Turkey’s President Recep Tayyip Erdogan underwent surgery to remove a cancerous tumor and suffers from epilepsy, among other possible health complications, which may explain his sometimes erratic behavior, angry outbursts and conflicting remarks that puzzle many outside observers, a Nordic Monitor investigation has found.

Just like the cloud obscuring how his government spends taxpayers’ money and enacts laws that deal blows to transparency in governance in Turkey, President Erdogan is also not forthcoming in revealing details about the status of his health, fueling all sorts of speculation. The president’s aides often portray him as perfectly healthy and downplay any health issue that have caught public attention. Nevertheless, there is enough evidence to confirm that the Turkish president has suffered or still experiences multiple health problems.

What is known for a fact is that he survived colon cancer and underwent surgery on November 26, 2011 in Istanbul when he was 57 years old. According to sources who have inside knowledge of Erdogan’s health, the cancer was discovered during an examination of Erdogan, who was complaining of digestive problems and blood in his stool. The sources were interviewed on condition of anonymity for fear of threats to their lives by the Erdogan government, which has dismissed and/or imprisoned over 20,000 health care professionals including doctors and nurses since 2016.

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His doctors performed both a colonoscopy and sigmoidoscopy by sampling areas of the colon suspected of possible tumor development. The microscopical examination of a tissue sample indicated that he had tumor known as a villous adenoma, which means he had an advanced form of adenoma and a precursor to cancer.

With further tests and examinations, it was later determined that Erdogan had late stage 2 or early stage 3 cancer and that the tumor was located 10-15 centimeters from the anal verge, which may also be classified as rectal cancer because of its close proximity to the anus.

Read more: Nordic Monitor