By BRADLEY BROOKS, 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."