A doctor who is not involved in caring for former President Joe Biden said his diagnosis shows the nuances and challenges of screening for prostate cancer.
Experts say Joe Biden’s cancer can no longer be treated but it can be treated
Former President Joe Biden’s cancer cells are ranked with a “high Gleason score.” This is what he means to treat him.
Former President Joe Biden has been diagnosed with an aggressive form of prostate cancer that has spread to the bone.
A doctor who is not involved in the care of the former president said his diagnosis shows the nuances and challenges of screening for prostate cancer.
Some people, including President Donald Trump, suggest that Biden likely had known about his cancer for a long time. However, several doctors said his tumor was overlooked or that he had a particularly aggressive form of cancer that is unlikely to be detected on routine testing.
Prostate cancer is usually very slow, so men over the age of 70 are not recommended for routine screening.
“He is receiving the best medical care we have to offer as a country and may not be screened for prostate cancer,” said Dr. Michael Morris, a memorial Sloan Kettering oncologist who specializes in treating men with prostate cancer. “Good care means that the tests don’t undertest, and that it means that you don’t overtest.”
But someone of his height likely had regular prostate-specific antigen tests, a blood test used to track the risk of prostate cancer, said Dr. Lee Richstone, urology chair at Northwell Lennox Hill Hospital in New York City.
“I would be very surprised if his PSA didn’t comply regularly, even at his age,” Richstone said.
The annual physics results released while Biden was president from 2021 to 2025 did not include information on PSA screening.
Some aggressive forms of prostate cancer lead to normal PSA test results, Richstone said. In such cases, cancer can be diagnosed via rectal examination or MRI.
Biden’s private staff announced that he was diagnosed two days ago after experiencing urinary symptoms on May 18th. A “nodule” was found in his prostate, according to a statement from his office., And the cancer was spreading to his bones.
Although tumors with widening prognosis are more severe, doctors said treatment options are still available. His future is difficult to predict, especially without knowing the details of his tumor and how he will respond to treatment.
How dangerous is prostate cancer?
Other than skin cancer, prostate cancer is the most common cancer among American men, according to the American Cancer Society.
The risk of inoculating prostate cancer increases with age. According to the American Cancer Society, black men are more likely to get it than white men, and are twice as likely to die from illness.
According to the NCI, there were an estimated 3.5 million men living in the United States in 2022 with prostate cancer.
For most men, prostate cancer is a slow-growing tumor that can be monitored without treatment.
If you get caught early, doctors often recommend active surveillance. This means monitoring the tumor for signs of growth, but not treating the cancer anytime soon.
According to the NCI, only about 2% of men died within five years of their diagnosis of prostate cancer.
However, in the case of Biden, where cancer is aggressive, some older patients “are at a serious risk of dying of prostate cancer,” Richstone said.
According to NCI, median five-year survival rate drops to nearly 38% for metastatic cancer.
Dr Atish Choudhry, an oncologist at the Dana Farmer Cancer Institute in Boston, said that although these total numbers represent the overall population, patients live longer.
“The prognosis from this point onwards actually depends heavily on the amount of cancer that is outside the prostate,” Choudhury said., Just as how he responds to treatment.
“Even after it spreads to the bone, there have been a huge advancement in treating prostate cancer, which is why people have lived for years with this particular diagnosis,” he said.
What we know about Biden’s cancer
May 18th, Biden’s private office told the former president he received a Gleason score of 9 and a Grade Group 5 Gleason score. The statement also said his cancer had spread to the bones.
According to Cleveland Clinic, a Gleason score of 8, 9, or 10 is at the high end of 8, 9, or 10 – cancer cells appear to be different from healthy cells, and Grade 5 is in a very advanced stage, Grade 5 is in a very advanced stage.
Biden and his family are reviewing treatment options with his doctor, Biden’s office said in a statement.
Biden’s cancer is “hormonally sensitive and allows for effective management,” a spokesperson said.
What types of treatment can Biden get?
Men with spreading prostate cancer can often be combatted by hormone-based treatment, said Morris of Memorial Sloan Kettering.
Morris said that combination therapy, including hormone therapy, is “particularly strong and durable,” despite “everything sounds bad,” even if a patient is diagnosed with spreading aggressive prostate cancer.
Doctors may try to prescribe medication to lower Biden’s testosterone levels. Alternatively, you could prescribe new drugs targeting “testosterone devices in the cancer itself,” Morris said.
“Frequently, we do both,” he said.
Other treatments could include radiation or chemotherapy, depending on the spread of the cancer and Biden’s overall health, some doctors said.
Discussions regarding PSA screening
The role of screening for prostate cancer has been debated for years amid changing guidelines.
The number of prostate cancers diagnosed annually fell from 2007 to 2014, consistent with changes in screening recommendations, the American Cancer Society said. Since 2014, rates have increased by 3% per year.
The influential US preventive services task force recommends that men ages 55-69 at typical risk for men ages 55-69 to decide whether to screen for prostate cancer with PSA testing. Men should discuss with their doctors the potential benefits and harms of screening before taking PSA, the task force said.
Choudhury said healthcare professionals are trying to balance the risks and benefits of screening.
Benefits include early detection of potentially dangerous cases. When less aggressive screening guidance was conducted over the past decade, studies have shown that men are diagnosed later and at a more advanced stage.
However, screening can cause potential harm. Risks include detection of non-fatal cancer, unnecessary biopsies or treatments that cause side effects and anxiety, Choudhury said.
Other doctors believe the Task Force’s recommendations on PSA screening missed the mark.
“Occasionally, people like President Biden have metastatic cancer and say, ‘What if we were screening him? We’d caught it early?’,” asked Dr. Edmund Forefak, a medical oncologist at Ohio State University Comprehensive Cancer Center. “Why didn’t we screen it? Because we consider everyone to be part of a group, not as an individual.”
Richstone said the task force has built recommendations based on “outdated practices.”
Doctors usually follow an increase in PSA outcomes on MRI. This is a step that reduced the number of biopsies, Richstone said.
“Our biopsies are targeted and lead to a much more accurate diagnosis, and are unlikely to recognize important cancers and not critical cancers,” Richstone said.
When to check out
Urinary symptoms like experienced Biden can become a common complaint among men with prostate cancer, Morris said., However, urinating due to enlargement of the prostate is also a normal part of aging.
Morris urged the man to notify him of sudden changes, such as having problems with urination or bleeding to consult a doctor. A primary care physician or urologist could conduct a test or order a PSA test to diagnose the condition, Morris said.
“If you have symptoms and problems that are interfering with your life, it’s no longer in the area of screening,” Morris said.
