Study questions kidney cancer treatment in elderly

In a stunning example of when treatment might be worse than the disease, a large review of Medicare records finds that older people with small kidney tumors were much less likely to die over the next five years if doctors monitored them instead of operating right away.

Even though nearly all of these tumors turned out to be cancer, they rarely proved fatal. And surgery roughly doubled patients' risk of developing heart problems or dying of other causes, doctors found.

After five years, 24 percent of those who had surgery had died, compared to only 13 percent of those who chose monitoring. Just 3 percent of people in each group died of kidney cancer.

The study only involved people 66 and older, but half of all kidney cancers occur in this age group. Younger people with longer life expectancies should still be offered surgery, doctors stressed.

The study also was observational — not an experiment where some people were given surgery and others were monitored, so it cannot prove which approach is best. Yet it offers a real-world look at how more than 7,000 Medicare patients with kidney tumors fared. Surgery is the standard treatment now.

"I think it should change care" and that older patients should be told "that they don't necessarily need to have the kidney tumor removed," said Dr. William Huang of New York University Langone Medical Center. "If the treatment doesn't improve cancer outcomes, then we should consider leaving them alone."

He led the study and will give results at a medical meeting in Orlando, Fla., later this week. The research was discussed Tuesday in a telephone news conference sponsored by the American Society of Clinical Oncology and two other cancer groups.

In the United States, about 65,000 new cases of kidney cancer and 13,700 deaths from the disease are expected this year. Two-thirds of cases are diagnosed at the local stage, when five-year survival is more than 90 percent.

However, most kidney tumors these days are found not because they cause symptoms, but are spotted by accident when people are having an X-ray or other imaging test for something else, like back trouble or chest pain.

Cancer experts increasingly question the need to treat certain slow-growing cancers that are not causing symptoms — prostate cancer in particular. Researchers wanted to know how life-threatening small kidney tumors were, especially in older people most likely to suffer complications from surgery.

They used federal cancer registries and Medicare records from 2000 to 2007 to find 8,317 people 66 and older with kidney tumors less than 1.5 inches wide.

Cancer was confirmed in 7,148 of them. About three-quarters of them had surgery and the rest chose to be monitored with periodic imaging tests.

After five years, 1,536 had died, including 191 of kidney cancer. For every 100 patients who chose monitoring, 11 more were alive at the five-year mark compared to the surgery group. Only 6 percent of those who chose monitoring eventually had surgery.

Furthermore, 27 percent of the surgery group but only 13 percent of the monitoring group developed a cardiovascular problem such as a heart attack, heart disease or stroke. These problems were more likely if doctors removed the entire kidney instead of just a part of it.

The results may help doctors persuade more patients to give monitoring a chance, said a cancer specialist with no role in the research, Dr. Bruce Roth of Washington University in St. Louis.

Some patients with any abnormality "can't sleep at night until something's done about it," he said. Doctors need to say, "We're not sticking our head in the sand, we're going to follow this" and can operate if it gets worse.

One of Huang's patients — 81-year-old Rhona Landorf, who lives in New York City — needed little persuasion.

"I was very happy not to have to be operated on," she said. "He said it's very slow growing and that having an operation would be worse for me than the cancer."

Landorf said her father had been a doctor, and she trusts her doctors' advice. Does she think about her tumor? "Not at all," she said.

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Online:

Kidney cancer info: http://www.cancer.net/cancer-types/kidney-cancer

and http://www.cancer.gov/cancertopics/types/kidney

Study: http://gucasym.org

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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MacFarlane gets Oscar-hosting advice from Crystal

LOS ANGELES (AP) — Despite getting advice from Billy Crystal and working as hard as he can to prepare to host the Academy Awards, Seth MacFarlane thinks his hosting gig is a "one-off" and that he'll be "flayed by the press" no matter what he does.

Speaking to reporters Tuesday from the Dolby Theatre, where he'll host the 85th annual Oscar ceremony on Feb. 24, the entertainer was alternately confident and self-deprecating.

"I'm not feeling a lot of pressure from myself," he said. "There is sort of a comfort in knowing that no matter what you do, you're going to get the same reactions in the reviews. So I could put on the worst or the best show in the world and I will still be flayed by the press."

Still, he said he's spent five months trying to strike a comedic balance that will satisfy the fans of his animated shows and the comparatively highbrow audience inside the Dolby Theatre.

"I've set myself up for the hardest job in the world because the fans of 'Family Guy' and 'Ted' and the shows and whatnot that I do are expecting one thing. If I deliver that, this crowd will walk out," he said.

He promises to add bite to the show —"The whole point of their bringing me on was to give it a little bit more of an edge"— but acknowledges there will be a lot of ego in the audience.

"You have a room full of people who are at the top of their game — they're successful, they're being honored, they're attractive — and yet this is also the group with the thinnest skin on the planet," he said, "so it's a tough group."

Ultimately, he hopes to hybridize the pointed barbs of three-time Golden Globes host Ricky Gervais with the classy style of Crystal, who hosted the Oscars nine times, most recently last year.

The 39-year-old entertainer said Crystal gave him some helpful advice, including "get comfortable with your shoes before you go on stage."

MacFarlane will sing during the show and is also a nominee for his original song for "Ted," but said he expects to lose the category to Adele.

He's aiming for "very much a classic Oscars with a much more current edge," and said, "It's impossible to work any harder than I have in preparation for this," but he still doesn't think he'll be invited back.

"This will probably be the only time I'm asked to do this," he said. "It feels like a one-off. But I'm still thrilled to be doing it. It's going to be a lot of fun. I will very much enjoy having done it once it's over."

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Contact AP Entertainment Writer Sandy Cohen at www.twitter.com/APSandy.

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Online:

www.oscars.org

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Downtown condo market showing signs of life

Downtown Chicago's condo market is on the rebound after many moribund years, as sales volume and pricing improve in a market constrained by a lack of inventory.

It's a rare piece of good news for downtown condo owners as well as for developers pondering projects and trying to line up financing.

With a steady stream of apartment projects delivering in the next two years, the lack of new condo construction could signal opportunities for companies interested in pursuing smaller projects in key neighborhoods because the demand is there. Until those projects materialize, condo owners looking to sell face a better market than they have in several years.

Sales of existing downtown condos rose 31.2 percent last year, to 4,675 units sold, while the median sales price of $300,000 was a gain of about 2.6 percent from 2011, according to data from Appraisal Research Counselors.

Another piece of good news for current condo owners: Of the 65 downtown buildings studied by the firm, the average sales price per square foot of units sold during the second half of last year rose while the number of distressed condo sales in those buildings saw a substantial drop. Distressed sales, which accounted for  28 percent of sales since 2010, fell to 17 percent of sales during the second half of 2012.

In addition, only 1,104 newly constructed condo units remain unsold downtown.

"When we see more transactions occurring, that's a really good indication of demand," said Gail Lissner, a vice president at the firm. "The look of the condo market has changed in terms of unsold inventory."

Lissner's remarks came Tuesday during a lunchtime briefing on the local housing market.

Most of the unsold inventory, more than 500 units, is in the South Loop and the bulk of it is in the newly named and repositioned 500-unit South Loop Luxury by Related.

The three buildings, once called One Museum Park West, 1600 Museum Park and Museum Park Place 2 were taken over by New York-based Related Cos. in July have been renamed the Grant, Adler Place and Harbor View, respectively.

Since December, 40 units there are under contract, according to Related Midwest, which officially launched sales in the project Tuesday.

Other new projects reporting positive sales trends are Park Monroe Phase II, a 48-unit adaptive reuse project with 16 sales and CA3, a 40-unit building with 18 sales.

"These are all great indicators of strong sales," Lissner said. "Price stabilization has occurred in the market. You don't hear people talking about bottoming out. That was so yesterday."

mepodmolik@tribune.com | Twitter @mepodmolik

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China joins U.S., Japan, EU in condemning N. Korea nuke test

AFP) - North Korea stages its most powerful nuclear test yet, claiming a breakthrough with a "miniaturized" device in a striking act of defiance that drew condemnation from global powers, including its sole patron China.

SEOUL (Reuters) - North Korea conducted its third nuclear test on Tuesday in defiance of existing U.N. resolutions, drawing condemnation from around the world, including from its only major ally, China, which summoned the North Korean ambassador to protest.

The reclusive North said the test was an act of self-defense against "U.S. hostility" and threatened further, stronger steps if necessary.

It said the test had "greater explosive force" than the 2006 and 2009 tests. Its KCNA news agency said it had used a "miniaturized" and lighter nuclear device, indicating that it had again used plutonium which is more suitable for use as a missile warhead.

North Korean leader Kim Jong-un, the third of his line to rule the country, has presided over two long-range rocket launches and a nuclear test during his first year in power, pursuing policies that have propelled his impoverished and malnourished country closer to becoming a nuclear weapons power.

China, which has shown signs of increasing exasperation with the recent bellicose tone of its neighbor, summoned the North Korean ambassador in Beijing and protested sternly, the Foreign Ministry said.

Foreign Minister Yang Jiechi said China was "strongly dissatisfied and resolutely opposed" to the test and urged North Korea to "stop any rhetoric or acts that could worsen situations and return to the right course of dialogue and consultation as soon as possible".

China is a permanent member of the Security Council.

U.S. President Barack Obama labeled the test a "highly provocative act" that hurt regional stability and pressed for new sanctions.

"The danger posed by North Korea's threatening activities warrants further swift and credible action by the international community. The United States will also continue to take steps necessary to defend ourselves and our allies," Obama said in a statement.

The Security Council will meet on Tuesday to discuss its reaction to the test, although North Korea is already one of the most heavily sanctioned states in the world and has few external economic links that can be targeted.

Japanese Prime Minister Shinzo Abe said the test was a "grave threat" that could not be tolerated. U.N. Secretary-General Ban Ki-moon said the test was a "clear and grave violation" of U.N. Security Council resolutions.

Russian Foreign Minister Sergei Lavrov urged North Korea to abandon its nuclear arms program and return to talks. NATO condemned the test as an "irresponsible act" that posed a grave threat to world peace.

The test "was only the first response we took with maximum restraint", an unnamed spokesman for the North Korean Foreign Ministry, which acts as Pyongyang's official voice to the outside world, said in a statement carried by the official KCNA news agency.

"If the United States continues to come out with hostility and complicates the situation, we will be forced to take stronger, second and third responses in consecutive steps."

North Korea often threatens the United States and its "puppet", South Korea, with destruction in colorful terms.

North Korea told the U.N. disarmament forum in Geneva that it would never bow to resolutions on its nuclear program and that prospects were "gloomy" for the denuclearization of the divided Korean peninsula because of a "hostile" U.S. policy.

South Korea, still technically at war with the North after the 1950-53 civil war ended in a mere truce, also denounced the test.

The magnitude was roughly twice as large as that of 2009, Lassina Zerbo, director of the international data centre division of the Vienna-based Comprehensive Nuclear-Test Ban Treaty Organization, said. The U.S. Geological Survey said that a seismic event measuring 5.1 magnitude had occurred.

"It was confirmed that the nuclear test that was carried out at a high level in a safe and perfect manner using a miniaturized and lighter nuclear device with greater explosive force than previously did not pose any negative impact on the surrounding ecological environment," KCNA said.

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Nokia protests against Indian tax probe

HELSINKI (Reuters) - Finnish phone maker Nokia said on Tuesday it was protesting against a tax investigation in India, a crucial market, in the latest dispute involving a foreign company's tax.

Nokia said it has not yet received any information on potential claims resulting from the investigation that started in January.

Last week, Anglo-Dutch oil major Royal Dutch Shell's Indian unit said it would challenge a local tax claim on a share sale, while British mobile phone firm Vodafone is trying to settle a long-running $2 billion tax dispute with Indian authorities.

Countries like India are crucial for Nokia's attempt to hold on to global market share. Earlier on Tuesday, it announced an expansion of its Asha line of low-end smartphones and India is widely seen as a key market for such cheaper models.

Nokia said the actions of the tax authorities were "unacceptable and inconsistent with Indian standards of fair play and governance."

The company objected to officials entering its factory in Chennai, southern India, which is one of its biggest facilities. Nokia said it has invested over $330 million in Chennai since setting up the factory in 2006.

A senior Indian tax official said in January that the investigation related to allegations that Nokia may have evaded around 30 billion rupees ($558 million) in taxes.

Nokia said on Tuesday it was in full compliance with local laws as well as a bilateral tax treaty between India and Finland related to withholding tax.

(Reporting by Ritsuko Ando; Editing by Erica Billingham)

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IOC drops wrestling from 2020 Olympics

LAUSANNE, Switzerland (AP) — IOC leaders dropped wrestling from the Olympic program on Tuesday, a surprise decision that removes one of the oldest Olympic sports from the 2020 Games.

The IOC executive board decided to retain modern pentathlon — the event considered most at risk — and remove wrestling instead from its list of 25 "core sports."

The IOC board acted after reviewing the 26 sports on the current Olympic program. Eliminating one sport allows the International Olympic Committee to add a new sport to the program later this year.

Wrestling, which combines freestyle and Greco-Roman events, goes back to the inaugural modern Olympics in Athens in 1896.

"This is a process of renewing and renovating the program for the Olympics," IOC spokesman Mark Adams said. "In the view of the executive board, this was the best program for the Olympic Games in 2020. It's not a case of what's wrong with wrestling, it is what's right with the 25 core sports."

Adams said the decision was made by secret ballot over several rounds, with members voting each time on which sport should not be included in the core group. IOC President Jacques Rogge did not vote.

Wrestling was voted out from a final group that also included modern pentathlon, taekwondo and field hockey, officials familiar with the vote told The Associated Press. They spoke on condition of anonymity because the voting details were not made public.

The board voted after reviewing a report by the IOC program commission report that analyzed 39 criteria, including television ratings, ticket sales, anti-doping policy and global participation and popularity. With no official rankings or recommendations contained in the report, the final decision by the 15-member board was also subject to political, emotional and sentimental factors.

The international wrestling federation, known by the French acronym FILA, is headed by Raphael Martinetti and is based in Corsier-sur-Vevey, Switzerland. Calls to the federation for comment were not immediately returned.

Wrestling featured 344 athletes competing in 11 medal events in freestyle and seven in Greco-Roman at last year's London Olympics. Women's wrestling was added to the Olympics at the 2004 Athens Games.

Wrestling will now join seven other sports in applying for inclusion in 2020. The others are a combined bid from baseball and softball, karate, squash, roller sports, sport climbing, wakeboarding and wushu. They will be vying for a single opening in 2020.

The IOC executive board will meet in May in St. Petersburg, Russia, to decide which sport or sports to propose for 2020 inclusion. The final vote will be made at the IOC session, or general assembly, in September in Buenos Aires, Argentina.

It is extremely unlikely that wrestling would be voted back in so soon after being removed by the executive board.

"Today's decision is not final," Adams said. "The session is sovereign and the session will make the final decision."

The last sports removed from the Olympics were baseball and softball, voted out by the IOC in 2005 and off the program since the 2008 Beijing Games. Golf and rugby will be joining the program at the 2016 Games in Rio de Janeiro.

Previously considered under the closest scrutiny was modern pentathlon, which has been on the Olympic program since the 1912 Stockholm Games. It was created by French baron Pierre de Coubertin, the founder of the modern Olympic movement, and combines fencing, horse riding, swimming, running and shooting.

Klaus Schormann, president of governing body UIPM, lobbied hard to protect his sport's Olympic status and it paid off in the end.

"We have promised things and we have delivered," he said after Tuesday's decision. "That gives me a great feeling. It also gives me new energy to develop our sport further and never give up."

Modern pentathlon also benefited from the work of Juan Antonio Samaranch Jr., the son of the former IOC president who is a UIPM vice president and member of the IOC board.

"We were considered weak in some of the scores in the program commission report but strong in others," Samaranch told the AP. "We played our cards to the best of our ability and stressed the positives. Tradition is one of our strongest assets, but we are also a multi-sport discipline that produces very complete people."

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Pope shows lifetime jobs aren't always for life

The world seems surprised that an 85-year-old globe-trotting pope who just started tweeting wants to resign, but should it be? Maybe what should be surprising is that more leaders his age do not, considering the toll aging takes on bodies and minds amid a culture of constant communication and change.

There may be more behind the story of why Pope Benedict XVI decided to leave a job normally held for life. But the pontiff made it about age. He said the job called for "both strength of mind and body" and said his was deteriorating. He spoke of "today's world, subject to so many rapid changes," implying a difficulty keeping up despite his recent debut on Twitter.

"This seemed to me a very brave, courageous decision," especially because older people often don't recognize their own decline, said Dr. Seth Landefeld, an expert on aging and chairman of medicine at the University of Alabama at Birmingham.

Age has driven many leaders from jobs that used to be for life — Supreme Court justices, monarchs and other heads of state. As lifetimes expand, the woes of old age are catching up with more in seats of power. Some are choosing to step down rather than suffer long declines and disabilities as the pope's last predecessor did.

Since 1955, only one U.S. Supreme Court justice — Chief Justice William Rehnquist — has died in office. Twenty-one others chose to retire, the most recent being John Paul Stevens, who stepped down in 2010 at age 90.

When Thurgood Marshall stepped down in 1991 at the age of 82, citing health reasons, the Supreme Court justice's answer was blunt: "What's wrong with me? I'm old. I'm getting old and falling apart."

One in 5 U.S. senators is 70 or older, and some have retired rather than seek new terms, such as Hawaii's Daniel Akaka, who left office in January at age 88.

The Netherlands' Queen Beatrix, who just turned 75, recently said she will pass the crown to a son and put the country "in the hands of a new generation."

In Germany, where the pope was born, Chancellor Angela Merkel, who is 58, said the pope's decision that he was no longer fit for the job "earns my very highest respect."

"In our time of ever-lengthening life, many people will be able to understand how the pope as well has to deal with the burdens of aging," she told reporters in Berlin.

Experts on aging agreed.

"People's mental capacities in their 80s and 90s aren't what they were in their 40s and 50s. Their short-term memory is often not as good, their ability to think quickly on their feet, to execute decisions is often not as good," Landefeld said. Change is tougher to handle with age, and leaders like popes and presidents face "extraordinary demands that would tax anybody's physical and mental stamina."

Dr. Barbara Messinger-Rapport, geriatrics chief at the Cleveland Clinic, noted that half of people 85 and older in developed countries have some dementia, usually Alzheimer's. Even without such a disease, "it takes longer to make decisions, it takes longer to learn new things," she said.

But that's far from universal, said Dr. Thomas Perls, an expert on aging at Boston University and director of the New England Centenarians Study.

"Usually a man who is entirely healthy in his early 80s has demonstrated his survival prowess" and can live much longer, he said. People of privilege have better odds because they have access to good food and health care, and tend to lead clean lives.

"Even in the 1500s and 1600s there were popes in their 80s. It's remarkable. That would be today's centenarians," Perls said.

Arizona Sen. John McCain turned 71 while running for president in 2007. Had he won, he would have been the oldest person elected to a first term as president. Ronald Reagan was days away from turning 70 when he started his first term as president in 1981; he won re-election in 1984. Vice President Joe Biden just turned 70.

In the U.S. Senate, where seniority is rewarded and revered, South Carolina's Strom Thurmond didn't retire until age 100 in 2002. Sen. Robert Byrd of West Virginia was the longest-serving senator when he died in office at 92 in 2010.

Now the oldest U.S. senator is 89-year-old Frank Lautenberg of New Jersey. The oldest congressman is Ralph Hall of Texas who turns 90 in May.

The legendary Alan Greenspan was about to turn 80 when he retired as chairman of the Federal Reserve in 2006; he still works as a consultant.

Elsewhere around the world, Cuba's Fidel Castro — one of the world's longest serving heads of state — stepped down in 2006 at age 79 due to an intestinal illness that nearly killed him, handing power to his younger brother Raul. But the island is an example of aged leaders pushing on well into their dotage. Raul Castro now is 81 and his two top lieutenants are also octogenarians. Later this month, he is expected to be named to a new, five-year term as president.

Other leaders who are still working:

—England's Queen Elizabeth, 86.

—Abdullah bin Abd al-Aziz al-Saud, king of Saudi Arabia, 88.

—Sabah al-Ahmad al-Jaber al-Sabah, emir of Kuwait, 83.

—Ruth Bader Ginsburg, U.S. Supreme Court associate justice, 79.

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Associated Press writers Paul Haven in Havana, Cuba; David Rising in Berlin; Seth Borenstein, Mark Sherman and Matt Yancey in Washington, and researcher Judy Ausuebel in New York contributed to this report.

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Back to New Orleans: Beyonce to perform at Essence

NEW ORLEANS (AP) — Beyonce is coming back to New Orleans and back to the Superdome.

After entertaining a huge television audience in a packed dome during the Super Bowl halftime show, Beyonce is now scheduled to perform at the Essence Festival.

Festival officials said Monday that she will return to the dome to headline one of three night concerts during the festival, which is set for the Fourth of July weekend.

Beyonce joins an Essence musical line-up that also includes Jill Scott, Maxwell, New Edition, Charlie Wilson, Keyshia Cole, LL Cool J, Brandy and others.

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Judge OKs auction of Hostess brands

Workers prepare Twinkies for packaging at a Schiller Park plant in 2005. The Twinkie, one of America's best-known snack treats, was created in Chicagoland by James Dewar in 1930. (Tim Boyle, Getty / April 20, 2005)

Reuters

6:01 p.m. CST, February 11, 2013

Hostess Brands Inc., the bankrupt maker of Twinkies snack cakes, received court permission on Monday to proceed with auctions for several of its brands, including Twinkies and Wonder Bread.

The U.S. Bankruptcy Court in White Plains, N.Y., cleared Hostess to sell off assets related to its Hostess and Dolly Madison Brands.

A hearing to approve the successful bidder is scheduled for March 19.

Private equity firms Apollo Global Management LLC and C. Dean Metropoulos & Co have set a baseline offer of $410 million to buy the company's snack cake brands including Hostess Twinkies and Dolly Madison, Hostess said last month.

The so-called stalking horse bid by the private equity firms, working together to buy the 82-year-old baker, would serve as the minimum offer for the business, which could still be topped by others.

Hostess was granted permission by a U.S. bankruptcy court judge in November to wind down its business and liquidate its assets after a strike by a baker's union crippled the company's operations.

The sale of assets, which range from Twinkies and Wonder Bread to real estate and baking equipment, is being run by Perella Weinberg Partners.

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Pope Benedict to resign at month's end, cites deteriorating 'strength'

ROME -- Pope Benedict surprised the world on Monday by saying he no longer had the mental and physical strength to cope with the demands of his ministry, becoming the first pontiff to step down since the Middle Ages and leaving his aides "incredulous".

The 85-year-old German-born Pope, hailed as a hero by conservative Catholics and viewed with suspicion by liberals, said he had noticed that his strength had deteriorated over recent months.

A Vatican spokesman said the Pope had not resigned because of "difficulties in the papacy" and the decision had been a surprise, indicating that even his closest aides were unaware that he was about to quit. The Pope does not fear schism in the Church after his resignation, the spokesman said.

Cardinal Francis George returned to Chicago from a committee meeting in Rome Sunday, spokeswoman Colleen Dolan said. She said he was just as surprised as she was and would release a statement later today.

The Pope's leadership of 1.2 billion Catholics has been beset by a child sexual abuse crisis that tarnished the Church, one address in which he upset Muslims and a scandal over the leaking of his private papers by his personal butler.

In a statement, the pope said in order to govern "...both strength of mind and body are necessary, strength which in the last few months, has deteriorated in me to the extent that I have had to recognize my incapacity to adequately fulfill the ministry entrusted to me.

"For this reason, and well aware of the seriousness of this act, with full freedom I declare that I renounce the ministry of Bishop of Rome, Successor of Saint Peter."

Before he was elected Pope, the former Cardinal Joseph Ratzinger was known by such critical epithets as "God's rottweiler" because of his stern stand on theological issues.

But after several years into his new job he showed that he not only did not bite but barely even barked.

In recent months, the Pope has looked increasingly frail in public sometimes being helped to walk by those around him.

A Vatican spokesman said the pontiff would step down from 1 p.m. CST on Feb. 28, leaving the office vacant until a successor was chosen to Benedict who succeeded John Paul, one of history's most popular pontiffs.

MEEK DEMEANOUR, STEELY INTELLECT

A spokesman for the German government said he was "moved" by the news while Israel's chief rabbi praised Benedict's inter-faith outreach and wished him good health.

Elected to the papacy on April 19, 2005 when he was 78 -- 20 years older than John Paul was when he was elected -- he ruled over a slower-paced, more cerebral and less impulsive Vatican.

But while conservatives cheered him for trying to reaffirm traditional Catholic identity, his critics accused him of turning back the clock on reforms by nearly half a century and hurting dialogue with Muslims, Jews and other Christians.

Under the German's meek demeanor lay a steely intellect ready to dissect theological works for their dogmatic purity and debate fiercely against dissenters.

After appearing uncomfortable in the limelight at the start, he began feeling at home with his new job and showed that he intended to be Pope in his way.

Despite great reverence for his charismatic, globe-trotting predecessor -- whom he put on the fast track to sainthood and whom he beatified in 2011 -- aides said he was determined not to change his quiet manner to imitate John Paul's style.

A quiet, professorial type who relaxed by playing the piano, he managed to show the world the gentle side of the man who was the Vatican's chief doctrinal enforcer for nearly a quarter of a century.

The first German pope for some 1,000 years and the second non-Italian in a row, he traveled regularly, making about four foreign trips a year, but never managed to draw the oceanic crowds of his predecessor.

STRING OF SCANDALS

The child abuse scandals hounded most of his papacy. He ordered an official inquiry into abuse in Ireland, which led to the resignation of several bishops.

Scandal from a source much closer to home hit in 2012 when the pontiff's butler, responsible for dressing him and bringing him meals, was found to be the source of leaked documents alleging corruption in the Vatican's business dealings, causing an international furor.

He confronted his own country's past when he visited the Nazi death camp at Auschwitz.

Calling himself "a son of Germany", he prayed and asked why God was silent when 1.5 million victims, most of them Jews, died there during World War Two.

Ratzinger served in the Hitler Youth during World War Two when membership was compulsory. He was never a member of the Nazi party and his family opposed Adolf Hitler's regime.

But his trip to Germany also prompted the first major crisis of his pontificate. In a university lecture he quoted a 14th century Byzantine emperor as saying Islam had only brought evil to the world and that it was spread by the sword.

After protests that included attacks on churches in the Middle East and the killing of a nun in Somalia, the Pope later said he regretted any misunderstanding the speech caused.

In a move that was widely seen as conciliatory, in late 2006 he made a historic trip to predominantly Muslim Turkey and prayed in Istanbul's Blue Mosque with a Turkish Mufti.

But months later, former Iranian President Mohammad Khatami met the Pope and said wounds between Christians and Muslims were still "very deep" as a result of the Regensburg speech.

Reuters

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