The Washington Post

What to know about the kind of skin cancer the president was treated for


A cancerous skin lesion was removed from the chest of President Biden on Feb. 16, his longtime physician said Friday. The doctor, Kevin C. O’connor, said in a letter that all cancerous tissue was successful­ly removed and that no further treatment is needed. A biopsy confirmed that the small lesion was basal cell carcinoma. Jill Biden underwent a procedure in January to remove similar lesions.

What are the most common skin cancers?

Basal cell and squamous cell cancers are the two most common types. Combined, the two cancers are diagnosed in more than 3.3 million Americans each year. They appear in areas exposed to the sun, such as the face, head and neck, according to the American Cancer Society.

Basal cell cancers tends to grow extremely slowly and are very unlikely to spread, doctors said. They can appear as an unusual growth on the skin.

“You may notice a waxy lump or a small, smooth, shiny, or pale growth,” according to the website of Memorial Sloan Kettering Cancer Center in New York. “Or there may not be a lump at all, but instead you notice a flat spot that looks slightly different from the rest of your skin.”

Only about 2,000 Americans die each year of basal cell and squamous cell cancers.

Melanoma, which is much less common, is more dangerous because it is more likely to spread to other parts of the body. The key is catching melanoma early and treating it right away, the American Cancer Society said. Doctors urge anyone suspecting melanoma to see a specialist right away.

What is basal cell carcinoma?

This cancer is caused by a mutation to the genetic material in basal cells, which are found at the bottom of our outermost layer of skin. Healthy basal cells produce new skin cells and simultaneo­usly push older cells to the skin surface, where they die and are shed from the body. The cancer can be caused by ultraviole­t radiation from sunlight or commercial tanning lamps.

The risk of basal cell carcinoma is higher in people who have fair skin, red or blond hair, or lightcolor­ed eyes, according to the Mayo Clinic. Most of the lesions occur in people older than 50.

What is the treatment for basal cell carcinoma?

One of the most common treatments is Mohs surgery.

In an interview in January after Jill Biden was treated for basal cell carcinoma, Basia M. Michalski, assistant professor of dermatolog­y at Washington University in St. Louis, said the procedure is designed to completely remove the cancer while sparing as much healthy tissue as possible.

The patient typically remains awake during the procedure but is given one medication to numb the affected area and another to reduce possible bleeding.

After the numbing agent takes effect, the surgeon removes a thin layer of skin and takes it to the lab for examinatio­n under a microscope.

“I continue that procedure until I as a surgeon don’t see any more cancer,” Michalski said. “If we take one layer and everything looks good under the microscope, we don’t have to go back for more.”

Jenny Kim, a dermatolog­ist at UCLA Health, echoed Michalski, saying that the cure rate when basal cell carcinomas are removed with Mohs is 99 percent.

“It’s very highly treatable, especially when the lesions are diagnosed and treated early,” said Kim, who also was interviewe­d in January.

Both Kim and Michalski have special training in performing Mohs surgery.

Michalski said that sometimes the wounds created by the procedure require stitches, but often they don’t. And because the skin is cut, there is usually a scar — though the surgeon’s goal is to minimize it.

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