Ted Kennedy’s Brain Cancer

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Ted Kennedy was a successful United States senator from Massachusetts for almost 47 years, from 1962 until his death in 2009 from a brain tumor called glioblastoma multiforme. He died 15 months after his diagnosis. Today we have no successful treatment for this type of brain tumor; surgical resection, irradiation and chemotherapy are ineffective treatments (Semin Cancer Biol, 2019.;58:118–29), with an average life expectancy after a diagnosis of 14-16 months. A possible cure comes from promising research on mRNA-based gene transfer (Oncotarget, Aug 23, 2016;7(34):55529-55542) that has been going on for more than 15 years and is the research that led to the development of the Moderna and Pfizer vaccines used to help prevent COVID-19.

Early Years
Ted Kennedy was born on February 22, 1932 in Boston, Massachusetts, to Rose Fitzgerald, the daughter of Boston mayor John “Honey Fitz” Fitzgerald, and Joseph P. Kennedy, a self-made millionaire who held many government appointments.

Kennedy entered Harvard in the class of 1954 but graduated in 1956, just a year ahead of my class of 1957. He had been suspended for two years for having someone else take his final exam for a Spanish class. I never met Ted Kennedy when we were in college, because I was a commuter student spending three hours a day on the streetcars, while he belonged to the exclusive private clubs that I never even knew existed. During his two year suspension from Harvard, he joined the army and lifted weights. He came back to school packing well over 200 pounds into his 6′ 2″ frame. He was much larger and stronger than when he left, and was a good football player. After graduation, he was turned down by Harvard Law School but was accepted at University of Virginia Law School, where he received his law degree in 1959.

Better Senator than Student
In 1962, shortly after his brother became President, he took his first job ever when he was elected to his brother’s United States Senate seat at age 30. In 1969, after the assassinations of Jack and Robert, he became the youngest-ever majority whip in the U.S. Senate and the leading candidate for the Democratic presidential nomination. He probably would have been elected President of the United States, but he hosted a party on the island of Chappaquiddick, and after the party, he was driving 28-year-old Mary Jo Kopechne back to her hotel when he missed a turn and drove off a bridge. Kennedy, a married man, left the scene and did nothing to rescue her. The next morning, police found the submerged car with Kopechne’s dead body inside. He was charged only with leaving the scene of an accident, but the scandal took him right out of the presidential campaign. In 1982, he was divorced from his wife of 24 years, Joan Bennett Kennedy. In 1992 he married D.C. lawyer Victoria Reggie and had two more children, Curran and Caroline Raclin.

He was a very good senator.  In 1996, he authored the Health Insurance Portability and Accountability Act, which allows people to change jobs and still keep their health insurance. In 1997, he authored the Children’s Health Act, which increased access to health care for children up to age 18. He also helped legislate immigration reform, criminal code reform, fair housing for the poor, health care and increased funds for AIDS research. He supported the “No Children Left Behind” laws. After the terrorist attacks on September 11, 2001, Kennedy sponsored the Bioterrorism Preparedness and Response Act to prevent, prepare for, and respond to bioterrorism emergencies. He also sponsored the Individuals with Disabilities Education Act and expanded Medicaid coverage.

Medical Conference to Decide On Treatment 
On May 17, 2008, Kennedy had a seizure and was diagnosed with glioblastoma multiforme, a highly malignant brain tumor that has no effective treatment. On May 30, Kennedy arranged a conference of more than a dozen experts from six medical schools. He had done this previously for two of his children who had cancer: A son, Edward Jr., had part of his right leg amputated in 1973 for bone cancer, followed by radiation and two years of chemotherapy. A daughter, Kara Kennedy Allen, had her lung cancer removed in 2003.

The Mass General neurosurgeons are among the most famous in the world and they felt that the tumor had already spread too far for him to benefit from surgery. The Duke surgeons recommended surgery and Kennedy decided to follow their advice. On June 2, 2008 the Duke surgeons operated on Kennedy for three and a half hours. They declared that the operation was successful and that Kennedy should experience no permanent nerve damage. Soon afterward, he gave a very emotional speech supporting Barack Obama for President at the Democratic Convention in Denver, Colorado.

On January 20, 2009, at Obama’s post-inauguration luncheon, he suffered another seizure. His doctors stated that “the incident was a result of simple fatigue.” He alternated staying in DC for his job in the Senate and in Florida for relaxation. On August 20, 2009, he requested a change in the Massachusetts law to allow for his quick replacement. The law at that time called for a special election to be held within five months of his leaving the Senate. He insisted this proposed legislation had nothing to do with his health. On August 25, 2009, he died at his Cape Cod home.

Unhealthful Lifestyle Increases Cancer Risk
Ted Kennedy had horrible lifestyle habits. He did not exercise and was obese. He often drank too much alcohol, which is a known carcinogen. Eight months before the brain tumor was found, doctors removed plaques that were blocking the left carotid artery leading to his brain. His diet appears to have been unhealthful and heavy in red meat and sugar. He took medication to lower his high blood pressure and statins to lower cholesterol.

A person who suffers a first seizure after age 60 is at high risk for a brain tumor. Other symptoms include headaches and changes in behavior, personality or temperament.

Treatments for Glioblastoma Multiforme
Patients diagnosed with glioblastoma are usually treated with surgery followed by chemotherapy and radiation and the tumor usually recurs within a few months to cause death within two years, a survival benefit over no treatment of 4-6 months (Front Physiol, Mar 10, 2018;9:170). Surgery to reduce the size of this brain cancer does not make radiation and chemotherapy more effective afterwards. Most neurosurgeons reserve surgery just to relieve the horrible progressive symptoms. Radiation can cause horrible loss of memory.

Kennedy lived for 15 months after being diagnosed with a glioblastoma, slightly longer than the average of one year. It is extremely unusual for a patient to live more than three years after diagnosis. The cancer grows so rapidly that it does not continue to respond to treatment. Normal brain cells continue to turn into tumor cells even after surgery. 25,000 Americans are diagnosed with glioblastoma each year, and fewer than ten percent survive more than two years. The bill for surgery can run from $100,000 to $500,000. While we have no cure for glioblastoma tumors today, some areas of research are promising.

How mRNA May Be Used to Combat Cancer
The mechanism that is working to immunize people against COVID-19 may also be useful in finding cures for many types of cancer. Indeed, it was mRNA research for a treatment for glioblastoma multiforme that paved the way for the development of the Pfizer and Moderna vaccines used to help prevent COVID-19 (Science, 1990, 247(4949 Pt 1):1465–8).  See Messenger RNA May Help to Beat Cancer

Cancer cells are different from normal cells. Normal cells go through a certain limited number of doublings and then die. This is called apoptosis. Thus skin cells live 28 days and die, red blood cells live 120 days and then die, and the cells on the inside of your lips live 24 to 48 hours and die, and so forth. Cancer means that your cells forget that they are supposed to have only a limited lifespan. For example, breast cancer is not fatal as long as it stays in your breast, but when breast cancer cells become so numerous that they spread to your lungs, brain or liver, they can destroy these organ’s cells and you die from lung, brain or liver failure.

Everybody makes millions of cancer cells every day, but your immune system recognizes that cancer cells are different from normal cells, and seeks out and destroys the cancer cells (Nature Medicine, February 2, 2014:20; 283-290). Your immune system destroys cancer cells using a mechanism that is similar to the way that it seeks out and destroys invading germs. Various germs continuously try to invade your body, but your immune system recognizes germs by their surface proteins that are different from your own surface proteins. So when a germ tries to enter your cells, your immune cells and cytokine proteins work to attack and kill the invading germs. In a like manner, your immune system recognizes that cancer cells are not normal and attacks cancer cells in the same way that it tries to kill germs. If your immune system loses its ability to tell that a cancer cell is different from a normal cell, the cancer cells can multiply, spread through your body and kill you.

For many years, scientists have been trying to make copies of cancer cells that can be transmitted with mRNA to restore your immune system’s ability to attack and kill those cancer cells. This research is now being accelerated by the successes in development of vaccines to combat COVID-19 (EFPIA Pipeline Review 2021 Update, February 2021).

Ted Kennedy
February 22, 1932 – August 25, 2009