President Bush will undergo a colon examination on Saturday that will leave him temporarily sedated, and he said that because the nation is at war he will transfer his presidential powers to Vice President Dick Cheney for the duration of the one-hour procedure.
The president said the colonoscopy was required because benign polyps had been discovered in a previous exam. Medical experts recommend that people undergo the test for early cancer detection beginning at age 50, and at an earlier age if there is a family history of colon cancer.
Bush, 55, who exercises regularly, said he had no health problems, a position the president has held during his 18 months in office.
The only notable medical event occurred when he choked on a pretzel and passed out temporarily while watching a football game in the White House.
The transfer of powers to the vice president is allowed under the 25th Amendment, enacted four years after President John F. Kennedy’s 1963 assassination.
The amendment allows for the temporary or permanent transfer of presidential power, and until its enactment the Constitution was silent on what happened if the president were alive but unable to serve.
The amendment also allows the vice president, when backed by a majority of the Cabinet, to assume presidential powers when the chief executive is unable to discharge his duties for some reason.
Invoked once before
The part dealing with transfer of power has been invoked only once–in 1985. Bush said he is doing so out of caution, adding that while the exam is routine, the times are not.
“I’m the first president to have done so under this type of procedure of physical examination,” Bush said. “I did so because we’re at war, and I just want to be super-cautious.”
Cheney, he added, will be “standing by, realizing he’s not going to be president that long.”
When President Ronald Reagan was shot in 1981, many thought it was unclear who was running the country while a bullet was being removed from his lung. Alexander Haig, then secretary of state, famously declared himself “in charge.”
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Reagan had colon surgery in 1985 and transferred power to Bush’s father, who was then vice president, but it was done haphazardly, in the view of scholars. The elder George Bush, for example, was not immediately notified that Reagan had signed a letter surrendering his responsibilities.
When the first President Bush occupied the Oval Office, he and Vice President Dan Quayle drew up a secret contingency plan for the transfer of power, and President Bill Clinton and Vice President Al Gore followed suit.
It is not known if the current president and vice president have a similar plan.
Bush emphasized Friday that a colonoscopy is routine.
“This is part of the annual physical, so I just decided to do it at this time,” he said. “It fit into my schedule. No signs. No symptoms.”
Two benign polyps were surgically removed from his colon in July 1998, according to records released by Bush’s presidential campaign.
During the colonoscopy, doctors check the entire length of the large intestine for signs of cancer or precancerous polyps. The colon is also inspected using a hollow, lighted tube about the width of a finger.
A similar, less invasive screening technique called a sigmoidoscopy allows doctors to examine the lower portion of the colon.
Although considered routine for patients older than 50, the tests are underused, experts say. Fewer than half of patients receive appropriate screening, according to a 1999 survey by the federal Centers for Disease Control and Prevention.
Such tests permit detection of cancer of the colon or rectum at an early stage, when the chance of successful treatment is high. If a polyp or other growth is found during the exam, doctors can take a biopsy sample with the colonoscope and test the tissue later.
148,000 new cases expected
Experts estimate 148,000 new cases of colon and rectal cancer will occur in the United States in 2002, with 56,000 deaths.
The American Cancer Society recommends that from age 50 on, men and women with an average risk of cancer receive a colonoscopy every 10 years. Other options include getting a sigmoidoscopy every five years, plus a check for blood in the stool every year.
People with a family history of colorectal cancer or who have recovered from the disease should get screened more often and sooner, experts say.
Patients like Bush, who have had benign polyps removed twice before, should have a colonoscopy within three years after removal of the growth.