Senator Kennedy Out of 'successful' Brain Surgery

Senator Edward M Kennedy is out of surgery at Duke University, and his doctor says a procedure to treat his cancerous brain tumor "was successful and accomplished our goals".

The 76-year-old senator now faces chemotherapy and radiation to treat the malignant glioma, a lethal type of brain tumor.

Kennedy surgeon Allan Friedman said on Monday his patient was awake during the 3 1/2-hour procedure, and should experience no permanent neurological effects from the surgery.

A spokeswoman for the Massachusetts Democrat says Kennedy spoke with his wife, Vicki, right after surgery. He told her: "I feel like a million bucks. I think I'll do that again tomorrow."

Targeted brain surgery like that chosen for Kennedy is a delicate balance - removing as much tumor as possible improves cancer control, but there's also the risk of harming healthy brain tissue that lets patients walk and talk.

"The surgeon usually does as much as possible within the bounds of safety. We do not want to do neurological damage in an effort to remove as much of the tumor as possible," said Dr. Mark Gilbert, a brain tumor expert at the University of Texas M D Anderson Cancer Center in Houston.

He spoke in Chicago from a conference attended by 30,000 cancer specialists featuring three hours of presentations today on experimental treatments for brain tumors.

Kennedy, 76, underwent the surgery today at Duke University Medical Center. He was diagnosed last month with a malignant glioma.

"Over the past several days, Vicki and I, along with my outstanding team of doctors at Massachusetts General Hospital, have consulted with experts from around the country and have decided that the best course of action for my brain tumour is targeted surgery," the senator said in the statement.

These operations start with the patient heavily sedated as surgeons cut through the scalp and remove a small area of the skull bone to expose the brain. The tumor usually is not on the surface, so surgeons must choose a path through the brain to get to it, said Dr Matthew Ewend, neurosurgery chief at the University of North Carolina, Chapel Hill.

To avoid cutting through vital areas controlling speech, doctors often bring the patient back to consciousness and stimulate tissue in the planned approach with a probe.

"We'll have them do language tests like hold up pictures, name objects, repeat words, hold a conversation," Ewend explained. "There's lots of local anesthesia, so this is not painful," he stressed.

Similar tests for brain areas that control movement can be done while the patient is unconscious, with a small electrical current to the brain. The patient doesn't have to be awake for doctors to see the reflex responses.

Once they see a safe path, the patient is put under again while the tumor is removed. That takes about three to four hours, Ewend said.