CARACAS (AP) ― Doctors in Cuba operated on Venezuelan President Hugo for cancer on Tuesday, his government said, after the illness reappeared despite a year and a half of surgeries and treatments.

Information Minister Ernesto Villegas, reading a statement on Venezuelan television, said the surgery was under way and that beforehand Chavez had expressed “absolute confidence he will overcome the obstacles that have emerged in the path of life.”

It is the fourth cancer-related operation that Chavez has undergone since June 2011.

Tareck El Aissami, a close confidant of Chavez, later told state television in Venezuela the operation was progressing without any problems.

“Everything is going well,” El Aissami said.

Cuban officials have been silent on Chavez’s surgery with news of developments coming from the government in Caracas. It is unclear if Venezuelan officials will announce when the surgery was completed.

The Venezuelan president announced on Saturday that he needed to have surgery again after tests showed “some malignant cells” had reappeared in the same area of his pelvic region where tumors were previously removed.

On the streets of Caracas, Venezuelans on both sides of the country’s deep political divide voiced concerns about Chavez’s condition and what might happen if he doesn’t survive his illness.

“It’s difficult to think about Venezuela without Chavez,” said Rafael Perdomo, a mechanic who has supported the president since 1998, when he first ran for the presidency. “I fear that we, the poor, could lose everything if Chavez dies.”

Chavez recently said for the first time that if his illness cuts short his presidency, Vice President Nicolas Maduro should take his place and be elected president to continue on with his socialist movement.

But Perdomo said he doesn’t trust Maduro the way he trusts Chavez.

Others Venezuelans said that while they’re sorry about Chavez’s health situation and wish him the best, it isn’t a particular concern for them. Many were out buying Christmas gifts and shopping for food ahead as they prepared for the holiday season.

“I’m sorry about what is happening to the president, but for many of us life goes on,” said Maria Colmenares, a housewife and opposition supporter, as she left a supermarket with bags of groceries and stood on a street corner waiting for a taxi.

“I feel pity for Chavez and his people, especially the Chavistas because they have put all their hopes in the president and they know that nobody is capable of replacing Chavez,” Colmenares added. “None of Chavez’s collaborators have his charisma.”

Chavez received a flurry of get-well messages from leaders across Latin America, including the presidents of Chile, Peru and other countries. Ecuadorean President Rafael Correa, who visited Chavez in Havana on Monday, said his ally was undergoing a “very delicate operation.”

“He’s passing through one of the hardest moments of his life. Our heart and our solidarity are with a historic president,’’ Correa said at an event Tuesday in the Ecuadorean city of Tulcan.

Chavez had said the surgery would present risks. But the government said in a statement on Tuesday that “his medical team has transmitted its optimism about the success of this operation.”

Groups of supporters have gathered to pray for Chavez this week in Venezuela and elsewhere. In Bolivia, American actor Sean Penn joined a candlelight vigil organized by the Venezuelan Embassy on Monday night, wearing a track suit emblazoned with the colors of Venezuela’s flag, just like one that Chavez has worn.

“He is one of the most important forces we’ve had on this planet. And I will wish him nothing but that great strength he has shown over and over again,” Penn told a crowd at the vigil, his voice quavering with emotion. He called Chavez “inspiring.”

Throughout his nearly 14-year-old presidency, Chavez has been loved by some Venezuelans and reviled by others as he has nationalized companies, crusaded against U.S. influence and labeled his enemies “oligarchs” and “squalid ones.”

Some Venezuelans said they’re concerned about the political upheaval if Chavez eventually dies in office.

“Many people don’t dare to say it, but they want Chavez’s death,’ said Omar Mendez, a shopkeeper who said he supports neither Chavez nor the opposition. “I would say something to those people: They should think hard about the consequences if Chavez does not survive this terrible illness because Chavez’s death could bring about an unprecedented political crisis.”

The 58-year-old president won re-election in October and is due to be sworn in for a new six-year term on Jan. 10. If Chavez were to die, the constitution says that new elections should be called and held within 30 days.

Chavez said on Saturday that if such a vote were held, his supporters should elect Maduro to take his place.

While speaking at a political rally on Monday, Maduro wiped away tears while referring to Chavez. “Even beyond this life, we’re going to be loyal to Hugo Chavez,” he said.

Chavez first announced he had been diagnosed with cancer in June 2011. He underwent a surgery for a pelvic abscess, and then had a baseball-sized tumor removed from his pelvic area. In February, he underwent another surgery when a tumor reappeared in the same area.

He has also undergone months of chemotherapy and radiation treatments. Throughout his treatments in Cuba, Chavez has kept secret some details of his illness, including the exact location and type of the tumors.

Chavez had previously said in July that tests showed he was cancer-free. But he said over the weekend that a new round of tests in Cuba had again found cancerous cells.