Austin Treated For Prostate Cancer Before Emergency, Pentagon Reveals

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Defense Secretary Lloyd Austin had surgery last month after a prostate cancer diagnosis, officials disclosed Tuesday, detailing for the first time what condition led to serious medical complications and a lengthy hospitalization that he kept secret for days from the White House, Congress and the American public.

Austin’s condition was announced by the Pentagon in a statement attributed to John Maddox and Gregory Chesnut, doctors at Walter Reed National Military Medical Center in Maryland. They said the retired Army general, 70, was diagnosed with cancer in December after routine screening and underwent a “minimally invasive surgical procedure” known as a prostatectomy, in which all or part of the organ is removed, while under general anesthesia. He was admitted Jan. 1 after developing complications from the surgery and remains a patient there.

As with his hospitalization, Austin withheld the existence of his cancer diagnosis from Biden and other key administration officials, the White House acknowledged – this time for weeks, raising new questions about his transparency with the president.

The two men, whom administration officials describe as close, had spoken by phone Saturday evening while Austin convalesced at Walter Reed. But officials said Biden did not learn until Tuesday, shortly before it was revealed publicly, what condition precipitated the defense secretary’s medical crisis.

John Kirby, a spokesman for the National Security Council, conceded during a news briefing, “We all recognize that this didn’t unfold the way it should have.”

“It’s not good,” he added. “It’s certainly not good.”

While Austin’s cancer was detected early and his prognosis is excellent, his doctors said, he developed nausea and pain in his abdomen, hip and leg. He was diagnosed with a urinary tract infection, and additional evaluation determined abdominal fluids had impaired the function of his small intestines, prompting doctors to drain his stomach with a tube through his nose, the statement says. Officials had said he was in “extreme pain” when taken by ambulance to Walter Reed.

“He has progressed steadily throughout his stay,” the doctors said in the statement. “His infection has cleared. He continues to make progress and we anticipate a full recovery although this can be a slow process. During this stay, Secretary Austin never lost consciousness and never underwent general anesthesia.”

Austin, known to be intensely private and spotlight-averse, required about a week in intensive care, officials said. The Pentagon publicly disclosed his hospitalization late Friday – four days after he was admitted. An uproar ensued when it was learned the Defense Department had notified Biden and the White House only one day before that.

Asked why the secretary had been so reluctant to disclose the nature of his medical situation, the Pentagon press secretary, Maj. Gen. Pat Ryder, said the matter was “intensely personal.”

While Austin is back on the job from his hospital room, defense officials already have started to make adjustments to account for his condition. He was due to meet with

Critics, including political adversaries and allies, have admonished the administration for its secrecy, with many noting the calamity that could have occurred with the United States actively, if indirectly, involved in two wars and the recent rise in attacks on U.S. forces deployed in the Middle East. Internally, some frustrated officials have complained as well, saying the handling of the incident showed “unbelievably bad judgment” on Austin’s part.

Kirby said the president was informed of Austin’s cancer by Jeff Zients, the White House chief of staff. Biden, Kirby said, had been unaware that Austin transferred his authorities to the Pentagon’s No. 2, Deputy Defense Secretary Kathleen Hicks, as he underwent surgery Dec. 22.

Once the Pentagon publicly disclosed Austin’s hospitalization at the very end of the workweek, its initial one-paragraph statement was vague and obfuscated what had occurred, referring to the surgery as an “elective medical procedure.”

The vast majority of surgical procedures are considered elective, which means they can be scheduled in advance. When hospitals were inundated with patients during the coronavirus pandemic, doctors warned that thousands of patients were suffering as a result of delayed elective procedures such as hernia repair and spinal fusion.

Ryder, when asked about this Tuesday, said he would “defer to medical officials” on whether that was an appropriate characterization.

Nitin Yerram, director of urological oncology at Hackensack University Medical Center in New Jersey, said most cancer surgeries are considered elective, a term that’s often misunderstood.

“We tend to think more of tummy tucks and cosmetic surgery,” Yerram said. “However, all ‘elective’ means is it’s a scheduled surgery with work-up done before that. The opposite of elective is emergent or trauma situation, such as a car crash, where it’s not a scheduled procedure.”

White House officials have repeatedly stated in recent days that Austin’s job is not in jeopardy despite his failure to disclose such a serious illness. “We have complete confidence in the secretary,” White House press secretary Karine Jean-Pierre told reporters.

Similarly, the Pentagon has said that Austin does not intend to resign and that no one working for him has offered to do so, either.

Some Republicans in Congress have said Austin should step down. Rep. Matt Rosendale (Mont.) announced Monday his plan to introduce articles of impeachment against the defense secretary.

Parallel internal reviews launched by the White House and the Pentagon – into the delegation of authority across Cabinet agencies and the handling of Austin’s hospitalization, respectively – raised the possibility that officials may withhold additional details about recent events while those investigations unfold. Ryder, in response to questions about what transpired in recent days, made repeated reference to the 30-day Defense Department review that’s underway.

That inquiry was ordered by Kelly Magsamen, Austin’s chief of staff who has faced scrutiny for her role amid the scandal. Speaking to reporters Monday, Ryder blamed the breakdown in notification protocol on Magsamen having contracted the flu, causing her to miss work. It remains unclear whether she delegated any responsibilities to subordinates while she was ill. Ryder said it was Magsamen who on Thursday ultimately notified Biden’s national security adviser, Jake Sullivan, that Austin was in the hospital.

It also was disclosed previously that, in addition to Magsamen, at least three other senior Defense Department officials – Gen. Charles Q. Brown Jr., chairman of the Joint Chiefs of Staff; Lt. Gen. Ronald Clark, Austin’s senior military assistant; and Ryder, the Pentagon’s chief spokesman – were aware of the secretary’s medical situation before the White House was told. Ryder said Tuesday that he has not talked to Austin this year.

Sen. Roger Wicker (Miss.), the Senate Armed Services Committee’s top Republican, issued a statement after Tuesday’s announcement saying that “there must be accountability.” He appeared to take aim at Magsamen, saying, “An internal review – ordered by the same Chief of Staff who played a part in this crisis – is woefully inadequate.”

Ryder, asked about that point Monday, said that “no one has more interest in making sure that we can learn from this and ensure that we’re doing what we need to do than the folks that are carrying out those responsibilities.”

The administration has been at a loss to explain why top officials did not interrogate the matter fully once it was discovered the defense secretary had concealed his hospitalization. Five days passed from the time the White House was notified that Austin was at Walter Reed to when Biden found out about the prostate cancer diagnosis, an indication that officials either hadn’t asked him or he had declined to share the information.

“I hear you,” Jean-Pierre said during questions from reporters. “That is something that we are going to get a sense of in this process. That’s why they’re going to do a review. That’s why the Pentagon is going to do a review.”

The fact that the diagnosis was a form of cancer made it all the more surprising that Biden did not know earlier. The president has put a large amount of focus in recent years on “cancer moonshot,” and speaking about cancer has been a key venue for connection with voters. His son Beau, who served with and befriended Austin when they were both in Iraq, died of brain cancer in 2015.

Prostate cancer ranks behind skin cancer as the most common form in men. Research has found that nearly all men with early stage prostate cancer survive after 10 years, regardless of how they are treated. Experts on the treatment say the prostate can be removed with robotic equipment that does not require making a large incision. Surgery indicates that the cancer has not spread and that the patient has a strong prognosis.

The White House has said Biden remains focused on Austin’s recovery and looks forward to having him back at the Pentagon as soon as possible. Kirby, speaking to reporters, sought to keep the focus there Tuesday.

“We all want to wish him the very best,” he said. “I mean, this is sadly, this is a disease that affects many millions of American men, particularly at that stage in life. And the key is early diagnosis. . . . We’re all going to learn a whole heck of a lot of lessons from this past week. One of the lessons I hope that everybody takes away is the value of early screening.”

(c) 2024, The Washington Post · Dan Lamothe, Matt Viser, Fenit Nirappil, Missy Ryan 


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