Reagan’s Cancer Believed Excised : Tests Find Malignancy, No Evidence It Has Spread; Outlook Optimistic

WASHINGTON —  Doctors reported Monday that the two-inch tumor they removed from President Reagan’s colon Saturday was cancerous, but they emphasized there is no evidence that the malignancy had spread.

They said the odds on the President’s surviving for five years or more are better than 50-50. And they said he should be able to resume his normal functions as President within a few weeks.

Reagan, who at 74 is the oldest President in U.S. history and has 3 1/2 years remaining in his second term, apparently took the news with his customary upbeat attitude. Navy Capt. Dale Oller, who headed the President’s surgical team, reported that Reagan had said, referring to the cancer: “Well, I’m glad that that’s all out.”

First Lady ‘Gratified’

The doctors, after examining a pathology report on the removed tumor, first explained the President’s condition to his wife, Nancy, during a 35-minute conversation in a sitting room next to the President’s bedroom. She was “gratified to hear that there was no evidence of spread from this tumor,” said Dr. Steven Rosenberg, chief of surgery for the National Cancer Institute.

Rosenberg said he normally explains a patient’s condition to the spouse first, because “it gives the family a chance to adjust to the information and perhaps be more supportive to the patient when the news is received.”

Then the doctors and Mrs. Reagan walked into the President’s room, where he was lying in bed reading a book. “He indicated that he had been waiting to hear the results,” Rosenberg said. But aside from telling them that he was glad all the cancer apparently had been removed, Reagan had little to say, Rosenberg reported, and the doctors left after about five minutes.

After another brief conference with the doctors, Mrs. Reagan then returned to the President’s room alone.

“The President has cancer,” Rosenberg informed reporters about 30 minutes later. But he said the cancer had been confined to the muscle of the bowel wall, adding:

“All of the lymph nodes surrounding the colon had no evidence of tumor. There was no evidence of tumor that was invading any blood vessels or nerves. And all of these findings are optimistic findings with respect to the future course of this disease. . . .

‘Completely Normal’

“There is no evidence in the President’s case that this cancer has spread. A complete examination of all of the internal organs at the time of surgery (showed that they) were completely normal. I think the chances are excellent that this tumor will not recur again.”

When asked the five-year survival rate for persons with this type of cancer, Rosenberg replied: “The majority of patients in exactly the President’s situation would certainly survive five years and beyond.” When queried again about the likelihood of surviving five years, he said: “It’s certainly greater than 50%.”

At another point, Rosenberg said: “The fact that the President has a greater than 50% (chance) of being cured of his disease for the remainder of his normal life span is a realistic estimate based on all of the aspects of the pathologic information that has been seen, and (it) neither represents an optimistic or a pessimistic view, but rather a view based on the available medical literature.”

Rosenberg said the chances are greater than 50% “that the President now has no cancer whatsoever . . . and he is completely cured. However, there is a chance that the tumor may recur at some time in the future. (That chance is) less than 50%.”

On Saturday, immediately after Reagan had undergone the nearly three hours of surgery at Bethesda Naval Medical Center, Oller had placed the five-year survival rate--even if the tumor turned out to be cancerous--at “better than 95%.”

More Serious Kind

But at the time, Oller was anticipating that the tumor would be a so-called Duke’s A lesion--the least serious of three kinds of colon growths because it does not spread beyond the surface of the bowel wall. Reagan’s tumor actually was found to be more serious, a Duke’s B, because it had invaded the muscles of the bowel wall. But it was not the most serious, Duke’s C, which means that it would have spread to the lymph nodes.

Rosenberg said that, if the cancer should recur, “the most common site” is the liver, where malignancy is far more difficult to cure, and he said the President now needs “regular X-rays of his chest, of his lungs, of his liver.” He added that Reagan should undergo a thorough examination of his colon with a colonoscope--a tube with a light--in six months and a repeat exam annually.

When asked whether Reagan should ease up on his presidential workload during the remainder of his term because of the cancer, the doctor said: “My advice . . . is always to resume their full and complete activity--and that will be my advice to the President.”

‘Superlative Recovery’

Oller said Reagan was continuing “his superlative recovery” and reported that “his vital signs are the same as a person who has not had surgery.”

White House spokesman Larry Speakes reported that the President’s temperature was running above normal but under 100 degrees. Reagan was continuing to take antibiotics to ward off infection, which is a particular threat during the first five days after colon surgery. But he no longer is taking painkillers, the spokesman said.

The President met with White House Chief of Staff Donald T. Regan for 20 minutes Monday. He also asked for books to read, including one titled “Calvin Coolidge: Return to These Hills.” He dozed off into a nap while reading it, Speakes said.