Venezuelan President Hugo Chavez was poised to return to Cuba on Sunday for more cancer treatment, having spoken for the first time of giving up power if his condition worsens or he dies.
Chavez (58) who won another six-year term just two months ago, having claimed to have beaten the disease, dramatically announced on Saturday night that malignant cells had returned and that he needed surgery.
Treatment is absolutely necessary, the populist leader said in a bombshell statement on state television in which he admitted he may have to relinquish the presidency and that Vice President Nicolas Maduro is his chosen successor.
The designation of an heir apparent in the event that something happened to him underlined the seriousness of Chavez's condition, which he said was inflicting strong pain and required him to take tranquilizers.
In power since 1999, the political firebrand and outspoken foe of the United States, has made repeated trips to the Castro brothers’ Cuba for cancer treatment, the most recent of which came before his re-election on October 7.
Over the past year and a half, Chavez has missed practically every regional meeting he was to have attended, such as the Summit of the Americas in Colombia, last month's Ibero-American summit and the Mercosur summit in Brazil where Venezuela was performing as full member for the first time.
He returned from Havana on Friday after a 10-day stay in Cuba but his medical team stressed a sense of urgency about the looming operation, his fourth since mid 2011.
”The doctor recommended that I undergo surgery yesterday (Friday) at the latest, or this weekend, he noted. But I did not agree and came back home.
In what appeared like a presentation of his final will, the once-omnipresent leader, who had not been seen in public for three weeks, urged Venezuelans to vote for Maduro in the next presidential poll should he become incapacitated.
Choose Maduro as president of the republic, Chavez said. I am asking you this from all my heart.
Maduro, who has been serving as Venezuela's foreign minister for the past six years, was appointed vice president in the wake of October's presidential poll. He has since held both portfolios.
The former bus driver who began his political career in the labour movement belongs to the more moderate wing of the Chavez entourage.
The radical wing is led by Diosdado Cabello, who, along with Chavez, took part in a failed 1992 military coup, and now presides over the National Assembly.
Under the Venezuelan constitution, if the new president is incapacitated before inauguration -- scheduled for January 10 -- new elections must be called in 30 days. The parliamentary speaker must then take charge until a new president is elected.
But if incapacitation or death occurs after the inauguration but in the first four years of a term, the vice president takes over and governs until an early election determines a new leader.
Exactly what type of cancer Chavez has remains a mystery since the long-time leader has handled his illness as a state secret.
Prior to Saturday's announcement, he had repeatedly claimed to have beaten an unspecified cancer in his pelvic region, diagnosed in 2011, and shrugged off his illness to see off a unified opposition and win power again.
Still, recurring bouts of the disease have dogged his presidency, requiring him to spend weeks at a time in Cuba. During his most recent visit, doctors again detected some malignant cells in the same area as before, Chavez said Saturday.
In Cuba last week, the official newspaper Granma reported that Chavez's treatment consisted of oxygenation.
The American Cancer Society says there is no evidence that this oxygen treatment -- in which a patient gets inside a pressurized chamber and breathes pure oxygen for an hour -- works against cancer. But the society also says it can serve as treatment for ailments stemming from radiation treatment.
Venezuelans reacted with shock and empathy to the news, and a rally in support was planned in downtown Caracas.
Bolivian President Evo Morales sent well wishes to his counterpart. This new battle for life will also be won,” he said.
Chavez appeared weak and subdued during the presidential campaign, but still managed to win another term that extends to 2019.
He was last seen in public on November 15, and two weeks later he went to Cuba for treatment. Unlike other trips to Cuba, this time Chavez did not make farewell remarks or hold a carefully choreographed photo opportunity.