Reagan Doctors Remove Polyps; Believed Benign

Doctors removed three “very small” polyps from President Reagan’s colon Friday and reported that they did not appear to be cancerous, the White House said.

The growths--discovered during a routine checkup Friday, six months after removal last July of a larger cancerous polyp in an operation in which two feet of the President’s bowel was removed--will be evaluated in a laboratory for signs of malignancy. The White House said the results will be released as soon as they are available, probably early next week.

Optimism on Tests

“All indications are that, when the lab results are in, they will confirm the President to be in excellent health,” the White House said.

Reagan underwent a battery of tests, including a colonoscopy, a CT scan (a computer reconstruction of X-ray images), blood tests and X-rays. The White House said that these tests “revealed no evidence of any disease.”

A gastroenterologist at the UCLA Medical Center said the finding of additional polyps in the President’s colon is “not unusual” and underscores the need for regular colonoscopy checkups for colon cancer patients. Reagan’s polyps were one to two millimeters across.

“A colon that makes one polyp is likely to make more polyps,” said Dr. Gary Gitnick, a professor of medicine. “I wouldn’t be surprised if six months or a year from now additional polyps were found.”

Dr. David F. Altman, director of the gastrointestinal clinic at the UC Medical Center in San Francisco, said that chances for malignancy in polyps one to two millimeters in size are “infinitesimally small.” By comparison, Altman said that the likelihood of malignancy in polyps less than one centimeter in size--or up to five to 10 times as wide--is 1%.

“New polyps that form have a period of four to six years before they grow to the size of substantial cancer risk,” Altman said. He suggested that the polyps may have been too small to have been detected in previous examinations or that they may have developed in the last six months.

Biopsy Specimens

Both physicians stressed the need to examine the biopsy specimens under the microscope for small clusters of malignant cells. Gitnick said that preparation and examination of the specimens usually takes three working days to complete.

Doctors at Bethesda Naval Hospital where the President’s checkup took place also took a sample of a “tiny papule,” or pimple, on the right side of Reagan’s face. They described the procedure as “a precaution” in the event the pimple proved cancerous.

Reagan had two patches of skin cancer removed from his nose last year in July and October. To avoid a recurrence, he has been told to stay out of the sun or to wear a sun block. The skin cancer, while troublesome to a lover of the outdoors like Reagan, is not life-threatening.

The discovery of the additional polyps in the colon is potentially more serious. Last July, a polyp uncovered in an identical examination turned out to be malignant and prompted the operation in which the section of Reagan’s bowel was removed.

Unlike that two-inch polyp, which had probably been growing for years, these new growths were only one to two millimeters across and had less chance of being malignant.

A Thumbs-up Sign

Reagan gave a thumbs-up sign as he emerged from the hospital after six hours of examinations. Responding to a shouted question from a reporter about how he felt, Reagan said, “Fine.”

In the colonoscopy, the same uncomfortable procedure that detected the President’s original cancer, a lighted tube was inserted into his lower intestine to search for potentially cancerous polyps or evidence of a tumor.

Depending on how he withstood the test, doctors warned that Reagan might have to spend the night in the hospital. The President, ducking out of a side door, appeared delighted with his early release.

The CT-scan, blood tests and X-rays were intended to determine whether any of Reagan’s other internal organs had been invaded by cancerous cells. At the time of his operation last July, doctors said they were confident the cancer had not spread beyond the bowel wall.

Reagan, optimistic by nature, has since told interviewers that it is incorrect to say he had cancer. He explained that he had a polyp that contained cancerous cells and that that was not the same as actually having the disease.

After leaving the hospital, Reagan flew by helicopter for a three-day weekend at Camp David, the presidential retreat in Maryland’s Catoctin Mountains. He was accompanied by Nancy Reagan and their pet spaniel, Rex.

Eleanor Clift reported from Washington and Robert Steinbrook reported from Los Angeles.