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Doctors Say Clarke Has Brain Cancer

By Amy Goldstein and Hamil R. Harris
Tuesday, March 11, 1997; Page A01

D.C. Council Chairman David A. Clarke was discharged yesterday from Johns Hopkins Hospital in Baltimore, where he was diagnosed with central nervous system lymphoma, described by his doctor as a fatal form of brain cancer.

Clarke's wife, Carole, said through a spokesman that the chairman does not plan to resign his seat on the council, where he has served as at-large member or chairman for 19 of the last 22 years.

After accompanying her husband by ambulance to their home in Mount Pleasant, Carole Clarke called council Chairman Pro Tempore Charlene Drew Jarvis (D-Ward 4) to tell her the diagnosis. Clarke's office disclosed the news yesterday, 2• months after he was hospitalized with neurological symptoms that included fainting, irritability, fatigue and slurred speech.

"My colleagues have nothing but sympathy for the chairman," Jarvis said, adding that without a resignation, "there is really no immediate action to take." But even Clarke's strongest council supporters said they do not expect him to to return and would consider legislation creating a benefits package to ensure that his medical care would be covered if he were to step down.

"We were hoping against hope that we would get some good news at the end of this," said D.C. Council member Frank Smith Jr. (D-Ward 1), one of Clarke's closest political allies. "Now we find out it is going to take a miracle for him to come back to us."

According to neurologist John Griffin, Clarke's main physician at Hopkins, the lymphoma—a cancer of the lymph system—is scattered in several patches of Clarke's brain. He said it was diagnosed last month through magnetic resonance imaging (MRI) and a brain tissue biopsy.

Clarke was treated with 11 sessions of radiation therapy, ending Thursday, that Griffin said might send the lymphoma into remission for an undetermined period but would not cure him.

"It is a fatal disease. The concern is it will come back at some point," the neurologist said. "Mr. Clarke and his wife know that."

Griffin said that the life expectancy of patients with Clarke's form of cancer varies from three months, for patients who do not receive treatment or do not respond to it, to a few years for patients who are otherwise healthy and respond well.

Griffin said it will take about a month to learn whether radiation therapy proves effective in Clarke's case. He said there is little medical data to help predict how long Clarke is likely to live because his medical circumstances are rare.

Central nervous system lymphoma has become more common since the 1970s, according to specialists, in part because it often is associated with AIDS. Griffin said several tests have determined that Clarke is not infected with HIV, the virus that causes AIDS.

But Clarke is one of a very small number of patients with this type of lymphoma who do not have HIV but do have extremely weakened immune systems. Griffin said he believes that Clarke's disease-fighting ability had been impaired for some time for undetermined reasons and that it "set the stage for the lymphoma to develop."

The council chairman has had visible medical problems for at least six months. He was admitted in December to Georgetown University Medical Center and transferred to Hopkins in the middle of last month, with his diagnosis uncertain.

A Georgetown spokeswoman, Clare Fiore, said yesterday that a diagnosis of central nervous system lymphoma "was being actively pursued and discussed with the family" while Clarke was at Georgetown. Fiore said that Clarke had received an MRI and a brain biopsy—the same diagnostic tests later performed at Hopkins—and that tissue from the biopsy had been sent for analysis to the National Institutes of Health, the Mayo Clinic and the Armed Forces Institute of Pathology.

"All the tests came back negative," Fiore said. She said that Clarke's Georgetown neurologist, who declined to be interviewed yesterday, believed that the lymphoma was masked because Clarke was taking steroidal medication at the recommendation of his own physician. According to a doctor involved in the case, Georgetown physicians had wanted to take Clarke off the steroids sooner.

Fiore said Georgetown doctors were preparing to stop the steroids and perform more tests when Clarke's family asked that he be transferred to Hopkins.

Griffin said Clarke's condition, including his comprehension ability, varied during his stay in Baltimore. He was not in a coma but was asleep much of the time, Griffin said.

"He was listening to music and responding to conversation and requests part of the time," Griffin said.

Clarke also had respiratory infections, Griffin said, and continues to take medication to control seizures and prevent swelling of brain tissue after the radiation treatments.

Clarke's spokesman, Robert Hainey, said the chairman was conscious yesterday when he returned home. Hainey added that Clarke "is not resigning [because] he has an aggressive treatment plan."

In the event of a resignation, an acting chairman would be appointed from among the council's four at-large members, and a special election would be held to fill the chairmanship permanently.

Carole Clarke issued a public statement that said: "After twelve long weeks, I am relieved that we finally know why David is sick. Jeffrey [their son] and I are not fully able to talk about our feelings at this time, but we hope and pray that he will get better."

Clarke first ran for the council in 1974 and held an at-large seat for eight years. He ran for chairman in 1982 and held that seat until his unsuccessful bid for mayor in 1990. In 1993, he won a special election to replace council Chairman John A. Wilson after Wilson's suicide.

© Copyright 1997 The Washington Post Company

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