Austin diagnosed with cancer, didn't tell Biden for weeks

Doctors on Tuesday disclosed that the reason Defense Secretary Lloyd Austin was hospitalized on Jan. 1 was due to complications from a late-December surgery to treat prostate cancer, answering a major question involving the Pentagon chief's mysterious health situation but raising further issues with how the episode was handled.

Less than an hour after the announcement, the White House disclosed that President Joe Biden didn't learn of Austin's diagnosis until Tuesday, weeks after the secretary learned he had cancer and days after the two spoke on the phone.

The disclosures come amid controversy over the Pentagon’s decision to keep members of the national security team, including Biden, in the dark for several days over his medical emergency.

Facing mounting criticism over the lack of transparency — including from a few powerful Democratic lawmakers — the administration took two steps on Tuesday aimed at addressing the fallout. The first was a directive from Jeff Zients, the White House chief of staff, instructing executive departments to review how they delegate authority when Cabinet secretaries are unable to perform their duties.

The second step was the long-awaited explanation of Austin’s condition.

A statement by Austin's doctors released by the Pentagon said that in early December, the Pentagon chief had a routine prostate screening, during which doctors discovered prostate cancer that required treatment.

On Dec. 22, the statement said he underwent a “minimally invasive” surgery while under general anesthesia to "treat and cure" the cancer, called prostatectomy, at Walter Reed National Military Medical Center. Austin recovered and was sent home.

On Jan. 1, he was admitted again to the hospital “with complications from the December 22 procedure, including nausea with severe abdominal, hip, and leg pain,” according to the statement from Dr. John Maddox and Dr. Gregory Chesnut. An initial evaluation found the cause to be a urinary tract infection.

The next day, Austin was transferred to an intensive care unit for close monitoring and “a higher level of care,” the statement read. Another evaluation found collections of abdominal fluid impaired the functions of his small intestines. A tube was placed through his nose to drain his stomach.

The doctors wrote that Austin is recovering well but did not provide a release date.

“He has progressed steadily throughout his stay,” the doctors wrote. “He continues to make progress and we anticipate a full recovery although this can be a slow process. During this stay, Secretary Austin never lost consciousness and never underwent general anesthesia.”

The medical update follows a tumultuous week in which top U.S. officials didn’t know that Austin was hospitalized.

Despite the fact that he was hospitalized on Jan. 1, Austin’s top staffers didn’t learn of the problem until the next day. Biden and national security adviser Jake Sullivan were notified on Jan. 4, and the next day, the Pentagon told members of Congress and released a statement to the media.

Biden didn't know about Austin's cancer diagnosis until Tuesday after he was briefed on what the secretary's doctors at Walter Reed were set to announce. National Security Council spokesperson John Kirby faced questions from reporters about how Biden couldn't know about a key Cabinet member's heath and what that says about the president's leadership.

The White House previously said that the two had a "cordial" conversation over the phone on Saturday, but Tuesday's disclosure implies that Austin didn't tell the president at the time that he had been diagnosed with cancer.

Sen. Roger Wicker (R-Miss.), the top Republican on the Senate Armed Services Committee, said the disclosure doesn't put to bed the serious questions that lawmakers from both parties have over Austin's conduct.

"I am glad Secretary Austin’s prognosis is good and he is expected to make a full recovery, but the underlying questions remain," he said in a statement. "The Secretary’s condition is severe. The failure to notify Congress of his inability to perform his duties was a clear violation of the law.

"It remains unclear who decided to ignore federal law but there must be accountability," Wicker continued. "An internal review — ordered by the same Chief of Staff who played a part in this crisis — is woefully inadequate,”

Austin has since apologized for the delay in disclosure, which prompted Republicans to call for the Pentagon chief to be fired. POLITICO reported that Biden has no plans to fire Austin and would not accept his resignation, but the White House and the Pentagon have launched reviews to ensure the proper channels are notified in an emergency.

“Secretary Austin continues to recover well and remains in good spirits,” Pentagon spokesperson Maj. Gen. Pat Ryder told reporters at the Pentagon on Tuesday. He “has full access to required secure communications capabilities and continues to monitor operations worldwide.”

DOD “recognizes the understandable concerns expressed by the public, Congress and the news media in terms of notification timelines and DOD transparency. I want to underscore, again, Secretary Austin is taking responsibility for the issues with transparency and the department is taking immediate steps.”

Prostate cancer is the most common cause of cancer among American men, according to the Pentagon statement on Tuesday. It impacts 1 in every 8 men — and 1 in every 6 African American men — during their lifetime.

“Despite the frequency of prostate cancer, discussions about screening, treatment, and support are often deeply personal and private ones. Early screening is important for detection and treatment of prostate cancer and people should talk to their doctors to see what screening is appropriate for them,” according to the statement.

A prostatectomy, the surgery Austin underwent, removes some or all of the prostate and is used to treat a number of conditions, most commonly cancer, according to the Mayo Clinic.

There are minimally invasive versions of the surgery, which are done with robots — Austin's doctors described his procedure as "minimally invasive" — as well as a more traditional open version.

Austin’s symptoms after surgery — severe abdominal, hip and leg pain and nausea — were not among those considered typical by the Mayo Clinic, which says serious complications are rare.

Prostatectomy patients are usually put under general anesthesia, the clinic says, though Austin's doctors said he was not. Patients are usually back to their normal routine four to six weeks after surgery, according to the clinic.

Daniel Payne contributed to this report.