Like Other Cancer Patients, President Must Face Stress of Diagnosis, Doctors Agree

No matter how psychologically strong an individual may be, being told that he or she has cancer is a traumatic experience, and President Reagan also must face the same stress, according to doctors who daily must tell patients that cancer has been diagnosed.

“It’s a crisis, with death being the bottom line. The real threat is death,” Dr. Jimmie Holland, chief of psychiatry at Memorial Sloan Kettering Cancer Center in New York, said in a telephone interview Tuesday.

Despite what aides say is Reagan’s upbeat attitude, a patient like the President, who considers himself exceptionally healthy, may “feel like he’s been hit on the head,” Holland said.

Indeed, “sometimes they say they feel like they have been betrayed by their body,” she said. But she emphasized that how well patients are able to cope with the news depends largely on how well they have dealt with earlier life crises.

Dr. Patricia Ganz, a medical oncologist at UCLA and Wadsworth Veterans Administration Hospital, agreed.

“I would think that President Reagan would do very well” in coping with the removal of a cancerous tumor from his colon, she said. “He overcame the assassination attempt in 1981, and that, I would think, would have been more stressful. I would not say that cancer would be more threatening.”

Holland said: “He uses remarkably good techniques that seem to have worked well in all of his crises. My feeling is that his good humor and laid-back approach will get him through this crisis as well as they did his others.”

Reagan’s recovery thus far from the colon cancer surgery he had Saturday at Bethesda Naval Medical Center has been described by his doctors as “spectacular” and better than that of nearly all of the patients who have had the same operation.

Physicians who have examined the 74-year-old President have consistently referred to him as young beyond his years. Reagan is said to take great pride in his physical prowess and a healthy life style that consists of watching his diet, exercising, consuming alcohol minimally or not at all and abstaining from smoking.

Even his age may be of benefit in overcoming the initial shock of being told that he has cancer.

“Older people have dealt with a lot of crises before their current one. They are seasoned in facing the bad news,” Holland said. “They assume that they won’t live forever. It’s different for a younger person.”

But this is not to say that even the psychologically stronger older person will be unaffected if his or her cancer recurs and requires a new kind of treatment, usually chemotherapy or radiation, Holland said. And the new crisis, she said, may be more severe than the initial one and involve a deeper mental depression.

In the case of the President, cancer specialists considered starting their patient on a course of anti-cancer chemotherapy after the surgery. The purpose would be to kill any cancer cells that may have escaped from the original tumor and be present in other organs where new growths could begin.

However, they have ruled against chemotherapy on grounds that for the stage of cancer that Reagan has, no benefit could be gained that would outweigh the side effects of the drugs.