RALEIGH, N.C.- Massachusetts Sen. Edward M. Kennedy emerged from the most precarious period following surgery to treat a brain tumor without any complications, spending Tuesday walking hospital hallways, spending time with his family and "keeping up with the news of the day," his office said.
Kennedy had a restful night's sleep after Monday's operation, a statement said, and the 76-year-old Democrat is expected to stay at the hospital in Durham for about a week before returning home to Massachusetts for further 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 the neurosurgeon said that generally, patients who make it through the first day following 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," Sampson said.
Kennedy's office issued a statement updating his condition a day after he underwent a risky, aggressive 3 1/2-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 described the surgery as a success.
"He is experiencing no complications, and has been walking the hallways, spending time with family and actively keeping up with the news of the day," Kennedy's office said in a statement. "He looks forward to returning home to Cape Cod soon, and is thankful for all the prayers and well wishes."
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 the University of North Carolina School of Medicine. "Physical tiredness. He went through a very grueling surgery, very tough on the body."
Doctors monitor the 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."
Other patients who have gone through such surgeries say they've bounced back quickly. Peggy Kronmeyer, 69, Laurel, Md., had a similar surgery in October 2005 at Georgetown. She said Tuesday the procedure went so well that she was home within three days, attending a family party and soon after going to church.
"I wasn't trying to prove anything. That was just how I felt," she said. "I wanted to be around my friends. I felt wonderful."
Surgery is just the first step in what can be an exhausting and anxious period of treatment. Once returning home to 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.
The outlook for patients with malignant gliomas is poor, and depends on what type of glioma a patient has. Experts have said median survival for the worst form is about 12 to 15 months, although that range is wide.