This type of concealment was common in the 1950s, writes Barron H. Lerner, M.D., of the Columbia College of Physicians and Surgeons in New York City, in his discussion of cancer and politics in a recent issue of The Lancet (Vol. 355, No. 9,219).

Evita’s husband, Juan Domingo Perón, even covertly arranged for cancer surgeon George T. Pack from New York to perform surgery.  Entering the operating room after Evita had been sedated, Dr. Pack effectively kept his identity concealed from his patient (and the Argentinean public), leaving Evita and the public to assume she was undergoing a noncancer-related operation.

According to Dr. Lerner, families and doctors feared that hearing the dreaded word "cancer" would cause patients to lose hope, become depressed and even commit suicide if they knew of their diagnosis.  However, there were also other reasons to keep Evita’s illness a secret from her and the public, Dr. Lerner writes. 

At the time of his wife's diagnosis, Juan Perón was running for re-election as president of Argentina.  The enormous public admiration for Evita raised concern that news of her cancer would weaken the Perón regime, which was already politically vulnerable.

"Much has been written about the medical care of prominent political figures, mostly during debate about whether their physicians should disclose serious illness," Dr. Lerner writes. "Evita’s case, and particularly Pack’s role, exemplifies the extraordinary lengths to which doctors and family would go to manage the personal and public aspects of a political leader’s illness.  The story of Eva Perón and George Pack thus illuminates the conflicts that arise when medical care has social and political ramifications."

Evita’s experience with cancer would most certainly have been different today.  Pap smears are now widely used to detect cervical cancer in its early and highly treatable stages.  In the late 1940s, the American Cancer Society had just begun its aggressive campaign to promote regular Pap screenings for women. 

In the past 50 years, the medical community has also moved towards informing patients of their conditions, except in cases of cultural differences and language problems.  Even among political figures, acknowledging cancer rather than shying away from public disclosures for fear of political repercussions has become more common.

One of the most groundbreaking events in this trend toward openness was Betty Ford’s open battle with breast cancer in the 1970s.  She believed that if she spoke of her disease candidly and without embarrassment, others might be encouraged to do the same. 

After Mrs. Ford's disclosure, mammography screening rates soared in America and breast cancer awareness increased dramatically.  Former President Ronald Reagan’s bout with colon cancer in the mid-1980s had a similar effect on colon cancer screenings.

With a few exceptions, political figures are continuing to go public with their battles with cancer.  This summer, New York City Mayor Rudolph W. Giuliani cited treatment for early prostate cancer as one of his main reasons for dropping out of the U.S. Senate race.  In December, Sen. John McCain disclosed information about his 1993 bout with melanoma skin cancer.

In addition, Ohio Rep. Deborah Pryce recently spoke out about her daughter Caroline’s battle with cancer and has started a program to raise money for pediatric cancer research and provide help to families coping with childhood cancer.

However, fear of public reaction is still a concern for some politicians and the doctors who care for them.  In 1992, doctors treating Paul Tsongas of Massachusetts, a presidential candidate, inaccurately described his condition as "cancer free" when a lymphoma had recurred after a bone marrow transplant, Dr. Lerner writes.

"To be sure, the illnesses of prominent politicians have broad ramifications for society," he writes. "Nevertheless, physicians caring for such individuals should – as George Pack did in the case of Eva Perón – view them first and foremost at patients."