No Cancer Found in Key Areas : Chances for Long-Term Survival Rated as Good

President Reagan’s physicians Monday found several reasons to be optimistic that the President’s chances of surviving his form of cancer are relatively good.

Although doctors announced that the two-inch polyp they removed Saturday from Reagan’s colon was cancerous, they took hope from the fact that they found no cancer cells in the lymph nodes, blood vessels or nerves that were a part of the two-foot-long segment of the colon that they removed.

That finding, they said, increased the chances that the President will be among the majority of patients with cancer of the colon who survive for at least five years.

“There is no evidence that the tumor has spread,” said Dr. Steven Rosenberg, chief of surgery at the National Cancer Institute and a member of the six-man surgical team that operated on Reagan. But Rosenberg conceded that the doctors cannot be certain that the tumor cells have not spread.

When colon cancer spreads elsewhere in the body, its most common targets are the liver and lungs. But the surgical team visually inspected those organs during Saturday’s operation and saw no sign of cancer. In addition, pictures of internal organs taken by a CAT scanner also showed nothing unusual.

According to cancer experts, the absence of cancer cells in the lymph nodes is the single most important factor influencing long term survival from colon cancer. Cancer in the nodes cuts the odds of surviving for an additional five or 10 years by half, according to the authors of one authoritative textbook on surgery.

But, although Reagan’s lymph nodes remained untouched, the cancer cells penetrated through several layers of cells that make up the colon wall and into the muscle cells, which lie immediately next to the tissues that contain lymph nodes.

Cancer cells can also spread by way of the bloodstream. Although the pathology report said that there was no involvement of blood vessels, experts say it is always possible that a few tumor cells were swept into blood passing through the cancerous colon tissue.

Use of Anti-Cancer Drugs

With certain kinds of cancer--breast, for example--it is now recommended that patients be given anti-cancer drugs if there is a possibility that tumor cells may have spread to other sites by way of the bloodstream. The purpose is to kill the cancer cells before they can start a new tumor elsewhere in the body.

But Rosenberg said that cancer specialists have differing opinions about using either chemotherapy or radiation for that purpose in colon cancer patients. He said that Reagan’s physicians, in consultation with Dr. Vincent DeVita, director of the National Cancer Institute, believe that no further therapy is needed now. “Surgery had the maximum chance of curing him,” he said.

One reason for ruling against chemotherapy is the belief by many experts that, for colon cancer, the benefits are outweighed by the side effects on the patient.

Rosenberg said that Reagan will undergo regular examinations of the liver and lungs and will receive another colon examination with a colonoscope in six months, followed thereafter by annual exams.

One of the blood tests that will be done more frequently is a search for a protein substance called CEA, or carcinoembryonic antigen, which is believed to be a marker indicating that new tumors have arisen in the colon.

96,000 Cases in Year

The American Cancer Society says that there will be 96,000 new cases of colon cancer with 51,600 deaths this year in the United States.

Reagan may benefit from some of the experimental cancer diagnosis and treatment efforts currently being financed by the National Cancer Institute.

One possibility is the encouraging study under way on monoclonal antibodies--so-called “guided missile” antibodies that are intended to zero in on cancer cells. Scientists hope to be able to develop monoclonal antibodies that are specific for cancer cells and, unlike anti-cancer drugs, do not harm normal cells.