In the wake of former President Joe Biden’s “aggressive” prostate cancer diagnosis, many questioned how the cancer was missed, or only picked up at a later stage, considering his highly monitored medical state.
“Last week, President Joe Biden was seen for a new finding of a prostate nodule after experiencing increasing urinary symptoms. On Friday, he was diagnosed with prostate cancer, characterized by a Gleason score of 9 (Grade Group 5) with metastasis to the bone,” a spokesperson said in a statement.
The 82-year-old has the most “aggressive” form of prostate cancer because the cells have been characterized by a Gleason score of 9, the most serious grade group, and have “metastasized” to the bone.
To determine how serious a diagnosis is, pathologists grade each sample of prostate cancer cells based on how quickly they are likely to grow or how aggressive they look, with Grade Group 1 being the least aggressive and Grade Group 5 being the most aggressive.
PSA blood testing, a method used to test for prostate-specific antigen, can sometimes have abnormal results, prompting false-positive or false-negative results, according to the American Cancer Society.
Some prostate cancers grow so slowly that they would never cause any problems during a person’s lifetime.
Even if screening detects prostate cancer, at times, medical professionals can’t tell if the cancer is truly dangerous and requires treatment.
Dr. Daniel Petrylak, a prostate cancer specialist at Yale Cancer Center, told WTNH in Connecticut that despite his surprise that the president’s condition wasn’t established earlier, if Biden’s PSA levels didn’t spike during previous screenings, the alarm would not have been raised.
“One thing that may be a wrinkle in this case is the fact that PSA levels with a high-grade tumor may be lower than you expect. Because the high-grade tumors make less PSA per cancer cell than the low-grade tumors,” Petrylak said.
“So sometimes the PSA does not go up and you may just have the bump or nodule present. That’s why it’s so important you consult with a physician regularly so you can detect the disease early,” the doctor added.
When prostate cancer cells metastasize to other parts of the body, they nearly always go to the bones first. If the cancer grows outside the prostate, medical treatment aims to prevent or slow the spread to the bones. If the cancer has already reached the bones, then controlling or relieving pain and other complications becomes a priority.
Biden has not yet revealed what treatment plan he will undergo.
North Carolina Congressman Greg Murphy, M.D., a surgeon, said, “While [I] definitely agree that Biden’s declining mental acuity was covered up, it is medically reckless to assume his prostate cancer was as well.
“I have treated prostate cancer patients for 30+ years. Let’s get the politics out of medicine,” he stated on X Sunday night.
Following PSA tests, medical practitioners may also conduct a digital rectal exam to assess the prostate gland. Typically, screening begins for men at age 50, where there is an average risk of prostate cancer, and they are expected to live at least 10 more years.
Yet according to the American Cancer Society, screening at age 40 is urged for men who have more than one first-degree relative who had prostate cancer at an early age. African American men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65) are also at higher risk.
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