Riordan Tells of Recent Bout With Cancer

Former Los Angeles Mayor Richard Riordan revealed Thursday that he secretly underwent 44 days of radiation treatments for prostate cancer while serving out his second term in City Hall. He said he is now free of all signs of disease.

Riordan seemed to suggest that, after months of conspicuously weighing whether to run for governor of California, he had resolved to do so. Asked in a brief interview, he said he was making his ordeal public now “because I’m running for office and I think the voters have a right to know about it.”

Riordan said he plans to make a final decision on a bid next month.

The cancer was discovered in October during a routine examination, Riordan and his doctors said. His radiation treatments stretched from late February until May 1. Riordan left office on June 30.

Cancer specialists say that men with the type and degree of cancer that afflicted Riordan have a high rate of long-term survival, if promptly treated.

He has a “clean bill of health,” said Dr. Derek Raghavan of USC, who coordinated Riordan’s cancer care. “His prognosis is excellent.”

In his opinion, Raghavan said, the 71-year-old Riordan would be fully capable of serving as governor for two terms.

Opponents of his presumed statehouse bid have already sought to make an issue of his age, and Riordan acknowledged that detractors are likely to try to use his health history to suggest he isn’t up to running a state with the world’s fifth-largest economy. He is 13 years older than Gov. Gray Davis, the probable Democratic candidate. If elected governor in November 2002, Riordan would be 76 at the end of the first term and, if reelected, 80 at the close of a second.

By disclosing his successful bout with the disease, which is the second most common cancer in men, Riordan evidently sought to allay concerns about his health weeks before he announces his plans.

Riordan and his doctors consented to separate interviews Thursday that were arranged by his gubernatorial exploratory committee. He said he had informed a dozen or more associates and supporters in recent days about the affliction and treatment.

His bout with cancer is certain to heighten talk of whether he has the endurance to be governor of the nation’s most populous state.

Even without formally entering the governor’s contest, Riordan, a Republican, has absorbed age-related barbs from Davis supporters. In a recent press missive, Garry South, the governor’s chief campaign strategist, noted that no incumbent has been denied a second term in California in 60 years.

“Of course, the only potential candidate around who remembers that last one is Dick Riordan,” South jibed.

The announcement of Riordan’s recent cancer adds to the national debate over how much personal information, particularly regarding illness, officials should disclose. New York City Mayor Rudolph W. Giuliani’s withdrawal from the U.S. Senate race last year because of prostate cancer is among the cases that stirred discussions of a candidate’s right to privacy and the voters’ right to know.

Riordan said he wanted to announce that he had cancer right away, but his oncologist advised against it because the ensuing hubbub would distract him from his duties and treatments.

“I felt he would be able to do his job better if he kept it private,” said Raghavan, chief of oncology at the Norris Comprehensive Cancer Center.

Political experts and ethics experts said Riordan’s handling of the problem appeared to strike a reasonable balance between public and private interests, though the unwritten rules that guide disclosures vary widely.

“It’s very tricky,” said Gale Kaufman, a Democratic strategist who worked for former New Jersey Sen. Bill Bradley’s presidential campaign, which was hampered in midstream by revelations of the Democrat’s heart arrhythmia.

She suggested there was one standard when Riordan was leaving City Hall and another now that he may run for governor. “During the last six months as mayor he may have felt it was nobody’s business,” Kaufman said. “But now it’s a different situation. As a candidate, or at least a prospective candidate, he opens himself up to a whole other level of scrutiny.”

A similar standard was voiced by George Annas, a law professor at Boston University and a specialist in medical ethics. Candidates have a responsibility to inform the public of any affliction that might affect their job performance, he said.

But officeholders have no obligation to disclose medical problems unless they significantly impair functioning, he said. And just having cancer, he added, probably would not qualify as requiring disclosure.

Moreover, a political culture that demands detailed medical information from officials could be self-defeating, he said, if it ultimately deters them from seeking treatment for serious illnesses lest they be exposed.

“We’re all better off if our public officials get treated,” said Annas, who lauded Riordan for keeping the problem to himself.

Riordan’s cancer was detected by a blood test taken as part of a physical exam last October, said his personal physician of more than a decade, Santa Monica internist Charles R. McElroy.

A subsequent biopsy of the prostate gland confirmed the cancer, known as adenocarcinoma. Further tests, including CT and bone scans, provided no evidence that the tumor had spread elsewhere in the body, McElroy said. He added that the tumor was confined to the inner prostate and had not penetrated the outer capsule of the walnut-sized gland.

The physicians would not specify the tumor’s so-called grade, which describes its aggressiveness.

The primary treatment consisted of external radiation aimed at the prostate five days a week for 44 days, in February, March and April. The treatment ended on May 1--the mayor’s birthday. He also took the drug Proscar, which is thought to reduce prostate swelling.

Riordan underwent the radiation treatments, which lasted less than half an hour, at an undisclosed hospital in the Valley before going to work, he said.

Remarkably, he and his doctors said he developed no side effects from the regimen, which can cause fatigue, impotence, diarrhea and other problems.

“I didn’t feel any effect whatsoever,” Riordan said. “I did as much exercise” as usual, he said, “and worked just as hard.”

The former mayor and his oncologist said the decision to treat the disease with radiation, rather than a more disruptive surgical procedure, was based exclusively on the medical prognosis and not on any desire to keep the treatments secret. Only his security detail and a close aide were aware of it, Riordan said.

Body scans and other tests performed after the treatments ended and as recently as a month ago have found no evidence of cancer anywhere in his body, his doctors said. Riordan is not undergoing any treatment for prostate problems and is taking no medication other than an anti-cholesterol drug.

“I think his illness is in complete remission and his prognosis is super,” Raghavan said. He has a good chance of being cured, Raghavan added, a term justified only if the disease vanishes for some years.

According to American Cancer Society statistics, Riordan’s outlook is good. Of those men whose prostate cancer is detected early and eradicated, 100% survive at least five years unless they die of something else. And 72% of all prostate cancer patients, regardless of at what stage the disease was found, are still alive 10 years after diagnosis.

Dr. Timothy Wilson, director of urology at the City of Hope National Medical Center in Duarte, estimated that a man diagnosed and treated as Riordan was would have an 80% to 85% chance of having no recurrence of the disease.

Because prostate tumors grow slowly, short-term survival rates are generally good, added Wilson, who was not involved in Riordan’s care. “You’ve got to follow men for 10 or 15 years to see if they’re going to die of the disease,” he said.

Prostate cancer, the second leading malignancy among men after skin cancer, strikes 198,000 men annually. It is also the second most deadly cancer, after lung cancer, killing 31,500 men annually. More than 80% of men with prostate cancer are over 65.

Riordan said he didn’t think voters would even consider the cancer and will instead reflect on his record as mayor and whether he has the energy to be governor.

“I’m probably more likely to get killed crossing the street or having a tree fall on me than from something like this,” he said.