Joe Biden's skin cancer diagnosis and treatment

President Joe Biden was diagnosed with basal cell carcinoma, a form of skin cancer, in February 2023. His physician, Dr. Kevin O'Connor, confirmed the diagnosis after a lesion was removed from Biden's chest during a routine skin check. Basal cell carcinoma is the most common type of skin cancer in the United States, accounting for roughly 80 percent of all skin cancer cases.

The lesion was removed completely during the initial examination, and Biden's medical team reported that no further treatment was needed beyond the removal itself. The White House released a statement confirming the diagnosis and noting that the president's prognosis was excellent. Biden continued his regular duties without interruption following the procedure.

Key Takeaways

  • Basal cell carcinoma is the most common skin cancer and typically grows slowly in the outermost layer of skin.
  • Biden's lesion was removed in a single outpatient procedure with no additional treatment required.
  • Basal cell carcinoma has a high survival rate when caught and treated early, as Biden's was.
  • The diagnosis was discovered during a routine skin examination, demonstrating the importance of regular skin checks.

How basal cell carcinoma develops

Basal cell carcinoma arises in the basal cells, which sit at the bottom layer of the epidermis (the outermost layer of skin). These cells constantly divide to replace older skin cells that shed from the surface. When DNA damage occurs in basal cells—usually from ultraviolet (UV) radiation exposure—the cells can begin to grow abnormally and form a tumor.

The cancer typically appears as a small, shiny bump or a flat, scaly patch on the skin. It often develops on areas exposed to the sun, though it can occur anywhere on the body. Basal cell carcinoma grows slowly and rarely spreads to other parts of the body, which is why it is considered the least aggressive form of skin cancer.

Why basal cell carcinoma is highly treatable

Basal cell carcinoma has one of the highest survival rates of any cancer type. When removed surgically—as Biden's was—the cancer is almost always cured at that point. The five-year survival rate for localized basal cell carcinoma is over 99 percent. This high rate reflects both the slow growth pattern of the cancer and the fact that it rarely metastasizes (spreads to distant organs).

Early detection significantly improves outcomes. Because basal cell carcinoma appears on the skin where it is visible, people and their doctors can often spot it before it becomes large or invasive. Biden's case illustrates this advantage: the lesion was found during a routine skin examination and removed in a single procedure.

Removal procedures for basal cell carcinoma

Several methods can remove basal cell carcinoma, and the choice depends on the size, location, and depth of the lesion. Surgical excision—cutting out the lesion along with a margin of healthy skin—is the most common approach and was the method used in Biden's case. The procedure is typically performed in an outpatient setting under local anesthesia.

Other removal options include curettage and electrodesiccation (scraping and burning), cryotherapy (freezing), laser therapy, and topical medications for very small, superficial lesions. A dermatologist determines which method is most appropriate based on the specific characteristics of the lesion. Pathology examination of the removed tissue confirms that all cancer cells have been eliminated.

Risk factors and prevention

Cumulative sun exposure over a lifetime is the primary risk factor for basal cell carcinoma. People with fair skin, light hair, and light eyes face higher risk, as do those who have experienced severe sunburns, especially in childhood. Older adults develop basal cell carcinoma more frequently simply because they have had more years of sun exposure.

Prevention centers on limiting UV exposure. This includes wearing sunscreen with SPF 30 or higher, seeking shade during peak sun hours (10 a.m. to 4 p.m.), wearing protective clothing, and avoiding tanning beds. Regular skin self-examinations and annual skin checks by a dermatologist can catch lesions early, when they are easiest to treat.

Recurrence and follow-up care

After basal cell carcinoma is removed, recurrence at the same site is possible but uncommon—typically occurring in fewer than 5 percent of cases when the lesion is removed surgically with adequate margins. People who have had one basal cell carcinoma are at higher risk of developing another lesion elsewhere on the body, since the underlying risk factors (sun exposure history and skin type) remain unchanged.

Ongoing surveillance through regular skin examinations is standard practice after treatment. Dermatologists typically recommend annual or more frequent checks depending on the individual's risk profile. Self-examination between appointments—using the ABCDE method (Asymmetry, Border irregularity, Color variation, Diameter larger than a pencil eraser, and Evolving or changing)—helps catch new lesions early.

Basal cell carcinoma versus other skin cancers

Skin cancer comes in three main types: basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell carcinoma is the most common and least aggressive. Squamous cell carcinoma, which arises in the middle layer of the epidermis, is the second most common and slightly more likely to spread. Melanoma, which develops in pigment-producing cells, is the rarest but most dangerous form.

The prognosis and treatment approach differ significantly among these types. While basal cell carcinoma is almost always curable with local removal, melanoma requires more extensive evaluation and sometimes additional treatment beyond surgical removal. Biden's diagnosis of basal cell carcinoma placed him in the most favorable category in terms of outcome and treatment burden.

Frequently Asked Questions

Is basal cell carcinoma life-threatening?

Basal cell carcinoma is rarely life-threatening. It grows slowly and almost never spreads to other organs. When removed surgically, it is almost always cured. Deaths from basal cell carcinoma are extremely rare and typically occur only when the cancer has been left untreated for many years and has grown very large.

Can basal cell carcinoma come back after removal?

Recurrence at the same site occurs in fewer than 5 percent of cases when removed surgically with proper margins. However, people who have had one basal cell carcinoma are at higher risk of developing another lesion elsewhere on the body because the underlying risk factors remain. Regular skin checks help catch new lesions early.

What does basal cell carcinoma look like?

Basal cell carcinoma often appears as a small, shiny, pearly bump, sometimes with a dimple or ulcer in the center. It can also look like a flat, scaly patch that may be red or brown. Lesions typically appear on sun-exposed areas like the face, ears, neck, and hands, though they can develop anywhere on the body.

Does everyone who gets basal cell carcinoma need chemotherapy?

No. Most basal cell carcinomas are treated with surgical removal alone and require no chemotherapy, radiation, or systemic treatment. Chemotherapy is reserved for very rare cases where the cancer has spread to distant organs, which is extremely uncommon with basal cell carcinoma.