What the Next President Can Do

I'm a four-year cancer survivor, and when people inquire how I'm feeling nowadays I say "good" and sincerely thank them for asking. But some well-wishers respond awkwardly. One politician I know has me in his mental file under "cancer" and accompanies his hearty hello with "Glad you beat it!" As anyone who has had advanced cancer can tell you, this is understandable but unhelpful. It also reflects why politicians are still so out of touch about the disease.

At bottom, they don't want to face the truth, which is that they've failed to protect the lives of our citizens. If a war were killing 565,000 Americans a year (and none of our wars ever has), you'd hear more than one or two references to it at the party conventions. And we'd be doing better fighting it.

The fact is, most cancers remain incurable. Fewer than a half dozen cancer drugs show great results. So it's no wonder survivors get nervous during checkups for many years after diagnosis. The five-year survival marker used by doctors is statistically arbitrary and only partially reassuring.

Consider the case of John McCain. He underwent surgery in 2000 for stage IIa melanoma, a potential deadly skin cancer. The surgery found no dangerous spreading and McCain received no chemo or radiation. Good signs. He's been cancer-free for eight years, which is even better. But the statistics, however inexact, remain a bit unnerving. For those who stay cancer-free for five years, the probability of recurrence of stage IIa melanoma is 14 percent. The probability of death is 9 percent, which doesn't even include the many other diseases from which a 72-year-old man faces sharply increased risk of mortality. (And nearly a third of those who live past 70 will suffer some cognitive impairment.) This is why giving Gov. Sarah Palin a thorough media scrubbing isn't some left-wing media jihad. It's simple prudence.

McCain neither ignores nor emphasizes his cancer experience. He skipped a Lance Armstrong LIVESTRONG Cancer Forum in Iowa in 2007 but appeared with Armstrong in July in Columbus, Ohio, where he shared his melanoma history, advocated sunscreen and explained his Senate work pushing mammography. Press coverage was skimpy as usual (not enough conflict in cancer for reporters), in part because the event came during Barack Obama's trip abroad. So the media missed a good story about just how badly McCain wants to win this election.

In 1997, McCain was passionate on the subject of tobacco, which kills hundreds of thousands of Americans a year. He used his position on the Senate Commerce Committee to advance strong new regulation of the tobacco industry and a new federal tax on cigarettes of more than $1 a pack, with the proceeds going to smoking prevention and medical research. The bill passed the Senate but was killed in the GOP House. So presumably McCain will move on this if he's elected. Country first, right?