Laboratory tests show that lymphatic cancer afflicting the former shah of Iran has spread to his liver and also was present in his spleen removed Friday, according to one of the four doctors who performed the operation.
Dr. Fouad Nur, head of the tumor section at Cairo's Military Hospital, said in a telephone interview today that this was the meaning of a medical bulletin issued by the hospital declaring that "lymphatic swelling" was discovered in the former shah's spleen and specimens of his liver removed during the surgery.
The American specialist who led the operating team, Dr. Michael DeBakey of Houston, called the condition of the former shah's liver "lymphatic infiltration." Whatever the terminology, however, the spread of the disease, histiocytic lymphoma, into his spleen and liver was interpreted as a grave sign.
The ailing Mohammad Reza Pahlavi, 60, deposed from his Iranian throne a year ago, was treated last fall in New York for what was then called cancer of the lymph nodes in his neck. His gall bladder also was removed. The pathological tests here now confirm that despite some chemotherapy the malady is progressing through other parts of his body.
In the United States, cancer specialists who have treated many similar cases, said that, if Pahlavi's condition is as the Egyptian doctor described, he could live from six months to a year but his chances of long survival would be poor.
Aside from the human drama of a fallen "king of kings" struggling with disease and reduced from the glories of his palace in Tehran to the stark gray military hospital in a Cairo suburb, Pahlavi's health also plays an indirect role in efforts to obtain freedom for American hostages in the occupied U.S. Embassy in Iran. Islamic militants holding the Americans have said the former shah's return to face trial for his conduct while monarch is a condition for their release.
Nur said that with dedication, Pahlavi can recover from his spleenectomy and return to a relatively normal life for an undetermined time. The key to his longevity, he said, lies in arresting the spread of his cancer with drugs. There is no question of removing his cancer-stricken liver, he said.
"I believe, we all believe, that this disease can be controlled by drugs," he said, adding that any prognosis for Pahlavi's long-term health is "the business of Allah."
The hospital bulletin, confirmed by Nur, said the test results also indicated that Pahlavi's bone marrow is functioning normally, meaning there was no indication of cancer there.
The former monarch left the intensive care unit today and moved about his room for the first time since the surgery, the bulletin said. He also was able for the first time to consume liquid by mouth, it added.
The medical bulletin, issued in the names of all the doctors treating Pahlavi, emphasized his satisfactory recovery from the operation and said his spirits were high. Like DeBakey, it never used the word "cancer" -- referring only to "lymphatic swelling."
Nur suggested the euphemism was used out of deference for the former shah's sinking fortunes since being driven from his country, refused exile everywhere but Egypt and stricken with a dreaded disease. He did not say whether DeBakey and his associates had themselves decided to use fuzzy language or whether this was decided by Pahlavi's entourage.
The former monarch is served here by several employes with connections to Rockefeller enterprises in the United States. Among them is Robert Armao, an adviser and spokesman, and john Read, an attorney. Ardeshir Zahedi, the shah's former ambassador in Washington, also has arrived in Cairo and is spending most of his time at the hospital.
Pahlavi arrived here March 24 in a chartered DC8 after an all-night flight from Panama with former empress Farah, their two pet dogs and a half-dozen aides. Shortly thereafter, another plane arrived with the couple's children and more aides. Pahlavi's sister, former princess Shams, and Zahedi, who has stayed out of the spotlight in recent months, arrived separately during the week.
The former shah's decision whether to remain in Egypt or seek refuge elsewhere is expected to revolve mainly around his health. Egyptian doctors say he can receive any cancer treatment he needs in Egypt but his own specialists could advise otherwise.In any case, no other country had publicly expressed willingness to accept him except Iran, which wants him in Tehran to stand trial.
If the former shah's liver and spleen are cancerous, "chances are" he may live "between six months and a year," said one American cancer specialist. "Less than a year," said another.
"It's not at all unexpected" that the histiocytic lymphoma -- the serious lymph gland cancer found in Pahlavi's neck last fall -- would now be found in the liver and spleen, said these doctors, who have not treated him but have treated many lymphoma patients.
Even in advanced cases like his, said one, "we are now seeing a 50 to 60 percent complete remission or cure rate" with vigorous chemotherapy -- treatment with a combination of anti-cancer drugs.
But in Pahlavi's case, said this doctor, he has alrready been treated for six years with a cancer chemical for an earlier, milder lymphatic disease. He was treated with radiation last fall. And he has been in debilitated -- poor -- condition.
"All this," said this doctor, means chemotherapy may still help him and he may get better for a time -- and a cure is not impossible -- "but the chances for it are now small."