When Tony Snow was asked to become President Bush's press secretary last year, he didn't agree until his doctors told him there were no signs of the colon cancer for which he had been treated in 2005.
Based on that assurance, he accepted one of the most demanding jobs in Washington.
But early Tuesday morning, Snow told Bush that the cancer had returned -- and had spread to his liver and elsewhere.
The report of the recurrence sent ripples of sadness through the White House staff, which has come to count on the former Fox News television and radio commentator to convey the administration's views to an increasingly skeptical public and, as the personable face of the White House, to defend it with charm and style against daily challenges from the Democratic Congress.
"He is not going to let this whip him, and he's upbeat," Bush told a small group of reporters in the White House Rose Garden on Tuesday morning. "My message to Tony is: Stay strong; a lot of people love you and care for you and will pray for you."
The disclosure of Snow's diagnosis followed last Thursday's announcement that Elizabeth Edwards, the wife of Democratic presidential contender John Edwards, was about to begin treatment for a recurrence of breast cancer, even as she and her husband continued to campaign.
Snow's response that day was emotional: "As somebody who has been through this, Elizabeth Edwards is setting a powerful example for a lot of people, and a good and positive one," he said.
The next day, he announced that he was undergoing surgery Monday for a small growth in his abdomen that doctors had been tracking for several months. All tests were negative for cancer, he told reporters, but he was having it removed "out of an aggressive sense of caution."
On Tuesday morning, Snow's deputy, Dana Perino, paused to regain her composure and dabbed at her eyes as she revealed her boss' condition moments after speaking with him.
Later, she told reporters at a televised news briefing that "the growth was cancerous and there has been some metastases, including to the liver." White House officials have not said where Snow, who lost his mother to colon cancer when he was 17, is being treated.
The growth that was removed is in the same area as the previous cancer, Perino said. The metastasis, or spread, to the liver is on the organ but has not invaded it, she added. She said she did not know where else cancer was found.
"He told me that he beat this thing before," she said, "and he intends to beat it again."
Those who know Snow were unanimous in describing him as one ready to seek aggressive treatment and to look ahead to returning to work. His staff and outside medical experts said recovery from the surgery alone would take at least four weeks. He will have chemotherapy as well, Perino said.
"If a glass-half-full outlook plays a role in his recovery, he will be better and back pronto," Mary Matalin, a Republican advisor and a former senior aide to Vice President Dick Cheney, wrote in an e-mail exchange. "He is going to beat this."
Recalling Snow's kind words about his wife last week, Edwards issued a statement Tuesday praising him as "an incredible example for people living with cancer and cancer survivors -- he lives every day to the fullest and faces every challenge with courage and determination."
Snow's cancer was initially diagnosed in February 2005 with stage 3 colon cancer, indicating that the disease had spread to nearby lymph nodes. His treatment included removal of his colon and six months of chemotherapy.
On average, more than 60% of patients with stage 3 colon cancer survive five years after initial treatment, Dr. Harmon J. Eyre, chief medical officer at the American Cancer Society, said in a written statement.
Dr. Lee S. Rosen, a specialist in gastrointestinal cancers and the president of Premiere Oncology, a treatment center in Santa Monica, said in a telephone interview that treatment of advanced colon cancer has undergone a revolution in the last five years.
"Larger and larger numbers of patients can be cured or maintained on therapy they tolerate well," he said.
In some cases, he said, tumors either can be shrunk by chemotherapy and removed surgically or can be kept from growing. Side effects in some patients may include nausea, vomiting and fatigue; in others the treatment is less debilitating and patients are able to work full time.
Snow's job is particularly intense, often requiring him to leave his home in Alexandria, Va., before dawn and return home after dark. He and his wife, Jill, have three children, ages 10, 11 and 14.
In a White House struggling to regain its bearing, under political siege in the wake of the November elections and setbacks in Iraq, he is not only the person who delivers the administration's message each day, but a key behind-the-scenes advisor on how to best persuade the American public of the president's course. He is Bush's third press secretary, following Ari Fleischer and Scott McClellan.
Snow, who is 51, approaches the job with energy, bringing to it communications skills honed during his work for Fox News and as a speechwriter for President George H.W. Bush, and the passion of a conservative advocate accustomed to expressing his views as a newspaper editorial writer.
"He says it is the best job he's ever had," Perino said. "He, in fact, has called it 'communications Disneyland.' So he loves the job, and I think his intention, of course, is to come back."