Stricken with a cancerous brain tumor in the autumn of his storied political career, Sen. Edward M. Kennedy was facing a daunting treatment regimen with "good spirits," his doctors here said Tuesday, while his family and political friends struggled with the uncertain realities posed by the stark diagnosis.
Medical tests performed over the weekend revealed that the 76-year-old Massachusetts Democrat has a malignant glioma on the left side of his brain. About 9,000 malignant glioma diagnoses are made in the U.S. each year, and survival rates are bleak for severe cases.
Kennedy's doctors took care not to describe the tumor's size or state of advancement. They did say that preliminary tests showed that the tumor was in Kennedy's parietal lobe, a section of the brain crucial for speech comprehension -- and an area that would complicate any immediate efforts to remove the cancer in its entirety.
Kennedy was airlifted from his Cape Cod home to Massachusetts General Hospital after a seizure Saturday. His doctors said Tuesday that he "has had no further seizures, remains in good overall condition, and is up and walking around the hospital."
In the clubby Senate anterooms of Washington's Capitol, where Kennedy has held forth since 1962 after filling the seat vacated by his brother, President Kennedy, fellow lawmakers struggled with their emotions and memories.
Democratic senators emerged ashen-faced from their weekly luncheon after Majority Leader Harry Reid of Nevada broke the news. West Virginia Sen. Robert C. Byrd, 90, wept from his wheelchair on the Senate floor when he tried to deliver a tribute. "Ted, Ted, my dear friend, I love you and miss you," Byrd said haltingly.
In the 28 years since he gave up his dream of a presidential bid, Kennedy has fashioned himself as the premier architect of across-the-aisle legislative dealmaking in the Senate. He was intimately involved in crafting and shepherding definitive healthcare, pension and immigration bills.
Bush saluted Kennedy on Tuesday as "a man of tremendous courage."
The three leading presidential candidates, all fellow members of the Senate, also offered paeans. But Kennedy's illness may have the deepest effect on Illinois Democrat Barack Obama's campaign. Obama -- who won the Oregon primary Tuesday night after a loss in Kentucky to rival Hillary Rodham Clinton of New York -- has been endorsed by Kennedy and had planned for his presence on the campaign trail.
Obama called Kennedy "a fighter for his entire life." Clinton said he was "one of the greatest legislators in Senate history." And John McCain, the presumptive Republican nominee, hailed Kennedy as the Senate's "last lion" and its "most effective member."
In their terse assessment of Kennedy's condition, released midday Tuesday, the doctors at Massachusetts General said his immediate treatment would "be determined after further testing and analysis." Dr. Lee Schwamm, vice chairman of neurology at the hospital, and Dr. Larry Ronan, a primary-care doctor, added that the "usual course of treatment includes combinations of various forms of radiation and chemotherapy."
Neither doctor speculated on Kennedy's chances of survival. While malignant gliomas are among the most common forms of brain tumors, they are not easily eradicated, several neurosurgery specialists said.
"The median survival figures are not great -- typically no more than 14.6 months" for the most pronounced malignancies, said Dr. John S. Yu, co-director of the Comprehensive Brain Tumor Program at Cedars-Sinai Medical Center in Los Angeles.
In standard cases of malignant gliomas in the parietal lobe, Yu said, patients would receive a seven-week course of radiation and chemotherapy. If an MRI showed no improvement at that point, cancer specialists could consider surgery -- a delicate procedure that could drastically affect a patient's ability to speak and understand language.
There also are several aggressive experimental options, said Dr. Keith L. Black, chairman of the neurosurgery department at Cedars-Sinai. Those include the use of Avastin, a drug that blocks the formation of new blood vessels that nourish the tumor, or therapeutic vaccines aimed at activating the body's immune system to fight the malignancy.
Kennedy's chances for recovery could be adversely affected by his age. "Generally, older than the age of 55 is associated with the worst prognosis," Yu said. But, he added, Kennedy's agile mind could provide an edge. "People who are in good mental shape tend to do better."
The Kennedy family did not comment on Tuesday's medical report. Since the seizure Saturday, Kennedy's wife, Vicki, and five children and stepchildren have been at his bedside. Other friends and family -- including Sen. John F. Kerry (D-Mass.) and Caroline Kennedy, daughter of President Kennedy, have been spotted entering the hospital.
A throng of media vans, television crews and reporters camped outside Massachusetts General on Tuesday night, awaiting any updates on the senator's condition. An Associated Press photographer allowed inside the hospital earlier in the day emerged with a shot of a relaxed Kennedy joking with relatives.
Down the block from the hospital, crowds of people in green jerseys and sweat shirts made their way to Fleet Center for a Boston Celtics game. Many said that the news of Kennedy's brain tumor had put a damper on the night.
"It's just sad that this has to happen to an individual who has had so many tragic events in his family," said Spencer Macalaster, 51, a Boston businessman. "They have had more than their share."
Blessed by the political fortunes of its sons, the Kennedy dynasty also has known crisis: the World War II air crash that killed Kennedy's oldest brother, Joseph; the 1963 assassination in Dallas of JFK, and the 1968 fatal shooting of Sen. Robert F. Kennedy in Los Angeles as he celebrated a victory in California's Democratic presidential primary.
"After everything his family suffered, he made such a wonderful success of his life and his career," said Kenneth R. Feinberg, who was Kennedy's administrative assistant in the late 1970s. "It's inconceivable to those of us who have worked with him to think of any public policy without his counsel."
Kennedy has had repeated brushes with mortality during his 46 years in the Senate. In 1964, he survived the crash of a small plane that killed an aide and the pilot as it was landing at a Massachusetts airstrip. Pulled from the wreckage by fellow senator Birch E. Bayh II (D-Ind.), Kennedy suffered a punctured lung, broken ribs and internal bleeding. He was aboard another small plane that was struck in the air by lightning in 2006 and had to make an emergency landing.
In one of the darkest moments of his life, in 1969, Kennedy's car veered off a bridge between Chappaquiddick Island and Martha's Vineyard. Mary Jo Kopechne, a campaign aide, drowned. But Kennedy left the scene and did not call police until the next day. Dogged by questions about his conduct and his relationship with Kopechne, he later pleaded guilty to leaving the scene of an accident and was given a suspended two-month jail sentence.
Kennedy's Senate term is not up until 2013. Under Massachusetts law, if he were to resign or die, a special election would be held 145 to 160 days after his seat was vacated.
Already, Boston political junkies were speculating over likely successors. The names on the Democratic side included Kennedy's nephew, Joseph P. Kennedy II, a former congressman and head of a nonprofit energy firm; Martha Coakley, the state's attorney general; Rep. Edward J. Markey and former Rep. Martin Meehan. Republican possibilities include former GOP presidential candidate and Massachusetts Gov. Mitt Romney or former Lt. Gov. Kerry Healey.
But for most of the Boston residents milling around Massachusetts General on Tuesday night, Kennedy's Senate seat still belonged to the man who over the years had made it uniquely his.
James R, Holland, 64, is a conservative who disagrees with Kennedy's policies on illegal immigration and taxes. But he was quick to say that he hoped to soon see "that Kennedy smile" again.
Braun reported from Washington and Hayasaki from Boston. Times staff writer Thomas H. Maugh II in Los Angeles contributed to this report.