WASHINGTON - US First lady Laura Bush said Tuesday she did not disclose she
had a skin cancer tumor removed five weeks ago because, "It's no big deal and we
knew it was no big deal at the time."
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 US first lady Laura Bush wears an AIDS Awareness lapel pin
while listening to President George W. Bush at a meeting on World AIDS Day
in the Roosevelt Room at the White House in Washington in this file photo
taken December 1, 2006. Mrs. Bush was treated for the second most common
type of skin cancer on her leg last month, her spokeswoman said on
December 18, 2006. Picture taken December 1, 2006. [AP]

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Mrs. Bush's comments, relayed by presidential spokesman Tony Snow, came a day
after the White House belatedly acknowledged she had a squamous cell carcinoma,
the second most common form of skin cancer, excised from her right shin a few
days after the Nov. 7 election. The troublesome patch was about the size of a
nickel, her spokeswoman said.
Unlike her husband, the first lady is not an elected official, Snow said.
"She's got the same right to medical privacy that you do," he told reporters at
a sometimes contentious briefing. He likened her skin cancer to colds, the flu,
stomach aches and other non-life threatening conditions.
"You guys are really stretching it," Snow said. Mrs. Bush's problem was
revealed only after the first lady's press secretary, Susan Whitson, was asked
Monday evening why Mrs. Bush was wearing a bandage on her leg at a Hanukkah
ceremony.
There is a keen sensitivity about White House medical problems because of
attempts to hide presidential problems. The most famous case was Woodrow
Wilson's stroke that left him unable to fulfill his duties and put the country
in the hands of his wife, who virtually ran the White House. Richard Nixon, John
F. Kennedy and Franklin D. Roosevelt also had health problems that were not
fully disclosed.
Betty Ford, after her husband left office, revealed she had a drug and
alcohol addiction and checked into a rehabilitation clinic.
Mrs. Bush, 60, has a significantly increased risk of developing a second
non-melanoma skin cancer within the next three to five years, said Dr. Clifford
Perlis, a dermatologist at Fox Chase Cancer Center in Philadelphia.
Doctors vary on how closely to watch for that, but at Fox Chase the advice
generally is to come in for skin exams every six months for two years. If no new
lesions appear, they're then checked annually
Whitson said the first lady was still wearing a bandage more than five weeks
after the procedure because the skin on that part of the leg is thin and "it
takes a little while to heal." Asked if plastic surgery might be required,
Whitson said, "No further procedures are needed at this point."
A squamous cell carcinoma is a tumor that affects the middle layer of the
skin. It is more aggressive than basal cell cancer, the most common form of skin
cancer. Squamous cell cancer is more likely than basal cell cancer to spread to
other locations, so patients need to have lymph nodes in the region near the
tumor routinely examined, according to the National Cancer Institute's Web site.
People with fair skin and prolonged sun exposure are more likely to develop
squamous cell carcinoma, and it is more common in the southern latitudes of the
northern hemisphere. Mrs. Bush is from Texas.
Snow said that while President Bush and Vice President Dick Cheney make
medical disclosures, "Other members of the family, not being elected, do not do
so, and have not done so in prior administrations, and are not likely to do so."
But there is a history of public disclosure of health problems involving the
first lady.
For example, the first lady's mother-in-law, Barbara Bush, disclosed she was
suffering from an overactive thyroid ailment known as Graves' disease when she
lived at the White House. Nancy Reagan in 1987 revealed she had breast cancer
and underwent a mastectomy.
More than 1 million cases of basal and squamous cell skin cancers are
diagnosed annually, according to the American Cancer Society, which says that
most but not all of these forms of skin cancer are highly curable.
Mrs. Bush was noticed wearing a bandage on her leg on Oct. 23 when she and
her husband posed for pictures with King Carl XVI Gustaf of Sweden. Questioned
at the time, Whitson told The Associated Press it was simply a sore.
Monday night, Whitson said Mrs. Bush had a biopsy in late October because the
sore was not healing. It was determined to be a squamous cell carcinoma and was
removed a few days after the election, Whitson said.
Squamous cell carcinoma shouldn't be confused with melanoma, the most
dangerous form of skin cancer. Together, basal and squamous cell carcinoma are
responsible for less than 0.1 percent of cancer deaths, while the American
Cancer Society estimates almost 8,000 Americans will die from melanoma this
year.