The abdomen is inflated with carbon dioxide gas to give the surgeon room to work and a good view of what needs to be done. Then a laparoscope, attached to a camera that sends images to a video monitor, is inserted into one hole. The other incisions are used to insert instruments needed to remove the cancer and put the colon back together. When the surgery is finished, the carbon dioxide is removed.

A study published in the New England Journal of Medicine in May 2004 found the minimally invasive technique, when performed by experienced surgeons, is "a safe and effective alternative to standard open surgery for most patients with cancer that is confined to the colon."

Age — President Hinckley is 95 — is not a factor in determining whether a patient should have laparoscopic or open surgery, Anderson said. And while age may be a factor for complications, it is only one of many, including medical conditions such as high blood pressure or various diseases.

It is unclear what kind of future treatment President Hinckley will require.

Sometimes, chemotherapy is used after surgery but usually in limited circumstances, medical oncologist Ward said. It may be used as an adjuvant therapy for cases in which .Cases where the cancer has spread to a distant site and doctors are trying to palliate the disease, and cases in which where the cancer was surgically removed but the patient has a "high chance of recurrence." ," in which case chemotherapy may be used as an adjuvant therapy.

"It's often recommended to people with stage 3 (cancer). People with stage 1 and stage 2 (cancer) have a good enough prognosis it's not usually recommended," Ward said. "It has to be risk stratified."

"It would be unusual to have someone that elderly undergo chemotherapy," said Anderson, who added that it is standard practice after colon cancer surgery to send the patient to a medical oncologist to discuss options, including chemotherapy.

Because chemotherapy and management of its possible side effects have been greatly improved, age might not prevent doctors from deciding chemotherapy is indicated.

Few of the clinical trials in colon cancer typically involve individuals older than 70, Ward said. "We don't have much data on the aging population. We need to get more."

Radiation use is typically confined to cases where the cancer is growing outside of the colon, Anderson said. "As a general rule, it's rarely used in colon cancer."

While President Hinckley is indisposed, church business is being handled by President Thomas S. Monson, first counselor in the First Presidency, and President James E. Faust, second counselor in the First Presidency.

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