Reagan Surgery ‘Went Perfectly’ : Possibly Cancerous 2-Inch Tumor Removed; No Other Malignancies

A six-man surgical team Saturday removed a possibly cancerous two-inch tumor and a two-foot section of President Reagan’s colon but reported that they found “absolutely” no other signs of malignancy.

Doctors at Bethesda Naval Medical Center said that if the large polyp proves to be cancerous--and they placed the odds that it will turn out so at higher than 50-50--there is a “very high likelihood” that they have excised all the malignancy.

“The operation went absolutely perfectly, as well as I have ever seen an operation of this type go,” said Dr. Edward Cattau, the hospital’s chief of gastronenterology.

Survival Rate ‘Excellent’

Navy Capt. Dale Oller, who led the operating team, said a patient’s long-term survival chances are “extraordinarily excellent--absolutely excellent,” once this type of tumor, even if cancerous, is removed. He called it “better than a 95% five-year survival rate.”

But doctors will not know until they complete tests Monday whether the polyp, taken from the upper end of the large intestine, is malignant or merely precancerous. And if it is cancerous, they will not learn the extent of the malignancy until they examine the test results.

The 2-hour, 53-minute surgery, which began shortly before noon, went “very, very, very well,” Oller told reporters.

Vice President George Bush assumed the powers of the presidency while Reagan was anesthetized.

About 4 1/2 hours after his surgery, said White House spokesman Larry Speakes, Reagan told key members of his staff that “I feel fit as a fiddle.”

Cattau told reporters: “The incidence of infection following an operation such as this should be about 2% or 3%.”

Reagan suffered from infection after 1981 surgery for removal of a bullet from his lung after an assassination attempt. The President then, as it later turned out, was in far graver danger than was disclosed at the time by the White House and doctors.

Speakes described Reagan as being “conversant” and “virtually free of pain.” A morphine painkiller was being injected, through a slow-release device, near the President’s spinal cord. The spokesman quoted Oller as telling White House senior officials that “if the President was needed to make a decision, he could make it.”

Just before being wheeled off to the operating room, Reagan had signed a letter temporarily transferring the powers of the presidency to Bush, effective upon being administered anesthesia. The President turned to his wife, Nancy, according to Speakes, and said: “I’m signing this letter, but you’re still my First Lady.” Reagan signed another letter roughly five hours after the surgery relieving Bush of his temporary powers.

Bush, who had returned to Washington from his vacation home in Maine to be on hand during the operation, apparently took no substantive action during his 7 hours, 54 minutes as acting President. He waited at the vice presidential mansion and played a set of tennis doubles.

The plan was for the President to sleep overnight in a recovery room, then to take up quarters in a large hospital suite and remain there for about a week. Mrs. Reagan placed family pictures throughout the President’s room.

The President’s doctors and aides said he would be able to conduct White House business from the hospital starting today. The surgeons estimated that full recovery would take from six to eight weeks. But Oller optimistically said there was “a very good possibility” that the President would be able to go horseback riding when he begins a vacation at his Santa Barbara ranch in 4 1/2 weeks.

Switchboard Set Up

A White House switchboard and secure equipment to receive cabled national security documents were installed Friday, when Reagan first entered the hospital for removal of a small, benign polyp and a thorough examination of the large intestine--the exam that unexpectedly found the large growth.

White House Chief of Staff Donald T. Regan planned to make periodic visits to the hospital to confer with the President.

“If the President needs to do some congressional arm-twisting, I’m sure he’ll be up to that (from his hospital bed),” Speakes said.

Reagan and his wife held hands and exchanged “I love you” as he was wheeled to the operating room, Speakes said. Looking at one of the doctors, and referring to the probing examination of his bowel with a colonoscope on Friday, the President quipped: “After all you did yesterday, this ought to be a breeze.”

Mrs. Reagan Given Reports

Mrs. Reagan received periodic reports from the operating room as the surgery progressed.

The two-inch tumor, together with about two feet of the approximately seven feet of colon, were removed about two hours into the operation.

Doctors said it was not necessary to perform a colostomy, essentially the fashioning of an opening from the large intestine to the surface of the skin for the elimination of waste. The President’s severed colon was stitched together and the surgeons said he probably would not notice any difference in his bowel.

“We do not know whether there was cancer in the (removed) polyp,” Oller said. “The examination of the President showed no evidence whatsoever, however, of tumor elsewhere.”

He said the liver and lymph nodes “looked totally normal,” so the surgeons did not feel it necessary to remove tissues from those areas for examination.

Doubts on Prognosis

Dr. Steven Rosenberg, chief of surgery for the National Cancer Institute, said that if the removed growth should be found to be malignant, the President’s prognosis would be “excellent” provided that the cancerous cells have not penetrated deeply into the colon wall. On the other hand, he said: “If the invasion is deeper, then the prognosis becomes more guarded--although this kind of operation can be curative in a very large proportion of instances.”

More Than Half Cancerous

Rosenberg said more than half of these types of polyps--called villous adenomas--are cancerous.

The doctors said that Reagan should have another complete colon examination in six months, and annually after that. This was the third polyp to be removed from the President in the last 14 months. The first two were small and benign.

Rosenberg marveled, as other doctors have, at the physical condition of his 74-year-old patient, the oldest President in U.S. history. “Everything you’ve heard about the President’s vigor on the outside was certainly corroborated on the inside,” he said.