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Kennedy up a day after tumor surgery

Kennedy had a restful night's sleep after Monday's operation, a statement said. The 76-year-old Democrat is expected to stay at the hospital in Durham for about a week before returning home to Massachusetts for more treatment.

All of that is good news. Dr. John Sampson, the associate deputy director of the brain tumor center at Duke University Medical Center, isn't involved in Kennedy's care, but he said that, generally, patients who make it through the first day after surgery without any complications have the strongest prospects for recovery.

“Most of the major complications – the disastrous complications – typically occur within the first six hours or at least the first 24 hours after surgery,” said Sampson, a neurosurgeon.

Kennedy's office issued a statement updating his condition a day after he underwent a risky, aggressive 31/2-hour surgery experts say is designed to remove as much of the tumor as possible before he receives chemotherapy and radiation treatments. His doctor has not said how much of the tumor was removed, but he described the surgery as a success.

Kennedy, who has served in the Senate since 1962, was diagnosed with a malignant glioma in the left parietal lobe of his brain after suffering a seizure on May 17 at his home in Hyannis Port, Mass.

Sampson and other doctors familiar with such surgery said other, less serious complications may present themselves later. Brain swelling can begin days after the surgery, causing loss of speech and movement, but that's usually only a temporary problem that doctors don't worry too much about, Sampson said.

“The main thing (patients are) going to be feeling is like they played a few quarters of football, pretty well beat up,” said Dr. Victor Perry, a neurosurgeon and associate professor at UNC School of Medicine. “Physical tiredness. He went through a very grueling surgery, very tough on the body.”

Doctors monitor patients closely for infection, which can arise five to 10 days after operation, Sampson said. Other late-presenting complications include bleeding into the brain, seizures, cardiac problems, lung problems, pneumonia and blood clots, said Dr. Kevin McGrail, the neurosurgery chief at Georgetown University Medical Center.

But McGrail agreed that most problems typically arise within the first 24 to 48 hours after surgery: “If he is doing well, that's a good sign.”

Once back in Massachusetts, Kennedy's doctor has said he will begin targeted radiation and chemotherapy treatment. That usually begins at least two weeks after the operations, experts said, because the treatment will halt any residual healing from the surgery.

Doctors have not detailed Kennedy's exact type of tumor, nor have they released his exact treatment plan. Typical radiation treatment continues five days a week for about six weeks. Treatment also includes the chemotherapy pill Temodar during and after radiation. Possible side effects include nausea, vomiting, fatigue and hair loss.

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