altitude, the gas will expand. But Barker said that any major complications from flying too soon after brain surgery are quite rare.

“As a realistic issue, I don’t caution people about it.”

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