Nobody was happier to be at the Hawaii Legislature on opening day than the man who until 2014 spent 20 years working there.

“I really miss you guys,” U.S. Rep. Mark Takai told his former colleagues as part of the traditional invocation.

Before leading the prayer, Takai said, “I am doing well,” and everyone in the chamber knew what he meant — that he was managing his fight with pancreatic cancer.

Afterwards the Democrat posed for lots of photos with legislators. During the week he visited all three local television news programs and attended the annual Red Mass popular with some lawmakers. Dan Boylan featured him in his MidWeek column.

Nationally, meanwhile, Takai began the new year garnering press for asking Speaker Paul Ryan, a Republican, for permission to wear aloha shirts on the floor of the House of Representatives on Fridays.

The freshman lawmaker ended the month sharing emotions and a hug with Vice President Joe Biden, which also got good press. It came at a House Democratic issues retreat in Baltimore, where talked Takai talked about their struggles with cancer. Biden’s son, Beau, died in May of brain cancer.

And on Friday Takai’s campaign was asking for contributions.

“Your support today will mean more yard signs, more staff, and more opportunities to carry our message of Putting People First to every corner of Oahu,” read an email blast.

If you haven’t figured it out already, Mark Takai is running for re-election. His recent high-level visibility illustrates that he’s active in his work, a job that he says he loves.

What’s less clear is exactly how well Takai is doing health-wise. He missed a number of votes because of cancer treatments that began last November at the National Institutes of Health in Bethesda, Maryland, although he did make it to the House floor for most votes in December.

“My family and I thank you for respecting our privacy,” he said in a statement during the Thanksgiving holidays.

At that time, Takai’s doctors did not allow him to travel back to Honolulu. The visit in January was his first time back home in two and a half months.

Takai, 48, has not tried to hide what he is going through. He has shared emails — both from his office and his campaign — and online posts that have included photos with his mother, his wife and kids. He also shared a photo taken over the holidays, when the greater Takai clan flew to Washington because he could not fly home.

Asked about his health Friday, Takai said, “I’m doing great.”

He receives chemotherapy once every three weeks at Johns Hopkins Hospital in Baltimore, a process that involves being hooked up intravenously for infusions. It’s done on an outpatient basis, so Takai does not have to stay in the hospital overnight.

A cycle of treatment concludes at the beginning of summer, at which time Takai said his doctors will evaluate how things are going.

For now, however, Takai said his doctor tells him that he is responding well to therapies and treatment, and he will be allowed to fly back to Hawaii twice in February — when he plans to formally launch his re-election campaign — and twice in March.

Most importantly, he has been given a medical green light to run for re-election.

“About a month ago I talked to my doctor, and he really wants me to run again,” said Takai. “He said, ‘Go for it, you should definitely run for re-election.’ So, they have cleared me for that.”

No Challengers Yet On Horizon

Takai is heavily favored to win re-election.

That’s because Hawaii favors Democrats and because no member of the congressional delegation has ever lost a bid to be re-elected to their own seat, save one: Charles Djou, a Republican who won a special winner-take-all election in 2010 but lost in the general to Democrat Colleen Hanabusa.

Takai’s chances are good for other reasons, too.

Hanabusa’s unsuccessful challenge of U.S. Sen. Brian Schatz in 2014 opened the District One seat representing urban Oahu. Takai swept the primary that included six other candidates, scoring a double-digit victory over runner-up Donna Mercado Kim, a state senator. He then beat Djou in the general in a closer race.

Congressman Mark Takai with left, Deputy Communications Director Alex Hetherington. washington DC. 23feb 2015. photograph Cory Lum/Civil Beat

Takai with Deputy Communications Director Alex Hetherington, left, in D.C. in February 2015.

Cory Lum/Civil Beat

Takai raised a lot of money for the 2014 election and was helped in no small part by Vote Vets. He is a lieutenant colonel in the Hawaii Army National Guard and was deployed to the Middle East. He said he has raised $800,000 since his first election, including $140,000 in the last three months of 2015. He currently has about a half-million dollars in his war chest.

No well-known politicians have indicated they will challenge Takai this year, and congressional candidates need to be raising money now — the primary is Aug. 13. At least one political expert thinks anybody would be foolish to try.

“Mark’s got lots of serious things to worry about in his life, but getting re-elected is not one of them.”— political analyist Neal Milner

“It’s hard to imagine he will have an opponent,” said Neal Milner, an emeritus political science professor and a Civil Beat columnist. “And so while he has a serious health issue, I can’t imagine that it’s going to affect the cushion enough that he brings as an incumbent Democrat to really effect the election. He certainly hasn’t made any enemies.”

Milner said any challenge based on Takai’s health could easily backfire as inappropriate. The only time such attacks might get traction is when age is a factor.

“Mark’s got lots of serious things to worry about in his life, but getting re-elected is not one of them,” Milner said.

‘A Fairly Deadly Cancer’

Pancreatic cancer is a serious disease.

The National Cancer Institute at the NIH says that incidences of carcinoma of the pancreas have “markedly increased” in recent decades, making it the fourth-leading cause of cancer death in the U.S. In 2015, there were an estimated 48,960 cases and 40,560 deaths. It is also difficult to detect and diagnose.

Naomi Takai with her son, Rep. Mark Takai, on the steps of Capitol Hill.

Naomi Takai with her son, Rep. Mark Takai, on the steps of Capitol Hill.

Rep. Mark Takai

The primary factor that influences prognosis is whether the tumor can be completely removed, or whether it has spread to the lymph nodes or elsewhere.

Dr. Jared Acoba, an assistant professor at the UH Cancer Center, said there are different types of pancreatic cancer. The most common is pancreatic adenocarcinoma.

“We see close to 200 cases a year, and it does have a reputation — for lack of better words — of being a fairly deadly cancer,” he said. “If you look at the rates of mortality, they are pretty close to the rates of incidents.”

Detecting pancreatic cancer early is key, said Acoba, but doctors are able to remove the growth just 20 percent of the time.

Asked if Takai has pancreatic adenocarcinoma, campaign aide Dylan Beesley said in an email, “As he has said, Rep. Takai is very grateful for his doctors, who found the pancreatic tumor early and have put him on a path to recovery. The Congressman’s prognosis is good and his doctors are encouraging him to travel home to Hawaii and to run for re-election.”

Elections: ‘I Live For These Things’

Takai believes he has a record of accomplishments from his short time in Washington. He singles out his seats on the House Armed Services and Small Business committees, the latter for which he is the ranking member on the Subcommittee on Contracting and the Workforce.

“Those two assignments have provided me with an opportunity to really advocate for Hawaii’s armed services,” he said, including lining up federal contracts for local enterprises.

Takai said he hoped to be involved somehow with the White House’s “moon shot” to defeat cancer, led by the vice president.

Congressman Mark Takai loads up his plate on ‘aloha friday’ at this offices. 27 feb 2015. photograph Cory Lum/Civil Beat

Congressman Mark Takai loads up his plate.

Cory Lum/Civil Beat

“One in every two men and one in every three women get cancer in the U.S., and everybody is affected,” said Takai, repeating what he told the vice president during an open microphone period at the Baltimore retreat. “Basically my intent was to thank him for what he is doing, that he has become the champion for people like me.”

Asked if he is up to the rigors of a campaign, Takai’s sense of humor and self-confidence came through clearly over the telephone.

“You are talking to Mark Takai,” he said. “What do you mean? I live for these things! Absolutely!”

He added, “I intend to be here for as long as my constituents give me the honor of serving them.”

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