President Joe Biden had a skin lesion removed from his chest last month that has since been tested and identified as a basal cell carcinoma, a common form of skin cancer and the same type that First Lady Jill Biden had removed in January, according to White House physician Kevin O’Connor, DO.
The lesion was discovered and “all cancerous tissue was successfully removed” during a routine physical on February 16, O’Connor said in an official statement. The site of removal has “healed nicely,” and Biden, 80, will continue to undergo regular skin screenings as part of his routine health care. O’Connor added that Biden is “healthy, vigorous” and “fit” to carry out his White House duties.
Basal cell carcinoma is a slow-growing cancer typically caused by long-term exposure to ultraviolet radiation (UV) from the sun or other sources of UV light, such as tanning beds. Ann Silk, a medical oncologist at the Dana-Farber Cancer Institute who treats skin cancers, told Stat News that basal cell carcinoma is “probably the most common human cancer.”
“If you have to get cancer, it’s kind of a good one to have because it’s easy to remove,” she said. “This is an easily curable cancer that should not impact one’s quality of life, prognosis or survival.”
Biden had “several localized non-melanoma skin cancers” removed from his body before starting his presidency, O’Connor said in the February statement, adding that they were caused by extensive time spent in the sun during his youth.
“Men are at a higher risk—that may be associated with outdoor activities or employment compared to women,” Silk said. “People who are fair-skinned are also at higher risk because melanin gives more protection from burning.”
The first lady had two basal cell carcinoma lesions removed from her right eye and chest in January and, in an Associated Press interview, said she is now “extra careful” about wearing sunscreen, especially when at the beach, one of her “favorite places in the world.”
Basal cell carcinoma is typically confined to the surface of the skin and can be removed with a shallow incision. It rarely becomes life-threatening or leads to serious complications.
What is skin cancer?
Cancer develops when cells grow out of control. Skin cancer is the most frequently diagnosed type of cancer. Basal and squamous cell skin cancers are most common and are usually treatable. Melanoma is less common but more likely to spread and become life-threatening. Other cancers that affect the skin include Merkel cell carcinoma, some types of lymphoma and Kaposi sarcoma. (See separate Cancer Health Basics about melanoma, lymphoma and Kaposi sarcoma.)
Basal and squamous cell skin cancers typically develop in areas exposed to the sun, but they also can occur elsewhere. Squamous cells make up the upper layer of the skin, or epidermis, while basal cells are found further down. As cancer progresses, it may involve the underlying deep layer of the skin, or dermis.
Melanoma affects melanocytes, or pigment-producing cells in the skin. Merkel cell carcinoma involves neuroendocrine cells in the skin. Kaposi sarcoma, a cancer of the lining of blood and lymph vessels, can occur anywhere in the body but often appears as skin lesions.
What are the symptoms of skin cancer?
Unusual changes in the skin may be a sign of skin cancer. Signs of squamous and basal cell cancer may include:
Pale or yellow flat patches that resemble scars
Red, scaly or itchy patches
Shiny pink or red or pearly bumps
Growths with raised edges and a depression in the center
Open sores with oozing or crusted areas
Sores that don’t heal or keeping coming back
Some squamous and basal cell cancers are flat and look similar to normal skin. New or changing moles may be a sign of melanoma and should be reported to your doctor.
Basal cell cancers usually do not spread beyond the skin. Squamous cell cancers are more likely to spread, but this is still uncommon. Melanoma is most likely to spread to other parts of the body, a process known as metastasis. Imaging scans may be done to see how much the cancer has progressed.
How is skin cancer treated?
Treatment for skin cancer depends on the type of cancer, how advanced it is when detected and whether it has spread to other parts of the body.
Surgery: Small and localized skin cancers can often be surgically removed; this is known as resection. Depending on how large and deep the tumor is, it may be possible to remove it at a doctor’s office.
Local therapy: Areas of abnormal skin may be destroyed using a variety of methods, including cryotherapy (freezing), photodynamic therapy (a drug activated by lasers) or topical medications.
Radiation: Radiation may be used to kill cancer cells that remain after surgery. It may also be used for tumors that are hard to remove or for people who should avoid surgery.
Chemotherapy: Traditional chemotherapy works by killing fast-growing cells, including cancer cells. It can also destroy rapidly dividing healthy cells, such as those in the gut or hair follicles, leading to side effects like nausea and hair loss. Basal cell skin cancer seldom requires systemic chemotherapy, but it may be used to treat squamous cell cancers that have spread.
Targeted therapy: Targeted drugs work against cancers with specific characteristics. For example, they may interfere with signaling pathways that regulate cell growth. Rare cases of advanced basal cell cancer may be treated with targeted therapy.
Immunotherapy: This type of treatment helps the immune system fight cancer. Medications known as immune response modifiers are sometimes applied to skin cancers to boost the immune system’s response. Checkpoint inhibitors and other types of immunotherapy are generally not used for common skin cancers, but they can be effective for advanced melanoma.