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Tsongas and full disclosure By claiming to be cancer-free, Tsongas changed the 1992 Democratic presidential primaries. If elected, he wouldn't have been able to complete his term.

THE BALTIMORE SUN

WASHINGTON - The recent death of former Sen. Paul E. Tsongas of Massachusetts from complications of treatment for cancer recalls how important it is for candidates for elected office to make full disclosure of their medical information.

When Tsongas ran unsuccessfully for the Democratic nomination the 1992 presidential campaign, he made an issue of his survival from a form of cancer known as non-Hodgkin's lymphoma. But Tsongas and his doctors at the Dana-Farber Cancer Institute in Boston, Ronald W. Takvorian and George P. Canellos, repeatedly said he had been cancer-free when he had not. In so doing, they implied that the cancer was cured when indeed it was not curable.

If Tsongas had been elected president, his illness might have changed history. The nation might have been grimly preparing for his state funeral while a new president was being sworn in.

Or, if the full facts had been known about the recurrence of his cancer earlier in 1992, another candidate might have won the eight primaries or caucuses that Tsongas captured and that candidate, not Bill Clinton, might have emerged as the nominee.

Tsongas' death Jan. 18 from pneumonia at age 55 came two days shy of what would have been a full term. The pneumonia was the final, fatal complication of many complications for treatment for non-Hodgkin's lymphoma that he had battled since 1983. In his fight, Tsongas underwent two bone marrow transplants, in 1986 and last May.

The first transplant failed. A cancerous lymph node was found in his armpit less than a year later, as Tsongas and his doctors later acknowledged.

Just after the 1992 presidential election, Tsongas' lymphoma recurred. And in the weeks when he hoped to be preparing to move into the White House, he was back in the hospital in a new battle against lymphoma.

Although Tsongas went back to his law office, he was under intense medical care, sick, and in a hospital for much of the past four years. Thus, Tsongas could not have run his presidency with the vigor he tackled other problems.

Heavy drug and radiation therapy left him with a complication known as myelodysplasia that leads to anemia and infection. Against heavy odds of success, Tsongas underwent a second bone marrow transplant to overcome myelodysplasia.

It generally takes more than a year for the immune system to recover after such a transplant, and it often leaves individuals 50 and older vulnerable to organ damage and infections.

On Jan. 3, Tsongas went back to the hospital for the last time, for liver and heart problems that were complications of his cancer therapy. On Jan. 10, his abdomen swollen from a buildup of fluid, he underwent an operation to relieve a condition known as portal hypertension. The surgery seemed to work but he succumbed to pneumonia.

There was no evidence of cancer when Tsongas died, the hospital said.

A President Tsongas probably would have had to resign the office for health reasons. Even if he stayed in office, the lack of stamina resulting from the second transplant makes it unlikely that a President Tsongas could have campaigned for re-election.

Tsongas' case played a role in disclosures last year by former Sen. Bob Dole and President Clinton about their health.

After delaying for a year, Dole, the Republican nominee, who underwent surgery for prostate cancer in 1991, allowed doctors to discuss his health fully and agreed to an interview about it. Taking his cue from Tsongas, Dole pledged that he would submit to an independent medical review of his health in the event that questions arose about a recurrence of cancer or his ability to serve.

VTC Less than a month before the election, and under pressure from Dole and news organizations, Clinton agreed to his first interview about his health. In it, Clinton agreed that the public had the right to know about a president's health.

In 1992, Tsongas acknowledged his error in not fully disclosing the recurrence of his cancer.

He urged Clinton to appoint a national commission to study the issue of what personal health information a presidential candidate should disclose.

Although Clinton has not done so, if Tsongas' request is carried out, it could become his important legacy for disclosing information about the health of presidential candidates.

Lawrence K. Altman, M.D., is a medical writer for the New York Times. This article was distributed by the New York Times News Service.

Pub Date: 1/26/97

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