Nature Medicine | Spoonful of Medicine

Off the record

As Sarah Palin and Joe Biden face off tonight in the vice presidential debates many voters will be assessing whether they can trust either one to step into the oval office should the president become incapacitated or die.

So, it’s no surprise that some people have been asking for John McCain to release his complete medical records, especially given his history of melanoma. One activist group has been pushing this agenda in television ads and in a video on YouTube.

The group’s popular YouTube video says that people with stage II melanoma, a type of tumor McCain had removed in 2000, have an approximately 60 percent chance of living for ten years after treatment. That statement is accurate. But the video ignores some subtleties. The New York Times reports that, since he’s already survived more than seven years cancer-free, he has a lower risk (I conferred with an oncologist who also said that for stage II melanoma, most instances of recurrence occur within the first few years). But McCain probably shouldn’t give up his skin checkups just yet, since older people have higher risk.

It’s disconcerting that the McCain campaign chose to release the candidate’s more than 1000 pages of records for only 3 hours to a group of reporters it selected—without allowing them access to recording devices, email or outside consultation. How many blebs, polyps, skin dots and detailed pathological reports did they miss? Either his records contain grist for an outside expert to cast doubt on his fitness, or they would put even the most politically partisan MD to sleep. We may never really know.

What about Obama? It seems his campaign also did not fully release his records either, instead providing a summary from his primary physician saying he was in excellent health.

Is the public entitled to know more? I’m sure most people would not welcome the public airing of their medical history, but it seems that a more open standard should apply to presidential candidates. Have the candidates done enough, or should they both release their complete records?

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