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Reagan Will Face Surgery Today for Cancer on Nose

July 31, 1987|JAMES GERSTENZANG | Times Staff Writer

WASHINGTON — President Reagan has suffered a recurrence of skin cancer on his nose and will enter Bethesda Naval Medical Center today for surgery to remove a small amount of tissue, the White House announced Thursday.

White House spokesman Marlin Fitzwater said a biopsy of tissue excised from near the tip of Reagan's nose on Wednesday indicated the need for deeper surgery, which will be performed this afternoon, using a local anesthetic.

It was uncertain whether the President, who canceled plans to spend the weekend at Camp David, would remain overnight at the hospital in Maryland.

Fitzwater said that the tissue sample was taken during a routine medical observation in the White House physician's office. He said that the biopsy, or microscopic examination, of the two to three millimeters of skin removed "indicated the presence of basal cell epithelioma"--a small tumor that rarely spreads.

Dr. Chung Hong Hu, an associate professor of dermatology at Stanford Medical School, said the cure rate for the condition is greater than 95% if it is treated early.

The President's skin problem is considered unrelated to the colon cancer for which he underwent surgery two years ago. Skin cancer was discovered on his nose shortly after that operation, and small patches of tissue were removed in July and October, 1985, at the White House.

The White House did not say whether the new cancer occurred in the same spots.

Not of Great Concern

Fitzwater said that the lesion was not a melanoma, a rare form of skin cancer that is often fatal, and White House officials indicated that the condition was not of great concern.

The President joked about it in his public appearances Thursday. "My nose gets laughs all the time," Reagan, wearing a small adhesive bandage on his nose, quipped to reporters during a White House ceremony with visiting Central American students.

In a speech before an anti-abortion group, he said that the bandage was a "billboard that says . . . stay out of the sun."

Although the condition for which Reagan will be treated today was described by the White House as "basal cell epithelioma," Fitzwater and skin cancer specialists said that the condition was the same as "basal cell carcinoma," the phrase used to describe the President's previous skin cancers.

The word "epithelioma" is preferred by some physicians, said one expert, Dr. Ronald Moy, a Pittsburgh specialist on recurrent skin cancers, because they prefer a "more benign term."

"I think they're just trying to downplay it a little bit," he said of White House officials.

Appear as a Sore

According to Stanford's Hu, the condition typically consists of small nodules that appear as a sore on the skin. A less common form of basal cell carcinoma, which accounts for less than 20% of all skin cancers of this type, looks like scar tissue and requires the excision of more skin, Hu said.

Moy said that the surgery Reagan will undergo generally takes 30 minutes to an hour and is most frequently performed in clinics and doctors' offices. The White House would not say why the procedure was being done in the hospital this time.

But Fitzwater said the President would undergo a slightly different procedure from that conducted Wednesday, and in 1985, at the White House, because the "biopsy showed there were enough cells there that they would have to go deeper." He would not discuss the procedure in detail.

He said that the surgery will be conducted by two Navy dermatologists, Adm. William Narva and Capt. Theodore Parlette, the chief of dermatology at the naval hospital. Col. John Hutton, Reagan's White House physician, will attend.

Limits Exposure to Sun

Skin cancer is caused by exposure to ultraviolet sunlight and the type that has afflicted Reagan is especially prevalent among Caucasians who live in sunny climates. Since the malignant tissue was detected two years ago, the 76-year-old Reagan has limited his exposure to the sun, even during his vacations to his California ranch.

Dr. Richard Bennett, a UCLA dermatologist, speculated that the surgeons will use the "Mohs technique," a form of microscopically controlled surgery, to remove the tissue because it is favored for recurrent skin cancers.

A larger amount of tissue is sliced away in this procedure than in some others, and each portion is examined under a microscope as it is removed until no more malignant cells remain, he said.

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