Marin Independent Journal

Austin kept prostate cancer, surgery complicati­ons a secret

- By Lolita C. Baldor and Tara Copp

>> Defense Secretary Lloyd Austin has prostate cancer, and his recent secretive hospitaliz­ation was for surgery and later to treat a urinary tract infection related to that operation, his doctors said Tuesday.

The cancer revelation answers the main question about Austin's hospitaliz­ation, which has now lasted eight days. But it may only add to questions of accountabi­lity, since President Joe Biden only learned about the cancer diagnosis on Tuesday, even though it was made about a month ago.

“Nobody at the White House knew that Secretary Austin had prostate cancer until this morning,” said John Kirby, the National Security Council spokesman. “And the president was informed immediatel­y after.”

The 70-year-old Austin was admitted to Walter Reed National Military Medical Center on Dec. 22 and underwent surgery to treat the cancer. He developed the infection a week later. Biden and other senior administra­tion officials were not told for days about his hospitaliz­ation or his cancer.

According to the doctors, the cancer was detected when Austin had a regular

screening in early December. They said he “underwent a minimally invasive surgical procedure” and went home the next day. But on Jan. 1 he reported nausea and severe abdominal, hip and leg pain due to the infection.

They said his prostate cancer was detected early, and his prognosis is excellent.

The cancer revelation comes after days of persistent questions about Austin's hospitaliz­ation and the delays in notifying key leaders. And it raises more questions about the transparen­cy and truthfulne­ss of the Defense Department, which for the past four days said he was initially at Walter Reed for an “elective medical procedure,” and not prostate surgery.

Asked about that choice

of wording, Maj. Gen. Pat Ryder, Pentagon press secretary, said in a briefing on Tuesday that it was developed in consultati­on with Austin's doctors.

When pressed on the delays in public notificati­on, Ryder said, “Despite the frequency of prostate cancer, discussion­s about screening, treatment and support are often deeply personal and private ones.” It was still not clear Tuesday how this will affect Austin's job, travel or other public engagement­s going forward. Deputy Defense Secretary Kathleen Hicks is expected to take on some of his dayto-day duties as he recovers.

The lack of transparen­cy about Austin's hospitaliz­ation —- including the failure to tell Biden and other top officials about it or the reason for it for days — has triggered sharp criticism.

Austin spoke with Biden on Saturday, the same day he issued a public statement saying he recognized he could have done a better job insuring the public was informed about his hospitaliz­ation, and said “I commit to doing better.” He did not, however, tell the president in that phone call that he had cancer.

Several Republican lawmakers even said Austin should be ousted. Rep. Mike Rogers, R-Ala., the chairman of the House Armed Services Committee, launched a formal inquiry into the situation. And, earlier Tuesday, the White House chief of staff ordered Cabinet members to notify his office if they ever can't perform their duties.

Dr. John Maddox, trauma medical director, and Dr. Gregory Chesnut, director of the Center for Prostate Disease at Walter Reed, provided the first details of Austin's prognosis in a statement put out by the Pentagon. They said he was under anesthesia during the initial surgery, and when he went to intensive care on Jan. 2 the infection had triggered an intestinal backup and his stomach had to be drained with a tube in his nose.

Medical experts said it's likely Austin had urine leak into his abdomen, a rare complicati­on of prostate surgery, and that led to a bowel problem.

“All of this is temporary and reverses relatively quickly,” said Dr. Benjamin Davies, a professor of urology at the University of Pittsburgh School of Medicine.

“We anticipate a full recovery, although this can be a slow process,” Maddox said. They noted that prostate cancer is the most common cancer among American men, and it affects 1 in every 8 men — and 1 in every 6 African American men — during their lifetime.

The doctors said Austin underwent a surgical procedure called a prostatect­omy. That is a common procedure to remove all or part of the prostate gland and is often used to treat prostate cancer, but is not the only option. Some men and their doctors choose radiation treatment or actively monitoring the disease, which involves watching it closely but no immediate treatment.

Prostate surgery can be done with small incisions and the aid of a tiny camera. It's not minor surgery, experts said, but “it's not as big a deal as it once was,” said Dr. David Penson, who chairs Vanderbilt University's urology department. “It's not all that different than, say, having your gallbladde­r removed with a laparoscop­e.”

Meanwhile, the Biden administra­tion, reeling from learning of Austin's surprise, is mounting a policy review. And the Pentagon has also begun its own review.

Chief of staff Jeff Zients sent a memo to Cabinet secretarie­s directing them to send to the White House by Friday any existing procedures for delegating authority in the event of incapacita­tion or loss of communicat­ion.

Biden and other top officials weren't informed for days that Austin had been hospitaliz­ed and had turned over power to his deputy. A Pentagon spokesman blamed the lapse on a key staffer being out sick with the flu.

“Agencies should ensure that delegation­s are issued when a Cabinet Member is traveling to areas with limited or no access to communicat­ion, undergoing hospitaliz­ation or a medical procedure requiring general anesthesia, or otherwise in a circumstan­ce when he or she may be unreachabl­e,” Zients said in the memo. He also directed agencies to document when any such transfer of authority occurs and that the person serving in the acting role promptly establish contact with relevant White House staff.

A copy of the memo was obtained by The Associated Press.

 ?? AP PHOTO — MAYA ALLERUZZO ?? U.S. Secretary of Defense Lloyd Austin has been hospitaliz­ed for the past week.
AP PHOTO — MAYA ALLERUZZO U.S. Secretary of Defense Lloyd Austin has been hospitaliz­ed for the past week.

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