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Archive for Wednesday, January 17, 2001

Skin growth removed from Clinton was cancerous

January 17, 2001

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— The skin growth that President Clinton had removed from his back last week was basal-cell carcinoma, a common and rarely life-threatening form of skin cancer, a White House spokesman said Tuesday.

At the regular news briefing, spokesman Jake Siewert said physicians at the Naval Medical Center in Bethesda, Md., reported "the lesion had been totally removed" and no further treatment is necessary.

"The president, I guess it could be said, had skin cancer that has been removed and he no longer has it," Siewert said.

Basal-cell carcinoma is diagnosed in more than 400,000 Americans a year. Fewer than 1 in 4,000 cases spread to other organs. Deaths from the disease are extremely rare.

"It's coming from sun exposure. Surgical excision is a cure. The prognosis is excellent," said Lynn McKinley-Grant, a dermatologist and skin-cancer specialist in Chevy Chase, Md. "It should not interfere at all with a person's lifestyle."

Melanoma, a form of skin cancer also associated with sun exposure, is frequently deadly if it spreads. It is unrelated to basal-cell carcinoma and to squamous-cell carcinoma, the other common and relatively benign skin cancer.

People who develop one basal-cell growth are at increased risk for others. Siewert said Clinton will be seen by a dermatologist in four to six months. If there are no new growths, he will then be examined annually.

Basal-cell cancers arise from the cells that produce keratin, the material that makes skin shiny and impermeable to water. They occur most often on the head and neck, and have highly variable appearance.

Their most common form is a nodule with translucent borders often described as "pearly." Sometimes the tumors have a dimple in the middle; sometimes they are pebbly. They can also be flat, red and scaly.

A study published several years ago found that among 1.1 million people enrolled in a cancer prevention study in 1982, those who'd previously had "non-melanoma skin cancer" (which includes basal cell) were at slightly increased risk of dying of certain other cancers in the ensuing 12 years.

Those cancers included melanoma, non-Hodgkin lymphoma, and lung cancer and pharynx cancer in both sexes; breast cancer in women; and salivary gland cancer, prostate cancer, testicular cancer, bladder cancer, and leukemia in men. The reason for this observation is unknown.

One theory is that people with skin cancer may have a very mild defect in their ability to repair damage to DNA in cells a problem that makes them somewhat more susceptible to numerous malignancies. Another theory is that cumulative exposure to ultraviolet radiation may cause a mild suppression of the immune system, which in turn increases cancer risk.

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