Former President Joe Biden has been recently diagnosed with an “aggressive form” of prostate cancer, as his team shared recently. The 82-year-old’s cancer is stage 4 and has “metastasized to the bone,” as the statement said, as per The New York Times.
“While this shows a more aggressive form of the disease, the cancer seems to be hormone-sensitive, which is still manageable,” the statement added. “The president and his family are currently reviewing treatment options with his physicians.”
Later on, Biden shared his own message on X, alongside a photo of himself and his wife, Jill Biden. As they explained, cancer touches all of them, and they are continuously learning that they are the strongest in the broken places. Ultimately, they thank everyone for lifting them up with all the love and support.
The news of the former president’s diagnosis raises plenty of questions about prostate cancer, including how to stay on top of one’s own prostate health. Here’s what Biden decided to share with us, plus what oncologists want you to know.
The truth about Biden’s cancer
Besides revealing that his cancer is stage 4 and has spread to the bone, his team also revealed that the disease is “characterized by a Gleason score of 9.” A Gleason score is basically a grading system for prostate cancer that’s often used to establish how abnormal the cancer cells are and how rapidly they are likely to spread and grow, according to the National Cancer Institute (NCI).
This Gleason score generally ranges from six to 10, with lower scores being more likely to spread slowly. A nine is definitely a more aggressive form of cancer, as pointed out by S. Adam Ramin, MD, a urologist, urologic oncologist, and medical director of Urology Cancer Specialists in Los Angeles, CA.
How common is this?
It seems that one in eight men is bound to be diagnosed with prostate cancer in their lifetime, according to the American Cancer Society (ACS). An estimated 313,780 new cases of prostate cancer are also expected to be diagnosed this year, and 35,770 people could die from the disease, per the ACS.
Biden’s special type of prostate cancer has started to “become more common in the past few years,” according to Dr. Ramin. The reason behind this is that, in 2018, the U.S. Preventive Services Task Force (USPSTF) recommended changing prostate cancer screening in the United States.
Before, the vast majority of men were screened on a regular basis for prostate cancer, particularly by their primary care provider. However, with the new recommendations, it seems that screening comes with a “small potential benefit of reducing the overall chance of death from prostate cancer in men,” recommending that men keep in touch with their healthcare provider before undergoing any screening.
“They also cited the reason as over-diagnosis of prostate cancer and treatment,” as Dr. Ramin explained. The expected result is that fewer men are open to getting screened. “As urologists, we noticed a spike in the number of patients who were being diagnosed with more advanced prostate cancer.”
How did it culminate in this diagnosis?
Details are quite scarce, but it seems that Biden’s team explained that his healthcare team found a “prostate nodule after experiencing increasing urinary symptoms” last week. He was then diagnosed with prostate cancer on Friday.
Early prostate cancer symptoms oftentimes include other issues, such as pain during urination (and a slow or weak urinary stream or the ongoing need to urinate often), and blood in the urine or semen, according to the ACS.
As it turns out, more advanced symptoms also include erectile dysfunction, pain in the hips, back, chest, and other areas, weakness or numbness in the legs and feet, as well as loss of bladder and bowel control, weight loss, and tiredness.
Prostate cancer screening also involves a blood test known as PSA, prostate-specific antigen, and a digital rectal exam. Around 85 to 90 percent of prostate cancers can be detected due to the PSA levels.
Why was it detected so late?
It’s still unclear. But it seems that the former president wasn’t really getting screened for prostate cancer, mainly because of the updated recommendations. The USPSTF strongly advised that men over 70 don’t get tested for prostate cancer.
That’s also due to ongoing concerns about overdiagnosis and overtreatment. Oftentimes, this cancer grows quite slowly, so much so that there’s this belief that men are more likely to die with prostate cancer than of it. Early prostate cancer could also go unnoticed.
The more prostate cancer spreads and advances, the more these symptoms will manifest themselves. But in the early stages, when the cancer is quite curable and treatable, the vast majority of men will have no symptoms at all. If symptoms do arise, you need to inform yourself of what those could be.
As prostate cancer is quite common, this advanced presentation is also less typical, especially in men who receive regular medical care. But sometimes, even with close monitoring, some aggressive prostate cancers can rapidly spread. This isn’t necessarily due to neglect or missed opportunities, but it’s just how fast and silent some forms of the disease can turn out to be.
What treatment options are out there?
Treatment options can greatly differ from case to case, but there is, however, a general protocol for this particular type of prostate cancer. Generally, people with Biden’s form of prostate cancer can be given a medication known as leuprolide, along with an oral anti-androgen medication.
“Prostate cancer feeds off of testosterone,” as Dr. Ramin says. “If you administer hormone therapy, you reduce testosterone levels close to zero, and the entire testosterone production in the body is instantly halted.”
That can definitely help the cancer from growing, or at least slow the growth. “There are, of course, other treatments found for bone metastasis, but this one is the most important one.” Dr. Ramin said. (Biden’s team also said that he and his family review various treatment options.)
What’s the general prognosis?
Stage 4 prostate cancer can’t be cured, as Dr. Ramin explained. “Unfortunately, there’s still a high chance of not being able to survive this cancer,” he added. The five-year survival rate assigned for prostate cancer that has already spread is 37%, according to the ACS. Dr. Ramin also explained that men should definitely reconsider getting screened for prostate cancer, especially if it has been a long time since they’ve done it last, or if they’ve never done it.
Getting diagnosed with such an aggressive, advanced type of cancer will not only affect your life expectancy but also your quality of life. That’s probably why Dr. Ramin and many others recommend that men continue discussing with their doctors to get screened for prostate cancer at appropriate intervals.
Takeaway
Regular screenings, especially for men over 50 or those who have a family history, are crucial in catching prostate cancer early on because it’s far more treatable this way. Even if evolving guidelines generally aim to reduce overtreatment, they also underscore a lot the need for informed, individualized medical decisions.
Biden’s diagnosis is nothing but a stark reminder of the importance of awareness, vigilance, as well as proactive health care. Men should be encouraged to have open conversations with their doctors, especially about prostate cancer risks and screening options. Early detection might not always guarantee prevention, but it can definitely improve the chances of managing the disease better.
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