Powell Has Surgery for Prostate Cancer

Secretary of State Colin L. Powell underwent surgery to remove a cancerous prostate gland Monday morning, State Department spokesman Richard Boucher said.

The cancer was localized, the surgery was without complication, and Powell was expected to be sending e-mails within a few days and to be back at work early in the new year, Boucher said.

Although the 66-year-old Powell was expected to make a full recovery, the surgery renewed long-standing speculation in Washington that the popular former general would not seek a second term as secretary of State.

Boucher said Monday’s surgery had no bearing on such a decision, and repeated Powell’s refrain that he “serves at the pleasure of the president.”

But others said the surgery would give Powell, who is believed to have lost key foreign policy battles over Iraq, North Korea and other issues to the more hard-line Vice President Dick Cheney and Defense Secretary Donald H. Rumsfeld, a gracious excuse to bow out whether or not President Bush is reelected.

Washington’s conventional wisdom holds that Powell will not serve a second term, but Powell loyalists are quick to point out that Beltway gossip also predicted he wouldn’t last through a first term. Speculation on those who might succeed him include national security advisor Condoleezza Rice, Deputy Defense Secretary Paul D. Wolfowitz and the U.S. administrator in Iraq, L. Paul Bremer III.

“It’s an enormous burden to be secretary of State for four years under the best of circumstances,” said Philip H. Gordon, a foreign policy specialist at the Brookings Institution. “To do that at a time when you have huge battles within the administration, when you lose a good number of them because the president sides with those with whom you are clashing, and when you have a major terrorist attack and a war.... It wouldn’t be surprising for anyone to conclude at the end of four years ... that that’s enough.”

The State Department did not release many details about Powell’s medical condition because “at some point, you’ve just got to let people wonder,” a senior State Department official said. But officials made clear that they expected the health problem to have no effect on Powell’s ability to do his job, and their statements seemed aimed at accentuating Powell’s strength and vigor.

Boucher said Powell had spoken by telephone with 23 other foreign ministers Sunday to discuss the implications of Saddam Hussein’s capture, and was still issuing instructions to his deputy on the way to the hospital. Deputy Secretary of State Richard L. Armitage will fill in during Powell’s absence.

Powell’s decision to keep details private contrasts with that of former Senate Majority Leader Bob Dole and other prominent Americans who have used their prostate cancer diagnoses as an opportunity to educate the public.

Among the Washington notables who have gone public with their conditions are Rep. Henry J. Hyde (R-Ill); Sens. John F. Kerry (D-Mass.), Paul S. Sarbanes (D-Md.) and Ted Stevens (R-Alaska); former Sen. Jesse Helms (R-N.C.); Supreme Court Justice John Paul Stevens; retired Gen. H. Norman Schwarzkopf; Washington Post Chairman Donald E. Graham; and conservative columnist Robert Novak.

Boucher said Powell had been diagnosed with the condition last fall, and had chosen this time for the surgery because he could clear his calendar and had no foreign travel plans.

Powell was expected to spend two to five days in Walter Reed Army Medical Center, where the two-hour surgery was performed, then recover at home.

Prostate cancer is the second most common cancer among men, following skin cancer. According to the American Cancer Society, one man in six will be diagnosed as having the disease, but only one in 32 will die of it.

The incidence of prostate cancer in African American men is two to three times higher than for white men, some studies have indicated. The reason is unknown.

Doctors not involved with Powell’s case said there was every reason to expect a full recovery. The delay between Powell’s diagnosis last fall and the surgery to remove the prostate on Monday “suggests this was an early-stage cancer confined to the prostate gland with a relatively low PSA,” the prostate specific antigen that is an indicator of the extent of the cancer, said Dr. Michael J. Manyak, professor and chairman of the department of urology at George Washington University Medical Center.

Had the cancer been more severe, doctors would have recommended surgery sooner, Manyak said.

“This suggests a very good potential outcome,” Manyak said. Although there are several other options for treatment of prostate cancer, including radiation, surgical removal of the cancer remains the best option for men of Powell’s age who are in general good health, he said.

Nonsurgical treatment is usually seen as more appropriate for men with other health problems or whose life expectancy is less than 10 years, Manyak said.

“He’s a very healthy gentleman, from my understanding ... so he really would fall into the category of someone who would benefit from surgery,” Manyak said.

All men over age 50 should have annual digital rectal examinations and blood tests of their PSA levels, while those who are African American or who have a close relative with prostate cancer should begin having annual screenings at age 40, Manyak said.