AMA President-elect Bobby Mukkamala diagnosed with cancer

AMA President-elect Dr. Bobby Mukkamala, has been diagnosed with a brain tumor and plans to undergo surgery in December, the Chicago-based physicians organization announced yesterday.

Mukkamala, 53, an otolaryngologist and head-and-neck surgeon from Flint, Mich., is scheduled to take over as AMA president in June.

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During a routine speech at the AMA's interim meeting in Florida earlier this month, Mukkamala experienced expressive aphasia, in which his words came out garbled and nonsensical, AMA said in a statement.

“In the middle of my speech, for a couple of minutes, I wasn’t making any sense,” Mukkamala said in the statement. “It was English, but none of it made any sense.”

With symptoms that might have indicated a transient ischemic attack, or stroke, Mukkamala visited an urgent care clinic in Florida, the statement said.

However, he had a normal blood pressure reading, and an electrocardiogram showed no signs of atrial fibrillation, the statement said. After having no more issues with speaking during the rest of the meeting, Mukkamala waited until returning home to Flint to undergo an MRI, it said.

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His MRI revealed an 8-centimeter temporal lobe tumor on the left side of the brain, which physicians suspect is a grade II glioma, the statement said. The AMA said the five-year survival rate ranges between 40% and 80% depending on the final pathology results.

“There's just no way to know until it's under a microscope, getting more testing,” Mukkamala said.

Gliomas come in grades II, III, and IV, with IV the most malignant, according to information from Northwestern Medicine's website. 

If cancerous, a glioma tumor could be considered a glioblastoma, considered to be a grade IV tumor, Northwestern's website said. Glioblastomas do not spread, or metastasize, to other parts of the body, but they can metastasize to other parts of the brain very quickly.

Mukkamala's tumor has likely been growing for years, and he recently started noticing small “brain farts” and not feeling quite as sharp as he’d previously been, the statement said.

Following surgery, Mukkamala said he will likely be taken away from patient care and AMA duties for about two or three months, during which time he would likely have chemotherapy and radiation, the statement said. It said he is currently being treated with a drug to prevent seizures and steroids to reduce the swelling around the tumor.

Next June, Mukkamala is set to succeed Dr. Bruce Scott, also an otolaryngologist, from Kentucky, to become the 180th president of the AMA.

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Mukkamala noted how his experience underscored "deep and vast inequities in the U.S., with healthcare access," with outcomes and lifespans that vary dramatically from ZIP code to ZIP code.

“Within 48 hours of this MRI scan, I had half a dozen opinions from leading neurosurgeons around the country,” Mukkamala said in the statement. “If I lived two miles that way [in Flint], there’s no way that I would even have a picture of my tumor, let alone access to that many opinions that quickly. I’d still be waiting — maybe for prior authorization.”

He added widespread shortages in neurosurgery and other specialties, especially in economically or socially underserved communities, also limit access to care.

“We're short on brain surgeons, so the better we can do to address that shortage, the more likely it is that the guy two miles from here can get in, get an appointment and get a plan in reasonably close to the same amount of time that it took me,” he said in the statement.

Mukkamala also warned in the statement that, while the U.S. Affordable Care Act currently protects against denial of care based on preexisting conditions, that portion of the ACA is under attack and at risk of being lost.

Republican opposition to the ACA includes an attack on the preexisting condition protections of the legislation.

On a personal level, the brain tumor diagnosis presents “a unique opportunity to share thoughts that usually go unsaid, thinking that there will always be time to share later,” he said in the statement. “Don’t wait to show affection to people until a moment like this."

This story first appeared in Crain's Chicago Business.