More Mixed Signals About Megrahi’s Prostate Cancer

Libya's most prominent prostate cancer patient, Abdelbasset al Megrahi, convicted as the "Lockerbie bomber," and released on compassionate grounds of his illness, either is or is not in an intensive care unit.

Megrahi served eight years of a life sentence for the murder of 270 people on Pan Am Flight 103, which exploded over the Scottish town of Lockerbie in 1988. Some relatives of British victims and some political commentators believe that Megrahi was a fall guy for Syrian involvement. At the same time outrage is swirling over a perceived exchange of Megrahi for renewal of UK interest in Libyan oil.

According to family members and a Libyan government official speaking earlier this week, Mr. Megrahi has been in an intensive care unit of the Tripoli Medical Centre for the past week. Libyan officials also released alarming information. "He has been admitted to the emergency room in the hospital," a Libyan official said. "He is in a bad way. He is unable to speak to anyone."

Video shot by UK Channel 4 over the weekend shows Megrahi driven to hospital by private car and in a bed, in silky pajamas, in a regular-looking private room. The TV is on, relatives milling about. The interviewer is allowed to approach the bed. According to Channel 4 blog, as noted in our previous report, room service delivered a meal to the room. Normally, none of this would be allowed to happen in intensive care.

At that time Mr. Megrahi was receiving a clear fluid through IV, probably intravenous hydration which many cancer patients receive at home. He was breathing through an oxygen mask of a type commonly used at home as well in hospital.

From a still shot we extracted of the Biosys vital signs monitor, it looks like this was hooked to a pulse oxygen monitor clipped to the patient's finger. The monitor registered high-normal heartbeat and normal-range blood-oxygen level, an indication that supportive oxygen was effective at that time.

After the video was aired, AP reported a different story from Libyan government officials.

Libya denied reports Wednesday that the only man convicted in the 1988 Lockerbie bombing was taken to intensive care after his illness from terminal prostate cancer worsened.

A Foreign Ministry spokesman, Mohammad Seyala, said Abdel Baset al-Megrahi has actually been moved to a special VIP wing of the hospital in Libya's capital, Tripoli, where he is being treated.

'Al-Megrahi is not in a dangerous situation and is receiving full treatment from a team of Libyan doctors,' said Seyala.

Non-specialist doctors as well as politicians and officials have claimed since before Megrahi's release that he is "dying." Unfortunately for him and his family, this may indeed be so. Prostate cancer kills about 10 thousand men a year in the UK.

No reliable evidence about the stage, course and tempo of Megrahi's prostate cancer has been disclosed, however. Nor has anyone disclosed any treatment options that may have been offered to Mr. Megrahi. Daily claims that he is dying may have deprived him of potentially helpful active therapy. Overall, misleading impressions are being conveyed about prostate cancer.

The air of passive acceptance surrounding belated diagnosis of this prison inmate's advanced prostate cancer bodes ill for other prisoners and for men free and at large throughout the UK. Keeping his medical records sealed protects the prison health care system -- and the overall UK health care system -- from necessary questions about how a man of 57 under close surveillance went from health to metastatic cancer without medical intervention.

A report released without full documentation and with doctors' names omitted, according to The Scotsman "said that a professor from Libya had been involved in Megrahi's care and the medical officer who wrote the report had been 'working with clinicians from Libya over the past ten months.'"

In view of Megrahi's status as a man convicted of murdering 270 of his fellow human beings, no decision to release him out of compassion justifies withholding his medical information from full public disclosure. Presumably, this information is in the hands of the Scottish prison system and/or the UK government. All of this information should be released to the press and the public so that it can be evaluated by independent medical oncologists.

If done expeditiously, who knows, even if it does not extend Mr. Megrahi's life by even a day it might help him and his family make wiser choices about palliative, comfort care in hospital or at home, beyond the lenses of paparazzi.

As long as the medical information remains hidden, the public may be left with the impression that advanced prostate cancer is untreatable and that men die of prostate cancer in a matter of days. Since that impression is generally false, the question arises whether Mr. Megrahi is actually being hastened toward death, as an all round embarrassing reminder (while alive) of how he has been used as a pawn.

If Megrahi's advanced prostate cancer was taken as an opportunity to justify releasing him in order to revive trade relations with Libya, then, ironically, everyone involved in that deal may want to see the angel of death arrive at his bedside as soon as possible.

For the time being Mr. Megrahi is like Schrödinger's cat -- with his medical records in a sealed black box, he can be said to be simultaneously in intensive care and not in intensive care; both "dying" and "not in a dangerous situation."


Abdel Baset al-Megrahi, Lockerbie Bomber, Reportedly Taken To Intensive Care... UPDATE: Libya Denies

Medical advice on Libyan bomber 'in doubt' 26 August