July 28, 2008 -- Republican presidential candidate John McCain downplayed the removal of a growth from his upper right cheek Monday, saying that his dermatologist is not worried, according to media reports.
"This morning, as part of his commitment to monitor his dermatological health on a regular basis, Senator John McCain visited the Mayo Clinic in Scottsdale, Ariz., for a routine examination. As a precaution, a biopsy was ordered of a very small area on Senator McCain's right cheek. This is a routine minor procedure,” Michael Yardley, chair of public affairs at the Mayo Clinic, said in a statement.
McCain has been treated several times for melanoma. WebMD spoke to a top skin cancer expert, who says that based on the information available, it is unlikely the growth is cancer. Here, he addressed the questions on many people's minds:
What is McCain's growth likely to be?
Without access to McCain's medical records, of course, it's difficult to say, according to John M. Kirkwood, MD, professor of medicine and dermatology and director of the Melanoma Center at The University of Pittsburgh Cancer Institute.
But based on the growth's location -- the cheek opposite the location of a melanoma removed in 2000 -- and other factors, Kirkwood says, "The growth is likely to be a noncancerous one, far and away the most likely."
"My best guess is it's a benign skin lesion," Kirkwood tells WebMD.
But,if McCain's growth were to turn out to be malignant, he says, "It is most likely to be one of the million non-melanoma skin cancers detected each year." Those include squamous cell and basal cell cancers, which are both highly curable if detected early.
Could the new growth be another melanoma?
Statistically speaking, the risk of a subsequent melanoma is increased in those with a history of the most deadly skin cancer, Kirkwood says, but that risk declines as the years go by. "If you have had one melanoma your risk of a second one is increased. The first year it is as high as 15 times more likely than the [general] population risk that you will have a new, primary melanoma."
But McCain is now eight years from his melanoma surgery, he says. So his risk is "much less elevated than it could have been a year or two after his diagnosis."
Why was the growth biopsied and being sent to pathology for analysis, as reported?
It's the standard of care, Kirkwood says, especially given McCain's history. "I think it's safe to say that in people with fair complexions who have been in the sun for much of his adult life, as McCain has been, new lesions of the skin should be evaluated cautiously."
Is McCain's dermatology schedule, with visits every three months, normal?
He is being watched very carefully, Kirkwood says, and perhaps more carefully than some others. But a frequent checkup schedule is the norm for anyone with a history of melanoma, Kirkwood says. For instance, at his clinic patients who have had any melanoma except those in the very earliest stages are advised to return for checkups every three months for a year, then every four months for a year, then every six months for five years before going to an annual check up if everything is clear.