Is Chavez sacrificing cancer care for privacy?

Feb 24, 2012, 8:57 AM

Associated Press

SAO PAULO (AP) – As Venezuelan President Hugo Chavez flies to Cuba Friday for surgery to remove a possibly cancerous growth, top doctors say he could be taking a risk by skipping more respected cancer centers in Brazil or the U.S. if his illness proves more complicated.

What muddies that assessment is the miserly amount of detail the firebrand leftist president has revealed about his condition. Since first disclosing his cancer in June, he has only said doctors removed a baseball-sized tumor in his pelvic region last year, and that the new growth discovered this week was two centimeters (one inch) in size and found in the same area.

He had earlier said his cancer was in remission after completing weeks of chemotherapy.

But late Thursday Chavez, 57, said he’s “preparing to face the worst.”

Referring to the new growth, he said: “The possibility that it’s malignant is greater than it not being (malignant).”

Medical experts said that if Chavez has a “standard” cancer, or one that hasn’t spread or isn’t a rarer and deadlier type of tumor, seeking treatment in Cuba is likely as good as anywhere else.

But if his cancer is more complex, many said he’s at risk in not opting for treatment in the U.S., Europe or Brazil _ which has Latin America’s most advanced cancer centers with specialized radiation equipment.

“If you have a ‘common’ cancer, that of the breast, colon or lung … then it’s going to be easy to find standards of care that are the same in the U.S., Brazil or Cuba,” said Dr. Julian Molina, an oncologist at the Mayo Clinic in Rochester, Minnesota. “The problem comes when you have a tumor that’s not one of the common ones, and that’s what most of us suspect Chavez has.”

Latin America’s top cancer doctor Paulo Hoff, who heads the cancer center at Sao Paulo’s Sirio-Libanes hospital, considered the region’s best, would not talk specifically about Chavez’s case. But he did say that a cancerous tumor in the pelvic region would be mainly limited to four types: prostate, rectal, bladder and sarcoma, the latter being a rare and deadly form of tumor.

Mayo clinic cancer specialist Molina said the consensus among doctors in Latin America and the U.S. he’s spoken with is that Chavez has a sarcoma tumor because those tend to come back in the same site where a previous tumor was removed, which appears to be the case with Chavez.

The leader made a live television appearance from a hall in the Miraflores government palace Thursday night. Shouting “I will live! I will live!” he pounded a table and said he would undergo surgery early next week. It’s not clear if Chavez would then have radiation therapy after surgery; if so, it normally begins between three and six weeks after the procedure.

Brazil’s President Dilma Rousseff, who successfully underwent cancer treatment at Hoff’s center in 2009, invited Chavez to seek treatment at the Sirio-Libanes hospital Sao Paulo last year when he was first diagnosed.

Hoff said the matter never went further than that and that he’s not involved in Chavez’s treatment. Given Chavez’s position, Hoff said, “I’m sure they did due diligence on deciding where he would be treated” and decided Cuba was a safe bet.

Cuba’s health system has long been one of the pillars of the 1959 revolution. Health care is free for all Cubans and generally considered good compared to what’s available to most people in Latin America and the Caribbean.

There has been some decline in the level of care over the years, however, as economic difficulties make it difficult to purchase medicine and supplies. The U.S. embargo also complicates replacing outdated equipment, despite the fact that the sanctions in theory exempt medicine and most supplies.

If Chavez’s cancer has spread to his liver, brain or lymphatic system, the most likely locales for a cancer coming from the pelvic region, he may need more advanced machines that can pinpoint intense bursts of radiation at tumors and not damage nearby tissue.

Dr. Demetrios Braddock, an associate professor of pathology at Yale University’s School of Medicine in New Haven, Connecticut, whose research focuses in part on cancers that spread, said a two-centimeter (one-inch) lesion “isn’t a small recurrence, that’s a significant tumor.”

“Even if it were sarcoma, the way it’s typically treated it to go back in and taken it out. That’s how it would probably be treated up here in the U.S.,” Braddock said, underscoring that’s the procedure taken if the cancer hasn’t spread.

Molina, however, questioned even that surgery, noting that the pelvic region “is really fully packed with organs, nerves, blood vessels … there is not much room to work.”

He added that Chavez’s previous surgery in the same area would have produced scar tissue, further complicating the procedure.

Molina said he didn’t know about the specific capability of surgeons in Cuba to deal with such a tumor. But both he and several doctors interviewed in Brazil acknowledged that surgeons in the U.S. have the advantage of routinely encountering more complex cancer cases and also having a much larger pool of colleagues to consult.

“When you go to a place like Cuba or Brazil, even with all the development in Brazil, you find less people with enough knowledge to make good advice about what to do,” Molina said. “That is where the concern about Chavez comes in _ the concern that the knowledge is not at the same level.”

Dr. Peter Bourne, chairman of the Medical Education Cooperation with Cuba, a nonprofit organization working to enhance ties between the Cuban and U.S. medical communities, said he routinely visits the island and knows its doctors are up to the challenge of treating all but the most “exotic” cancers.

“They have a very excellent cancer institute in Havana, which is the facility where he’s being treated,” said Bourne, a former drug czar in the Carter administration who works closely with Cuban doctors and routinely visits the island. Chavez has not publicly specified where he’s being treated in Cuba.

Bourne, trained in psychiatry, acknowledged he has no inside information on the illness Chavez is facing. But based on the information that is public, it “seems certain he has cancer of the colon and that the treatment for it would be similar wherever he might seek it.”

Bourne, for one, said he thought Cuban doctors would be up to the task of tackling a dangerous recurrence of sarcoma.

“They’re very sophisticated in Cuba,” he said, “and would be able to treat that as well as he would be treated anywhere.”


Associated Press writer Peter Orsi contributed to this story from Havana.

(Copyright 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.)

World News

Britain's Prime Minister Boris Johnson speaks during a press conference in London, Saturday Nov. 27...
Associated Press

Omicron variant spreads to more countries, leads to preventative measures

The new potentially more contagious omicron variant of the coronavirus popped up in more European countries on Saturday.
7 days ago
UN Secretary-General Antonio Guterres gestures during an interview at the COP26 U.N. Climate Summit...
Associated Press

UN chief says global warming goal on ‘life support’

GLASGOW, Scotland (AP) — United Nations Secretary-General Antonio Guterres on Thursday warned that a key temperature goal in climate talks is “on life support” but he still hopes that world governments will step up their pledges to slash emissions of greenhouse gases. In an exclusive interview with The Associated Press, Guterres said the negotiations set […]
23 days ago
Soldiers patrol near the hamlet Plaza Vieja, in the Michoacan state of Mexico, Thursday, Oct. 28, 2...
Associated Press

Mexico’s army stands between gangs, enforcing turf divisions

AGUILILLA, Mexico (AP) — In western Mexico a small squad of soldiers with about a half-dozen trucks and sandbag emplacements stands guard on a rural highway. In one direction, almost within earshot, one drug cartel operates a roadblock extorting farmers. In the other direction, a rival cartel carries out armed patrols in trucks bearing its […]
26 days ago
First commuters drive on a land road in Frankfurt, Germany, early Wednesday, Nov. 3, 2021. (AP Phot...
Associated Press

Investors bet big on climate fight but motives questioned

GLASGOW, Scotland (AP) — Governments and big investors announced fresh plans Wednesday to pour trillions of dollars into curbing global warming, reflecting the financial world’s growing embrace of efforts to fight climate change as both a business necessity and opportunity. But some social justice activists called for scrutiny of investors’ motives, warning that the same […]
1 month ago
Thousands of pro-democracy protesters take to the streets to condemn a takeover by military officia...
Associated Press

Sudan’s military takes power in coup, arrests prime minister

CAIRO (AP) — Sudan’s military seized power Monday, dissolving the transitional government hours after troops arrested the prime minister, and thousands flooded the streets to protest the coup that threatened the country’s shaky progress toward democracy. Security forces opened fire on some of them, and three protesters were killed, according to the Sudan Doctors’ Committee, […]
1 month ago
In this image provided by the Department of Defense, a CH-47 Chinook from the 82nd Combat Aviation ...
Associated Press

Last US troops depart from Afghanistan, ending America’s longest war

Hours ahead of President Joe Biden's Tuesday deadline for shutting down a final airlift, and thus ending the U.S. war, Air Force transport planes carried a remaining contingent of troops from Kabul airport.
3 months ago

Sponsored Articles


Thyroid issues: Here are the warning signs and what to do

In a 100-person office in the United States, an estimated 12 co-workers, employees and loved ones, will likely develop a thyroid condition during their lifetime. That’s because, according to the American Thyroid Association, more than 12% of the U.S. population will experience thyroid issues.
Schwartz Laser Eye Center

How to sharpen your vision with elective procedures

Imagine opening your eyes in the morning and being able to see clearly. You wouldn’t have to wait to put on glasses or contacts, and there would be no more blurry showers nor forgetting where your glasses are.
PNC Bank

3 cool tips to turn everyday moments into learning experiences for your child

Early brain development has a crucial impact on a child’s ability to learn and succeed in school and life. Research has shown that 90% of a child’s brain is developed by age five.
Is Chavez sacrificing cancer care for privacy?