Jill Biden's advocacy for curing cancer didn't start with her son's death in 2015 from brain cancer. It began decades earlier, long before she came into the national spotlight, and could now be further energised by her own brush with a common form of skin cancer.
The first lady often says the worst three words anyone will ever hear are, You have cancer." She heard a version of that phrase for herself this past week.
A lesion that doctors had found above her right eye during a routine screening late last year was removed on Wednesday and confirmed to be basal cell carcinoma a highly treatable form of skin cancer.
While Biden was being prepped to remove the lesion, doctors found and removed another one from the left side of her chest, also confirmed to be basal cell carcinoma. A third lesion from her left eyelid was being examined.
While it's too early to know when and how Biden might address her situation publicly, her experience could inject new purpose into what has become part of her life's work highlighting research into curing cancer and urging people to get regular screenings.
Personal experiences can add potency to a public figure's advocacy.
Nothing like I've been there, done that' and being personally involved," said Myra Gutin, a first lady scholar at Rider University.
Biden's spokesperson, Vanessa Valdivia, said the first lady's fight against cancer has always been personal. She knows that cancer touches us all.
Biden's advocacy dates to 1993, when four girlfriends were diagnosed with breast cancer, including her pal Winnie, who succumbed to the disease. She said last year in a speech that Winnie inspired me to take up the cause of prevention and education.
That experience led her to create the Biden Breast Health Initiative, one of the first breast health programmes in the United States, to teach 16-to 18-year-old girls about caring for their breasts. Biden was among staffers who went into Delaware's high schools to conduct lectures and demonstrations.
Her mother, Bonny Jean Jacobs, and father, Donald Jacobs, died of cancer, in 2008 and 1999, respectively. A few years ago, one of her four sisters needed an auto-stem cell transplant to treat her cancer.
In May 2015, Beau Biden, President Joe Biden's son with his late first wife, died of a rare and aggressive brain cancer, leaving behind a wife and two young kids. Joe Biden was vice president at the time and the blow from Beau's loss led him to decide against running for president in 2016.
Jill Biden, who had helped raise Beau from a young age after she married his dad, was convinced he would survive the disease and later described feeling blinded by the darkness when he died.
After their son's death, the Bidens helped push for a national commitment to end cancer as we know it. Then-President Barack Obama Biden's boss put the vice president in charge of what the White House named the Cancer Moonshot.
The Bidens resurrected the initiative after Joe Biden became president and added a new goal of cutting cancer death rates by at least 50 per cent over the next 25 years, and improving the experience of living with and surviving cancer for patients and their families.
We're ensuring that all of our government is ready to get to work, Jill Biden said at the relaunch announcement at the White House last February. We're going to break down the walls that hold research back. We're going to bring the best of our nation together patients, survivors, caregivers, researchers, doctors, and advocates all of you so that we can get this done.
In the years between Biden serving as vice president and running for president, the Bidens headed up the Biden Cancer Initiative, a charity.
Jill Biden, 71, has been using her first lady platform to highlight research into a cancer cure, along with other issues she has long championed, including education and military families.
Her first trip outside of Washington after the January 2021 inauguration was to Virginia Commonwealth University's Massey Cancer Center in Richmond to call for an end to disparities in health care that she said have hurt communities of colour.
She has toured cancer centers, including those for children, in New York City, South Carolina, Tennessee, Costa Rica, San Francisco and Florida, among others. She joined the Philadelphia Eagles and Phillies two of her favourite professional sports teams for events, including during the World Series, to highlight efforts to fight cancer through early detection and to honour patients.
For Breast Cancer Awareness Month last October, Jill Biden hosted a White House event with the American Cancer Society and singer Mary J. Blige, who became an advocate for cancer screening after losing aunts and other relatives to various forms of cancer.
The first lady also partnered with the Lifetime cable channel to encourage women to get mammograms. A Democrat, she gave an interview last year to Newsmax, the conservative cable news channel, to discuss the federal investment in accelerating the cancer fight.
She regularly encourages audiences to schedule cancer screening appointments they skipped during the pandemic out of fear of visiting doctor's offices.
Asked on Friday how the first lady was doing, the president flashed a thumbs-up to reporters.
Basal cell carcinoma, for which the first lady was treated with the procedure known as Mohs surgery, is the most common type of skin cancer, but also the most curable form. It's considered highly treatable, especially when caught early. It is a slow-growing cancer that doesn't usually spread and seldom causes serious complications or becomes life-threatening.
The Skin Cancer Foundation says the delicate skin around the eyes is especially vulnerable to damage from the sun's ultraviolet rays, which makes basal cell carcinoma on and around the eyelids particularly common.