The figure at the front of the Maryland Senate chamber was as familiar as he was formidable. Thomas V. Mike Miller Jr., a fixture on this ornate rostrum for three decades, commanded the session as he had thousands of previous ones, gavel in hand, jokes at the ready, that unmistakable neoclassical wave of white hair cresting over his dark collar.

But this wasn’t like other legislative sessions. The reliably robust Miller — the country’s longest continuously serving Senate president — leaned a cane against the woodwork. Senators awkwardly bumped elbows or fists with their 76-year-old president instead of shaking his hand. Those iconic tresses were strangely on his mind.

“My hair is coming out in gobs,” the Democrat confided to the lawmakers, reporters and visitors filling the chamber on a recent January morning. “You know, The Washington Post 20 years ago did a story on the four different shades of my hair. Now they’ll be able to do the four different shades of baldness of my hair.”

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Mike Miller has cancer. He is struggling to cope — and so is the Senate he has led since 1987. His treatment for Stage 4 prostate cancer that has metastasized to his spine and pelvic area is overlapping with the 90 days of his 33rd session as leader. The first of a probable six rounds of chemotherapy began two days after the Assembly’s opening session. His second round began this week.

“Personally, it felt a little uncomfortable. . . to see him physically being not what you’re used to,” said Sen. Paul G. Pinsky (D-Prince George’s). “I really want him to beat this thing.”

Emotions have swelled frequently during the usually breezy first days of the session, still weeks away from the passions of vote whipping and arm twisting. Tears flowed freely during the opening session. Gov. Larry Hogan (R) sparked a standing ovation Wednesday when he saluted Miller’s cancer fight at his annual State of the State speech.

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Miller himself has choked up at several gatherings. During a meeting this month with the Maryland Economic Development Association, he was unable to finish an anecdote about his father, his voice trailing off in the suddenly silent room. He faltered again when touching on some of his legacy issues: casinos, education, Chesapeake Bay restoration. House Speaker Michael E. Busch (D-Anne Arundel) approached his longtime Senate counterpart, comforting him with his hand on Miller’s back.

The State House has dealt with illnesses among its most powerful members before. Staffers still wear the rubber “Iron Mike” bracelets from Busch’s recent liver transplant and heart bypass surgery. Hogan publicly endured treatment for non-Hodgkin’s lymphoma in 2015. But Annapolis has had a harder time adjusting to a whiff of mortality in its seemingly indomitable Senate president.

Acorns have become oak trees in the years since Miller took up the gavel. Mortgages have been taken out and paid off. Babies have been born, become adults and, in at least one case, been elected to the Maryland Senate — all while Miller has ruled the rostrum with the ease of a captain on his quarterdeck, a preacher in his pulpit, a father at the head of the table.

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“This is an eight or a nine on the Richter scale when it comes to the Maryland Senate,” said Robert Neall, Hogan’s secretary of health and a former Republican state senator who came to the opening session to support his longtime friend.

Several days later, as Miller smoothly ordered quorum calls, introduced visitors and applauded a senator’s new baby, he loomed like one of the columns rising to the galleries above. When he sat, his alabaster hair disappeared against the marble wall. After 32 years, Miller seemed not so much the leader of the Senate as its human manifestation.

“The Senate has become part of him, and he’s become part of it,” Neall said.

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A Prince George’s County lawyer, Miller got his start in politics under the tutelage of Democratic Party bosses in the 1960s. After being elected to the House of Delegates in 1970, he climbed rapidly, reaching the Senate four years later. He has been in office through eight Maryland governors, evolving from machine pol to nimble pragmatist, maintaining power even as the Senate grew younger and more liberal around him. Miller has charmed, strong-armed, boosted and blocked the process through thousands of votes and more than 22,000 laws.

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But suddenly, there is a bit less of Miller amid the Senate’s unfolding rituals and routines. The president, who typically haunts many of the after-hours receptions, has instead been heading home to Chesapeake Beach in Southern Maryland each afternoon.

“That’s usually his table right there, but we haven’t seen him yet,” said Alex DiBeneditto, maitre d’ of Harry Browne’s, an upscale legislative hangout across the street from the State House. Nor have they been sending over Miller’s favorite lunch: the crispy chicken salad.

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His doctors and daughters frown on it.

“I have four daughters, and they are automatic caregivers,” he said. “They constantly worry about what I eat.”

In his book-crowded office across from the Senate chamber, Miller was by turns wistful and defiant about the upheavals that cancer has brought to a job he could otherwise “do in my sleep.”

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Even handshaking is forbidden, as his staff constantly reminds him, to avoid germs while his immune system is weakened by the chemo. A bottle of hand sanitizer sat incongruously near the unopened liquor bottles in this legislative man cave.

At home in District 27, which stretches nearly from the Potomac to the Chesapeake, he has cut back radically on the fire department inductions and other rites that usually fill his off hours.

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“I just don’t have any choice whatsoever,” he said, leaning back in a striped armchair and spreading his hands. “It’s a new chapter in my life.”

A new chapter with old roots. He marvels at being able to have both breakfast and dinner with his wife, Patti, whom he met when both were students at the University of Maryland.

“It’s like we’re getting married all over again,” he told reporters Wednesday.

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Miller had quietly gotten treatment for cancer back in the summer. But it was only in December, just days before the beginning of the new session, that his oncologists at Johns Hopkins told him the disease had spread. By the time lawmakers had gathered in Annapolis, rumors were rampant that the president was not well.

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“I had been joking with him about the time coming when he would step down, and I said ‘Mike, they will have to carry you out on a stretcher,’ ” said former senator Thomas “Mac” Middleton (D-Charles County), who served six terms with Miller. “That was before I found out.”

Now, political watchers are inevitably wondering, at least in private, whether Miller’s health problems will mark the end — or at least the beginning of the end — of his remarkable run. He surprised his colleagues recently by announcing that senators would have a chance to preside in his place, something unheard of in past years.

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Miller said the innovation had nothing to do with thoughts of succession. Still, he allows that after being reelected for a 12th term in November, he will not run again.

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“This is obviously my last four-year term as a senator,” he said.

In the meantime, he is determined to carry on through his treatment. Hogan, a fellow Prince George’s native whom Miller babysat when the governor was 5, offered his Democratic rival a room in the governor’s mansion if he needs a place to nap.

“I said to him, anytime he just needs to take a break,” Hogan said in an interview, remembering how draining his own treatments were.

The governor also tried to give Miller some peace about his growing expanse of scalp.

“The hair doesn’t make the man,” said Hogan, who has chosen to keep a mostly shaved look long after his chemo ended. “He might even look tougher without hair.”

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The governor added: “There’s nobody like him. I just hope he’s going to be with us for many more years to come.”

Two weeks into the session, the impacts of the first round of chemo had faded, and Miller seemed more his old self. He left the cane in his office much of the time. His voice was stronger, and the flashes of weepy reflection had given way to the boisterous humor his colleagues are used to. At one moment, he described to the chamber how his wife was cutting the ends from his socks to accommodate his “curling toes.”

“Is that out of order?” he asked over his colleagues’ laughter. “Is that too much information?”

But with treatments scheduled for weeks to come, lawmakers, lobbyists and Miller himself are wondering how his ups and downs will mesh with the session’s cycle.

Would the combative Miller wrangle the lawmaking into shape with his usual salty vigor? Not even he could answer that.

“We have to see, we have to see,” he said, considering how wrestling with mortality might temper his temper.

But then, as the bells rang to call senators to the chamber, he seemed to stir himself.

“I surprised myself Tuesday morning, using the f-word” during the Democratic caucus meeting, he said. “I told them, ‘We don’t need just 24 votes, we need 29 votes to override the governor’s veto.’ ”

Soon he was leaning forward, his blue eyes shining.

“I’m in the game, I’m on top of it, I’m right there,” he said. “People are gonna f--- with me? You’re gonna f--- with me? You f--- with me, you’re gonna get f---ed back.”

He sat back, smiling broadly, restored for a time by a therapy of his own design.

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