The information provided by the hospital caring for Toronto Mayor Rob Ford on Wednesday evening was very vague — likely deliberately so.
A CT scan had revealed the mayor had a tumour in his abdomen. It was discovered after he complained of unbearable pain in the lower left quadrant of his torso, said Dr. Rueben Devlin, CEO of Humber River Hospital.
Devlin said additional testing is needed to determine what kind of tumour the mayor has. He said the hospital hopes to have the results within a few days.
With so little information, it isn't possible to project with any certainty what the tumour is, whether it is benign or cancerous, or what Ford's prognosis is. The abdomen is home to multiple organs — the stomach, the liver, the pancreas as well as the small intestine and the colon. And abdominal pain is a symptom of several of these forms of the disease.
However, a gastroenterologist from Australia's leading cancer centre said that based on the information that has been made public, the "commonest thing to be thinking about" would be colorectal cancer.
"There are a lot of differential diagnoses that could be made from that," Dr. Alex Boussioutas, of the Peter MacCallum Cancer Centre in Melbourne, said of the information that has been made public.
"But the commonest thing to be thinking about and the one that we would want to exclude would be colon cancer, obviously.... So if I had to hazard a guess as a clinician that's what I would be thinking was happening."
Boussioutas said if Ford's doctors suspect he has colon cancer, they will likely use X-ray imaging to try to identify whether the cancer is on the outside of the bowel or the inside. A colonoscopy — a procedure involving the snaking of a scope up into the colon from the rectum — would follow to try to get a piece of tumour tissue to analyze.
The biopsied tissue would reveal whether the tumour is cancerous, and if it is, the type and stage of the disease. As well, Devlin said Ford's doctors will be looking to see if the tumour had spread.
Ford previously had abdominal surgery to remove a tumour on his appendix. That procedure was done in 2009.
“I had a major surgery on my appendix; they took out a piece of my colon. So I had a tumour in my appendix, and that’s pretty scary when that happens,” he told CTV in a September 2010 interview.
Boussioutas said the events could be linked, and would raise questions about whether Ford has a genetic predisposition for cancer.
Ford's father, Doug Ford Sr. died of colon cancer in 2006.
Given Ford's age, it would be rare to have had one colorectal cancer, let alone two, Boussioutas said.
"At 45, that's unusual. The peak age for onset of colorectal cancer is in the 60s, so 65 or thereabouts. And so anyone under the age of 50 we'd be certainly looking at a potential genetic association," he said. "Because it has implications for the rest of his family, potentially."
