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Brazil's Silva beginning chemotherapy for tumor
Former Brazilian President Luiz Inacio Lula da Silva beginning chemo for larynx tumor
By The Associated Press

SAO PAULO (AP) ' The tumor found in the throat of Brazil's popular former President Luiz Inacio Lula da Silva was detected in an intermediate stage and shows the "classic aggressiveness" of larynx cancer, doctors said Monday.

Silva entered Sao Paulo's Sirio-Libanes Hospital to undergo his first chemotherapy treatment Monday. The team of physicians treating him said he was upbeat and they were confident he would make a full recovery. Silva is expected to also undergo radiation therapy early next year, and doctors were hopeful surgery to remove the tumor would not be necessary.

"It's the most common type of tumor in this part of the body, and it has a classic aggressiveness," said Dr. Paulo Hoff, one of the oncologists overseeing Silva's treatment. "The tumor was detected in an intermediate stage, relatively early but not so early it could be resolved with a small surgery."

The cancer had not spread to other parts of Silva's body, Hoff said. He confirmed that because of the chemotherapy, Silva, 66, would lose his hair and thick, gray beard, a trademark look he maintained through his decades as a union leader who aggressively took on Brazil's military dictatorship and then through a long political career.

President Dilma Rousseff, who was elected last year because of Silva's tireless campaigning, was expected to visit him at the Sao Paulo hospital later Monday.

In 2009, Rousseff had a malignant tumor removed from her left armpit at the same hospital. She underwent chemotherapy treatment and was given a clean bill of health in August 2010.

Doctors said Silva would spend the night as a precautionary step, so they could monitor his response to the first chemotherapy treatment.

Dr. Gady Har-El, chairman of head and neck surgery at Lenox Hill Hospital in New York, said that the use of chemotherapy for Silva is an indication the cancer was not caught in its early stages.

"In general, early cancer of the larynx is treated with just one modality, either radiation or surgery," he said. "The fact they added chemotherapy says it's not an early cancer."

Har-El said that because of the chemotherapy, Silva can expect discomfort in the throat and difficulty in swallowing, the latter of which could lead to the his needing a feeding tube inserted into his stomach if the pain inhibits his ability to eat.

Silva's doctors said that because of the location of the tumor, surgery would carry the chance that Silva could lose his voice, a development that could have an impact on Brazilian politics, as Silva's rousing campaign rallies and high-energy speeches are a potent political weapon.

Silva maintains enormous influence within the ruling Workers Party that he founded, and Alexandre Barros, with the Early Warning political risk group in Brasilia, said that Rousseff's administration has yet to distinguish itself as being independent from Silva's legacy, so his continued support of the president is vital

Brazil will hold nationwide municipal elections next year, and candidates from the Workers Party may be hurt if Silva cannot attend rallies and participate in campaigns.

The next presidential election will be held in 2014. Despite speculation he might run himself, Silva has said Rousseff will be the ruling party's candidate.

"There is the possibility that if he survives, he could help win even more votes in 2014," Barros said. "If he were to lose his voice, it's hard to say what the result would be, though I've never heard of there being a voiceless leader in the world."

Silva's doctors said it will be about 40 days before they will know how Silva's tumor is responding to the chemotherapy.

Dr. Roberto Kalil, Silva's physician since he first won the presidency, said the former leader was upbeat when he entered the hospital and prepared for the challenge awaiting him.

"He's very calm. Obviously at first there was anxiety, a shock," Kalil said. "He arrived in excellent spirits, in his usual way, extremely confident."

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