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Diagnosing Rudy

Rudy Giuliani poured cold water - at least for one more day - on speculation he's about to drop out of New York's Senate race.

"I've made no decision about the treatment, much less a decision about whether to run," said the Big Apple mayor on Monday, referring to plans for handling his prostate cancer diagnosed more two weeks ago.

Implicit in that statement is that the mayor's political future depends entirely on his medical future. That's what Giuliani has said all along, and it's why he insisted he's not ready to answer the questions the baying press puts to him each day. Giuliani says he needs to take time to consult with doctors about his treatment, and that he won't make his decision "until I have what I feel is enough information."

The mayor dismissed scornfully a Newsweek report that said he had settled on a course of surgery followed by radiation and, consequently, would withdraw because of the rigors of that option.

"That is absolutely false," he flashed. Besides, Giuliani added, "That can't even possibly be true because that's not a sensible treatment plan for somebody with my cancer."

Dr. LaMar McGinnis, the senior medical researcher at the American Cancer Society, agreed. Since Giuliani's cancer is at an early stage, treatment would consist of either surgery or radiation, but not both, just as the mayor said Monday. Dr. McGinnis said Giuliani could choose among surgery, external beam radiation therapy, or Brachy therapy, in which irradiated pellets are placed in the prostate to eradicate the tumor internally.

Surgery generally means a recovery of some three to four weeks, though McGinnis said there are cases where patients are back to work in a week. External beam radiation or Brachy therapy have even less impact - they are administered on an outpatient basis and lots of patients never stop working.

All three treatments generally involve temporary spells of incontinence or impotence, which clear up in the majority of patients. All three are equally successful in curing the cancer.

Giuliani has plenty of time to consider his choices, at least from a medical standpoint, said McGinnis. "There is no great urgency about this," he remarked. "Patients so often hear the big 'C' word and think the clock is ticking, but that's not a factor." Giuliani could safely take weeks to make up his mind.

And could the mayor conceivably undergo any one of these three treatments and still campaign for the U.S. Senate?

"Oh, surely," McGinnis asserted. Many men "are back at work, and it's as if nothing has happened, other than they carry cancer on their mind in a different manner than they did previously."

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Which leads to an interesting question. Certainly none of us, quite properly, knows the specifics of Giuliani's condition, nor what his doctors are telling him, but general observation suggests that his cancer need not drive him from the race. But could something else?

That's much tougher to figure than a dispassionate consideration of medical risks and advantages. Whether his disintegrating marriage is enough to make him withdraw, only Giuliani knows - and he wouldn't go there during his regular Monday press conference. "I'm not going to answer questions about my private life," he said.

His political life is another matter, because it affects a whole lot of other people. "I think if he can stay in the race, it's probably best for the party, because he does have money in place ... and he has the highest name identification," said Rep. Peter King (R-N.Y.), a possible contender for the Senate seat if Giuliani drops out.

A less cheery view comes from Republican consultant Nelson Warfield. He argued Giuliani is "not the strongest Republican to contend with Hillary Clinton for the Senate seat, but the problem is the Republican leadership is handcuffed to him at this point, and they're reluctant to give him the shove off the stage."

Maybe the GOP wants Giuliani, maybe it doesn't, but it certainly wants him to fish or cut bait soon, before the state party convention at the end of the month - and before Hillary runs away with a lead. But Giuliani said, "I don't feel under pressure from the state Republican party ... I spoke to Bill Powers (the New York state Republican chair) over the weekend, and he did not in any way pressure me to make a decision."

Giuliani said he'll spend much of Tuesday and Wednesday meeting with doctors and considering his options. As he described that process, he sounded almost as though he were discussing his political life, not just his medical choices.

"Sometimes I wake up and I think one way is best, and other times I wake up and think another way will be best," he mused. "Each one has benefits and detriments in terms of the impact it can have on you."

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