Venezuela's Hugo Chavez will undergo another operation in Cuba in the coming days after doctors found a possibly malignant lesion in his pelvis where surgeons removed a large cancerous tumour last year, he said on Tuesday.
The 57-year-old socialist president confirmed he travelled to Havana for the tests on Saturday. Rumours of the unannounced trip had prompted a flood of speculation among the opposition and supporters alike that he was at death's door.
Chavez's health is the wildcard ahead of an October 7 presidential election, when he will seek a new six-year term. He has never given many details about his condition so the news he needs more surgery was bound to fuel doubts about his recovery.
There is no metastasis, just this small lesion in the same place where they removed the tumour, the president said during a televised tour of a factory in his home state of Barinas.
Because of the growing Rumours, I'm obliged to give this information now ... it's a small lesion, about 2 cm across, very clearly visible. This will need to be taken out, it needs more surgery, supposedly less complicated than before.
During one of two lengthy phone calls to state TV later in the evening, Chavez said the operation would take place in Cuba.
I'll go to Havana. Everything is ready there, with the same doctors who operated on me before, he said. To do it here we would have had to implement things, elements. It is safer there for this type of operation.
But he denied he was rushing back to Cuba: All in due time. Tomorrow I'll be working all day, preparing myself for the weekend ... Unfortunately, I will not be able to continue at the same rate in the coming weeks.
Chavez said no one should be alarmed by the news, and that he was in good physical shape for the challenge ahead. Donning a bright red hard hat to stroll around the factory, the president had joked with workers and looked to be in reasonable health.
No one can say if it (the lesion) is malignant, but there is a high probability because it is in the same place, he said.
He had insisted he was completely recovered, although medical experts had said it was too soon to make such a call.
One cancer doctor in the United States told Reuters that with such little detail it was impossible to know his real condition, but that the latest turn of events did not look good.
They have always played their cards close to their chest, so you never really know, said the doctor, who has followed the case from afar but asked not to be named.
But a two centimetre lesion in the same space where he had cancer before means there is a high probability of malignancy. This is serious, very significant.
TENSIONS TO GROW
One medical source close to the team treating Chavez in Venezuela said he had been suffering a tumour lysis, or cell breakdown, which carried symptoms including a high fever.
Venezuela's information minister had earlier denounced a report that Chavez had been rushed back to Havana for emergency treatment as part of a dirty war by scum, launched by the opposition ahead of the election.
A prominent opposition-leaning Venezuelan journalist, Nelson Bocaranda, wrote on Monday that Chavez, who had two operations in Havana last June, had returned unexpectedly to Cuba over the weekend and that some of his relatives had flown there too.
Chavez allies were scathing about Bocaranda after the president appeared on television. Deputy Foreign Minister Temir Porras joked on Twitter: They'll have to take me for an emergency operation in Cuba. I'm dying of laughter!
Local political analyst Luis Vicente Leon said any new sympathy bounce in support linked to the president's illness would be lower and shorter-lasting the second time round.
Clearly the tensions within Chavismo will grow because of the uncertainty generated by this announcement, he said.
The public's reactions to Chavez's news were mixed.
Maybe it's time for a change in the country. Everything points to that, said Elizabeth Gonzalez, a 42-year-old housewife in Caracas. Car park attendant William Perez said the president had looked alright in Barinas, if a bit swollen-faced.
He didn't appear bad or tired. He's a fighter, and like his motto he'll live and he'll conquer! he said.
Barclays Capital noted that polls show more than three-quarters of Venezuelans believed Chavez had fully recovered.
However, if that perception changes it could significantly affect Chavez's re-election chances, not only physically limiting his ability to campaign but also creating doubts about the viability of a new term in office, it said.
The opposition is newly united behind one candidate - youthful state governor Henrique Capriles - and see the vote as their best chance to end Chavez's 13 years in power.
Recent opinion polls have given Chavez an edge over Capriles, thanks partly to a huge program of new state spending on social projects. But about a third of Venezuelans remain undecided, and competition for their votes will be intense.
Before Chavez's reappearance on Tuesday, Venezuelan analyst Diego Moya-Ocampos had suggested his absence could well be a strategy by Chavez's campaign team to put the focus back on him and not Capriles, who since winning the opposition primary had been at the center of media and political attention.
He said the fact that the latest Rumours had spread so fast just underlined the anxiety among loyalists each time Chavez vanished from view for more than a couple of days.
Chavez apologised to his supporters on Tuesday, saying he knew the speculation about his health was upsetting for them.
Always these Rumours ... There are people who want me dead, who hate me so much, he said. I am very sorry, because I know that while some people are happy, the majority are suffering.
(Additional reporting by Andrew Cawthorne, Marianna Parraga, Eyanir Chinea and Mario Naranjo in Caracas, and Daniel Bases in New York; Editing by Kieran Murray and Eric Beech)