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The medical elephant in Specter’s room (Updated)

by Paul Scoles

CORRECTION APPENDED (See bottom)

There was an 800-pound gorilla in the room in Lancaster last weekend, and nobody talked about it

The Democratic State Committee and the national Democratic machine made a major mistake in supporting Arlen Specter for reelection. In fact they made several mistakes, but other, more practiced commentators will deal with the politics (although it seems pretty clear from the polls that he can’t beat Republican Pat Toomey).

I’m talking about the medical mistake. Out of deference, or politeness, or concern about how various interest groups would react, Joe Sestak’s campaign has opted not to make an issue of Specter’s age and medical condition. But it needs to be a major issue.

As a matter of full disclosure, I should note that I am a Sestak supporter, and I’m proud to count Joe as a friend. I have not discussed writing this with Joe or his campaign, and they have no idea I am doing so. They would no doubt discourage me from raising the subject in such a public forum—and I expect to catch hell for it.

I think, however, that the urgency of the issue transcends squeamishness over offending senior constituencies or any others.

Specter was diagnosed in 2005 with Hodgkin’s disease, a cancer of the lymphatic system. He responded to treatment, but the cancer recurred in 2008. Cancerous tumors of this type, indeed, of all types, are “staged” by oncologists, which means they are described by various factors related to the location and type of tumor, how widespread the tumor is in the body, and what other symptoms are present when the diagnosis is made. Typically, tumors are staged as one through four, based on location and spread, with four being the worst.  They are then sub-staged as type A, when no generalized symptoms (such as fever) are seen, and Stage B, when such symptoms are seen. Typically, stage B tumors have poorer survival rates. Researchers have gathered survival data which is sorted according to various factors, such as ethnicity, other diseases present in the patient, and age at diagnosis. Statistical predictions can then be made as to the likelihood of survival for a period of time for any given patient.

His 2005 diagnosis was for stage IV-B Hodgkin’s lymphoma. According to National Cancer Institute data, the relative ten-year survival rate in patients with this tumor at this stage was almost 90 percent for ages 15-24,  but only 21 percent for patients diagnosed at age 75 or older. As for his 2008 recurrence, good statistics on recurrent disease are hard to find, but suggest that the overall five-year survival is around 22 percent. That data is not stratified by age, and advanced age is strongly associated with worse outcomes in Hodgkin’s lymphoma. Specter turns 80 on this month. So in other words, according to most data, Specter’s likelihood of being alive and disease free through a full six-year term is about 1 in 5.

The political implications should be obvious. First, Republicans will have no qualms about making this a major issue in a race against Toomey in November. Second, and more importantly, if the Senator is not able to complete his term due to disease, his replacement will be appointed by the Governor, and polling data at this point strongly suggests that the next governor will be a Republican. That means the Democrats lose the seat—and the precious 60-vote super majority that the party establishment rolled over to get, and then lost in Massachusetts anyway, will be even further away.

Of course, there’s always the risk that a lame-duck Specter could revert to his Republican roots between the May primary and January of 2011, but that’s relatively small compared to the damage six years of a far-right, ultraconservative activist like Pat Toomey would do.

Pennsylvania Democrats need to recognize reality, and, with all due respect for Senator Specter’s age and years of service, realize he should not be their candidate. Specter should, if he truly has the best interests of the Democratic Party at heart, say that he has been honored by their endorsement, but he feels, for reasons of health, that he should not undertake the arduous process of a reelection campaign.

He should opt for honorable retirement, become Pennsylvania’s Elder Statesman, and support Joe Sestak for Senate.

The writer, an orthopedic surgeon, is a former candidate for Congress in the 7th District and a former vice-chair of the Delaware County Democratic Party.

Correction: This op-ed originally misstated the type of cancer with which Specter was diagnosed in 2005. It is Hodgkin’s disease, not Non-Hodgkin’s lymphoma, which typically has lower survival rates than Hodgkin’s.

February 8, 2010 at 2:00 pm

--Paul Scoles

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comments [23] | post a comment

  1. Matt

    Feb 8th, 2010

    Wow.. we all knew Sestak supporters would be disappointed at the endorsement, but this takes sour grapes to a whole new level.

    You stay classy, Paul.

  2. chesco dem comm person

    Feb 8th, 2010

    Paul,
    First of all, we never made your health a big deal when you ran. Secondly, I received a call from the Sestak campaign a few weeks ago where the Senator’s health was brought up. They have been running a whisper campaign based on lies and innuendo. I am proud to support Senator Specter in a few weeks at the committee endorsement. Though I expect the committee to endorse Joe….I think he seriously needs to drop this campaign and think about others and the party…..something he will never do.

  3. delco committee person

    Feb 8th, 2010

    Dr Scoles-
    This is truly pathetic.
    Senator Spector is not my favorite candidate, but the information you have shared is totally inappropriate, and I sincerely hope you ‘catch hell’ from the Sestaks.
    I hope readers know that the rest of us in Delco are not supporting this cruel argument.
    Can this column be withdrawn? Please?

  4. HateSestak

    Feb 8th, 2010

    Does Representative Sestak has any scruples whatsoever? This is unquestionably the most morally reprehensible piece I have ever read. I admire Senator Specter for the tenacity, the sheer will, that he has demonstrated. He has overcome medical woes that easily would have crushed another human being. Senator Specter commands my respect. Representative Sestak most assuredly does not. Shameful. Utterly shameful.

  5. LMJ

    Feb 8th, 2010

    I don’t think the Sestak campaign is connected to this. They and the Delco Dems don’t talk much. Also, while this is a difficult subject to broach, general good health is a requirement for a lot of jobs. The subject the author raises should be considered. A U.S. Senator’s health, stamina and general physical&mental condition should be such that one can reasonably expect him to fulfill a 6-year-term.
    Also it should not be the goal of a US Senator to hold office until they die of natural causes. Doing so risks turning the US Senate into another House of Lords.

  6. Former Scoles Supporter

    Feb 8th, 2010

    Paul,
    Back in the 1990’s when you sued because you could no longer practice medicine because you were HIV-Positive, that was sad. When you ran for congress and the opposition made up a whisper campaign about you, that was terrible. When you, of all people, come on her and disqualify Senator Specter and his ability to serve because of health issues, you are now the most disgusting person in politics. What’s not fair game for you personally, is fair for others? Apologize now! Who are you kidding, you are tied at the hip to Rich Sestak and Team Sestak. This is pretty much their message as told by a “medical professional”. What is next, you will use your medical education on tv to tell us ex-tenze work? Give me a break.

  7. David Diano

    Feb 8th, 2010

    Paul-
    The polls are equally “clear” that Sestak has even less chance against Toomey.
    I think the polls are a bit bogus because few people realize that Toomey is to the Right of Rick Santorum.

    I expect that the Sestak campaign is actually VERY happy that you are making an issue of Specter’s health, though they can’t admit it publicly. (though, they might not like the blow-back you are getting in the comments) They loved it when I used to trash Weldon in the blogs, and they had no fingerprints on it.

    The Dems squandered the 60-vote super majority with Nelson (and Lieberman, who is really a republican). Specter did his job as part of the 60.
    Specter’s in a lot better health and vigor than my parents, who are 10 years his junior. I’d have a hard time keeping up with his schedule.

    If you are really concerned about the best interests of the party, you should be advocating for Sestak to accept the Democratic polls, the unions, and his rejection at state committee, and then support Arlen Specter.
    Instead, Sestak plans to waste $5 million dollars plus whatever he forces Specter to spend, instead of spending against Toomey.

    Paul, I won’t personally attack you here in public, because of my respect for your difficult congressional run in 2004. However, you really need to stop kissing the hind quarters of the Sestak clan and wake up to what they are really about: Joe and nothing else. If you think they give a rat’s @ss about you or Delco, or PA or the Democratic party, you have deluded yourself.

    If you honestly think Sestak has a better shot at beating Toomey, that’s a legitimate point of debate. But to “diagnose” Specter as not healthy enough for the race is as a bad as when Bill Frist “diagnosed” Terry Shiavo.
    Maybe you should do an analysis of Sestak’s blood pressure when he screams at his staff or watches his political career go down the tubes.

    I like the story of when you were Treasurer and the two month delay getting the Sestak campaign to pay the $625 for their table and sponsor ad for the Delco 2008 FDR-JFK dinner.

  8. [...] From PA2010: Specter was diagnosed in 2005 with Hodgkin’s disease, a cancer of the lymphatic system. [...]

  9. HateSestak

    Feb 8th, 2010

    I’m sure Sestak will receive exceptional health care – in the prison hospital.

  10. Rob

    Feb 8th, 2010

    I am sorry, but Specter’s health is as legitimate an issue as McCain’s was in 2008. One of the reasons that McCain’s choice of Palin was so atrocious is that McCain has suffered from recurrent melanoma. That was spoken of in the campaign. It is something that voters needed to consider then and is a legitimate consideration now.

  11. Dan Hirschhorn

    Feb 8th, 2010

    Hey folks,

    Dan Hirschhorn here, editor of pa2010.com. I just wanted to chime in for one moment. I understand the objections to this piece, even though I don’t agree with calls to remove it from the site.

    I’ve addressed some of the concerns people have voiced on my blog. I hope you’ll take a chance to check it out below:

    http://www.pa2010.com/2010/02/an-op-ed-note-and-super-important-correction/

    Thanks for reading.

    Dan

  12. Johnny

    Feb 9th, 2010

    Thanks for saying something that so many of us have been thinking about for some time. Sen. Specter does not look well at all and the fact that the Republicans won’t hesitate to use this as an issue should be a reality check for all Democrats. I think this article said the truth plain and simple and voters need to face these kind of issues and vote with common sense.

  13. Greg K., PA

    Feb 9th, 2010

    The man plays squash several times a week; he’s successfully fought of the cancer and yet still has seemingly boundless energy. I fully expect Sen. Specter to make it through a full term and I imagine he’ll probably retire after that.

    And to say that Congressman Sestak should be the party’s nominee because Sen. Specter is behind in the polls is ridiculous because Sestak is even further behind in the polls. The polls at this point are essentially meaningless – we still have tons of people who haven’t made up their minds and Pat Toomey is still portraying himself as a moderate instead of the ultra-conservative (more conservative than Rick Santorum) that he is.

  14. Barry OConnell

    Feb 9th, 2010

    With the choice between Arlen’s health and Sestak’s morals and work ethic, I am 100 percent fo Arlen Specter. This article is a disgrace and so is Paul Scoles.
    With disdain,
    Barry OConnell
    Lycoming County

  15. Paul Scoles

    Feb 9th, 2010

    I think it’s telling that none of the objections to the op/ed addressed the issue at hand preferring to focus on whether the Sestak campaign was consulted (it was not); whether this provides the other party with ammunition for the general election (none they didn’t already have, NCI SEER statistics are not exactly private) and even chastising me with the charge that my health was never made an issue in my brief campaign (it was; the DELCO Times worked it into the virtually every story, and Curt Weldon’s only comment in the campaign was on the issue). The statistics remain unchallenged, and the question remains the same:whether the health of an 80 year old with recurrent lymphatic cancer is a legitimate issue for concern in a critical Senate race. I believe it is.

  16. [...] Sestak needs to make Specter’s age and medical condition an issue?… [...]

  17. 95 South

    Feb 9th, 2010

    Pat Toomey, he’s tanned, rested, healty and ready, and Oh, also ahead in the polls!!!!

  18. chesco dem comm person

    Feb 9th, 2010

    As a committee person, we as a group never made an issue of it. No where does anybody say your health wasn’t brought up. The locals here know you are close to Rich Sestak and find it hard to believe that you didn’t talk with him about it. We all know there is a chance of Specter dieing. Does that mean Minnesota should have voted out Wellstone because he may die? Or Murtha? Or Leo Ryan? No when it is ones time to go, maybe it is, we cannot dictate when a politician may die. Under your “dumb logic” WV would have dumped Robert Byrd years ago and gave up everything he has done over the past 10 to 15 years.

  19. Jack K.

    Feb 9th, 2010

    A disgusting piece of commentary from Dr. Scoles. There is such a thing as the Hippocratic Oath, yes? Maybe a glance back at it would humanize you again, sir.

    I’m a registered independent, leaning toward Mr. Toomey, and these types of puerile, disgusting antics only confirm my decision to go with the most upstanding, principled candidate in the race.

  20. Taj Magruder

    Feb 9th, 2010

    I’m a volunteer/campus coordinator/intern with the Sestak campaign, and I support Joe because he is a true Democrat — not because Specter is eldery and ill. All of us can die at any moment, whether from disease, car accident, etc.

    That being said, I don’t understand some of the objections raised about Sestak’s morals and work ethic here. By running against Specter, he is clearly putting principle before politics. Moreover, he is the most productive member of his legislative class, and he has traveled to EVERY SINGLE county in the state already. In a single day, he does dozens of events, interviews, etc.

  21. Son of Tommy

    Feb 10th, 2010

    The Good Doctor Scoles raises an issue of debate, regardless of its genesis or his motive. Senator Specter is old, and sick. The issue deserves to be discussed and aired and the people may consider it when they vote.
    I like Joe. I like Arlen. I am worried about who can beat Toomey. I am not sure either can. Too many Dems have been raised their whole life to hate and beat Specter. Why are we supporting him now? Hoeffel got like 48% against him six years ago…Why are we now supposed to hold our noses and vote for him? If he is the nominee at the top of the ticket, what base does he excite or mobilize? the Republicans that always carried him won’t vote for him and the Spectercrats are too few. The real liberal base of our party will unfortunately stay home in November, helping Corbett, Meehan and all the other republiclowns and teabaggers.
    I don’t think Sestak is the greatest in the world, but he stands a better chance of getting the liberal base and hte moderate dems and moderate repubs a clear choice against toomey, and also some down ticket help.
    Just some thoughts.

  22. sharonsj

    Feb 10th, 2010

    I do not care about Specter’s health. I want to know where he and Sestak stand on issues–and that’s how I’ll decide to vote. And either of them is better than looney Toomey.

  23. Bill Greenlaw

    Feb 10th, 2010

    Beyond all the problems listed above, the statistical underpinning of this opinion piece is inappropriate.

    Survival rates can not be extrapolated as the writer suggests. Once someone survives for a number of years with Hodgkin Lymphoma their survival rate is actually quite high for their remaining years. To put this another way, most deaths due to Hodgkin Lymphoma occur within the first few years after diagnosis.

    Specter is a survivor. He is likely to continue to survive. Let’s decide this on the issues, not some falsely construed statistical argument.

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