Defense Secretary Lloyd Austin was diagnosed with prostate cancer and underwent surgery in late December, which led to a secondary infection and his current hospitalization since Jan. 1 -- a series of serious health issues that remained undisclosed to the public, president and Congress until late last week, the Pentagon said Tuesday.
The information on Austin's ongoing medical issues was released by doctors at Walter Reed National Military Medical Center in Maryland, who said the defense secretary was diagnosed with prostate cancer in early December and "underwent a minimally invasive surgical procedure called a prostatectomy" on Dec. 22.
On Jan. 1, Austin, 70, developed severe abdominal, hip and leg pain, which led to another hospitalization and a diagnosis of a urinary tract infection and abdominal fluid that was impairing his small intestines, the statement from the doctors said.
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Overall, Austin's doctors said "his prostate cancer was detected early, and his prognosis is excellent." They also noted the infection that prompted his second hospitalization had cleared and said "he continues to make progress and we anticipate a full recovery, although this can be a slow process."
Austin and his staff did not notify the public or other key officials of either hospitalization until Friday, flouting convention and leaving the White House and Congress unaware that the Pentagon's top civilian leader was sidelined by serious medical issues.
After a weekend of speculation and revelations about how little top government officials knew about the status of a key cabinet secretary, Maj. Gen. Pat Ryder, the Pentagon's top spokesman, said that a series of issues and missteps -- including Austin's chief of staff coming down with the flu and his own failure to ask follow-up questions -- were to blame for the secrecy.
The lack of notification caused major political blowback -- including calls from some Republicans in Congress for Austin's resignation -- that the Pentagon was still wrestling with Tuesday.
Adding to the disclosure delays, John Kirby, the spokesperson for the White House's National Security Council, told reporters at a briefing Tuesday that President Joe Biden was unaware of Austin's cancer diagnosis until Tuesday morning -- even though the pair spoke over the weekend in a "good conversation on Saturday," according to Ryder.
However, Kirby was adamant that military operations were not impacted by Austin's hospitalizations and absence.
The statement from Walter Reed also offered more detail on the severity of Austin's medical issues throughout last week.
The fluid that collected in his abdomen "resulted in the backup of his intestinal contents, which was treated by placing a tube through his nose to drain his stomach," the statement said. It also noted that Austin "never lost consciousness and never underwent general anesthesia."
During his initial surgery for prostate cancer on Dec. 22, Austin was under general anesthesia, the doctors said in the statement. "Secretary Austin recovered uneventfully from his surgery and returned home the next morning," they said.
There has been no official explanation as to why Austin chose to not disclose his prostate cancer or the subsequent lack of communication by the Pentagon. But the defense secretary did say that he took "full responsibility for my decisions about disclosure." Broadly, though, prostate cancer is a diagnosis that many men feel reluctant to share.
Prostate cancer is the most frequently diagnosed malignancy in male U.S. military veterans, with 12,000 former service members affected each year. Roughly one in five veterans will be diagnosed with prostate cancer in their lifetimes, a rate twice that of the general population, according to Zero Prostate Cancer, a nonprofit organization that assists patients and families and advocates for research and treatments.
Austin spent 41 years in the Army before his retirement in 2016 at the rank of general. In that time, he was not only recognized for his leadership of soldiers during some of the key moments of the Global War on Terror but he would go on to serve as the Army's second-highest ranking officer and the head of U.S. Central Command, which is responsible for all military operations in the Middle East and Afghanistan.
Some veterans have a higher risk of developing prostate cancer as a result of environmental exposures. The disease has been linked to exposure to defoliants used during the Vietnam War and tied to service as an aviator or member of a ground crew, although no definitive link to a substance such as jet fuel has been established.
Other risks for the development of prostate cancer include age -- the illness is most common in men over 65 -- and ethnicity, with Black Americans having the highest incidence rate of all ethnicities, as well as genetic anomalies, diet, smoking and other factors.
Walter Reed National Military Medical Center in Bethesda, Maryland, hosts the Defense Department's Prostate Center of Excellence, treating patients and conducting research to prevent or treat the life-threatening spread of the illness. The facility offers state-of-the-art treatment for prostate cancer including minimally invasive surgery, image-guided radiation therapy and radiation implants designed to destroy the cancer cells.
The cause of Austin's complications from the initial surgery in December that led to his readmission to Walter Reed was not immediately apparent from the information provided by his doctors.
Hospital readmission rates -- a metric often used to assess the quality of care at U.S. hospitals and clinics -- are not publicly released for Walter Reed, but the facility has consistently, since 2017, received high marks from the National Surgical Quality Improvement Program for complications related to surgery, noted as "exemplary" in 2022.
Infections are the top reason in the U.S. that patients are readmitted to the hospital following a surgery, as was the case with Austin.
According to data posted on the hospital's website, Walter Reed has performed consistently to national standards for central line-associated blood infections -- those caused when bacteria enter a patient's bloodstream via a required hospital device access point -- and catheter-associated urinary tract infections. However, in 2014 and 2015, it performed worse than the national benchmarks for the latter.
For outpatient elective surgery, Leapfrog, a nonprofit hospital watchdog organization, gave the hospital its top ratings for staffing such procedures but its lowest ratings for performing safe surgery checklists every time one is performed.
