Three small polyps removed from President Reagan`s colon and a slice of skin taken from a bump on his face were all found to be noncancerous, the White House said Saturday.
The polyps were found and the skin sample taken Friday during a postsurgery cancer check-up at Bethesda Naval Hospital in suburban Washington. The President`s personal physician, Dr. T. Burton Smith, delivered the test results to him Saturday.
Reagan was spending the weekend at his Camp David retreat in Maryland and he delivered his regular five-minute Saturday radio speech from there.
The White House announced the test results in a terse two-sentence statement:
”Final laboratory evaluation on the three intestinal polyps and facial tissue removed from the President yesterday has been completed and all are benign. The President was informed of the results by his physician at Camp David this morning.”
Medical experts expressed optimism that the publicity surrounding the President`s colon cancer, combined with new technology and a better understanding of the role polyps play in the disease, could significantly reduce the rate of colon cancer in this country.
Reagan, who will be 75 on Feb. 6, spent about 6 hours at the hospital Friday.
It was the first examination of his colon since his successful cancer surgery last July, and Reagan`s doctors also conducted blood tests, X-rays and a CAT scan.
After that surgery, in which they removed a 2-inch cancerous tumor and a 2-foot section of his colon, Reagan`s doctors had urged that he undergo regular check-ups to be sure there was no recurrence of the cancer.
The President also had a patch of skin cancer removed from his nose last summer.
The three ”very small” new growths were removed from Reagan`s colon in a nonsurgical procedure called a colonoscopy in which a long, flexible tube is inserted in the rectum. The CAT scan provides highly detailed pictures of the brain, lungs, pancreas, kidneys and other organs and is used to detect whether any new tumors are forming.
In an earlier statement Friday evening, before all the test results were fully evaluated, the White House had said there was no evidence of any disease.
American doctors say the publicity about Reagan`s health should promote public awareness about cancer and probably lead other people to earlier detection and thus a better chance of cure.
Dr. Stephen Hanauer, a University of Chicago gastroenterologist, said Saturday, ”We`re seeing twice as many patients for colonoscopies as we did before Reagan had his surgery last July and that is true all around the country.” Colonoscopy examinations are up to 20 to 30 a week at the U. of C., he added.
Development of the flexible colonoscope within the last 10 years is a technological breakthrough because it enables a doctor to carefully examine the entire lining of the colon, usually about 4 feet long, Hanauer said.
Since cancer specialists believe that probably all colon cancers occur in polyps, and that they may take several years to become malignant, the routine removal of these growths in susceptible people would ”definitely reduce the rate of colon cancer,” Hanauer said.
Reagan`s three new polyps measured 1 to 2 millimeters in size, about the thickness of a pencil lead, the White House said. The vast majority of such polyps are benign but some become cancerous.
The size of polyps is important. Once they become half an inch in diameter, the risk is 50 percent that they are malignant.
A colonoscopic examination of Reagan`s large intestine last summer revealed the malignant growth at the top of the colon. The cancer had not spread to other areas in his body and surgeons removed the tumor along with the 2-foot section of colon.
At that time Reagan was given a better than 50 percent chance of being cured of cancer. Since the original cancer has not recurred, his chance of being cured by the surgery is now about 60 to 70 percent, said Dr. John Schaffner of Rush-Presbyterian-St. Luke`s Medical Center in Chicago.
If the President remains free of the original cancer for three years, he will probably be considered totally cured, he said.
Normally a person like Reagan, who is prone to forming polyps, would have a 5 to 10 percent risk of developing a new colon cancer, Schaffner said.
But with regular colonoscopic examinations, probably every six months, and the routine removal of newly formed polyps, the President may never develop another colon cancer, he said.
This same optimistic outlook is becoming routine for other colon cancer patients who undergo the same type of examination and treatment, he said.
Reagan is the oldest president and his health continues to be a source of amazement to doctors.
”He`s doing exceptionally well,” said Hanauer. ”He`s survived a gunshot wound and cancer and his general health is excellent. His overall outlook is very good.”
Reagan continues to follow a low-fat, high-fiber diet recommended by the American Cancer Society as a means of reducing the risk of developing a variety of cancers.
The flexible fiberoptic colonoscope, with a powerful light at the tip, enables doctors to examine the colon visually for polyps or other abnormal growths.
The tip of the device is also equipped with a tiny instrument that can snip off a small sample of the growth for laboratory examination and a wire snare that loops around a polyp and cuts it off at the base. For extremely small polyps, electrocoagulation is used to burn off the growths after a tissue sample has been taken. Electrocoagulation was used to remove Reagan`s three tiny polyps.
An estimated 10 percent of people develop polyps, and the risk of developing them increases with age. There are two kinds: hyperplastic, which are thought to never turn into cancer, and villous adenomas, which can become malignant. The tumor removed from Reagan in July was an adenoma type.
Colon cancer is second only to lung cancer in incidence in the United States. Each year an estimated 138,000 new cases are diagnosed and about 60,000 people die from the disease.
People who have a change in bowel habits or who have blood in their stool should undergo a thorough colon examination, Hanauer said.
Those who have an increased risk of developing colon cancer and who should be regularly monitored include people with polyps or who have had colon cancer, those with a family history of polyps and inflammatory bowel disorders, and women with histories of cancers of the genital tract, he said. For people who do not have symptoms, the cancer society recommends a digital rectal examination every year after age 40 and a stool blood test every year after age 50. A proctoscopic examination is urged every three to five years after age 50 following two annual examinations with negative results. A procto exam involves the lower part of the bowel.
Colonoscopic examinations are usually reserved for people in high-risk groups since the procedure can cost between $400 and $1,000.
