Joe Biden diagnosed with aggressive form of prostate cancer

Post Reply New Topic

Former President Joe Biden has been diagnosed with prostate cancer, his personal office announced Sunday.

“Last week, President Joe Biden was seen for a new finding of a prostate nodule after experiencing increasing urinary symptoms,” his personal office said in a statement. “On Friday he was diagnosed with prostate cancer, characterized by a Gleason score of 9 (Grade Group 5) with metastasis to the bone.”

Metastasis means the cancer has spread from its primary site (in Biden’s cancer, the prostate) to other tissue in the body.

“While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive which allows for effective management,” the statement continued. “The President and his family are reviewing treatment options with his physicians.”

A spokesperson for Biden’s office did not have any additional comment.

Biden and his family are meeting with doctors and considering "multiple treatment options," including hormone treatment, according to a source familiar with Biden's and his family's thinking.

Biden is at his home in Wilmington, Delaware, the source said, but it is unclear where he will receive treatment.

Biden’s Gleason score of 9 (Group grade 5) means the cancer is likelier than others to grow and spread.

“Gleason 9 is, by definition, aggressive, but you don’t know how bad it is unless you know what the PET scan looks like,” said Dr. Alan Tan, genitourinary section lead at Vanderbilt University Medical Center in Nashville, Tennessee. Tan was not involved with Biden’s case.

Tan said that type of prostate cancer is not rare. “This is the most common thing I see in my clinic,” he said. “This is bread-and-butter genitourinary oncology.”

Prostate cancer experts not involved with Biden’s treatment said the disease most likely is not a death sentence. If he responds well to treatment, he could have the disease controlled for years. Most men diagnosed with prostate cancer do not die of it.

Tan said an 82-year-old stands “a very good chance of still getting into remission” within as little as six months with treatment. The question, Tan said, is how long the remission would last.

Dr. Chris George, a prostate cancer specialist at Northwestern Medicine who is not involved with Biden’s case, said that if Biden responds to treatment, he could live for years as the treatment keeps the disease in check. (That his cancer is hormone-sensitive suggests he will respond to treatment, experts said.)

President Donald Trump said he and first lady Melania Trump were "saddened to hear about" Biden's diagnosis.

"We extend our warmest and best wishes to Jill and the family, and we wish Joe a fast and successful recovery," Trump wrote on Truth Social.

Former Vice President Kamala Harris said she and former second gentleman Doug Emhoff are keeping the former first couple "in our hearts and prayers."

About 1 in 8 men will be diagnosed with prostate cancer, according to the American Cancer Society. The cancer is common in older men, and it is the second-leading cause of cancer death in American men, behind lung cancer, according to the cancer society.

A spokesperson for Biden previously disclosed last Tuesday that a “small nodule” was found on Biden’s prostate during a routine physical examination, which "necessitated further evaluation.”

Praying for my friend and former colleague, Joe Biden, after hearing news of his diagnosis," said Sen. Dick Durbin, D-Ill. "Loretta and I will be keeping Joe, the entire Biden family, and the medical professionals treating him in our thoughts during this time. Continue to keep the faith, Joe.”

“I’m praying for President Biden and his family as they take on this challenge. Americans will be with them every step of the way," Sen. Tim Kaine, D-Va., said.

Biden has also received messages of support from the Republican members of Congress who were once eager to make his health the centerpiece of the 2024 election.

“I’m sorry to see this news. Cancer is truly awful. My Dad passed away in 2021 with cancer,” Rep. Marjorie Taylor Greene, R-Ga., said, urging supporters to pray for Biden and his family.

During his presidency, Biden aimed to prevent millions of cancer deaths through the relaunch of his public-private Cancer Moonshot initiative, which funded research into treatments, expanded no-cost screening programs and, according to Biden administration records, resulted in nearly 8 million people being screened for prostate, breast, colorectal, lung, cervical and skin cancer.

At his first event after he left the 2024 presidential race, Biden announced $150 million in new grants to support research and “allow surgeons to provide more successful tumor-removal surgeries for people facing cancer.”

Biden initially began leading the Moonshot program in 2016, as vice president, roughly six months after his eldest son, Beau, died of brain cancer.

In 2021, Biden underwent a colonoscopy at Walter Reed National Military Medical Center, during which a “single 3 mm benign-appearing polyp” was identified and removed, the White House physician at the time, Dr. Kevin O’Connor, revealed.

O’Connor said in a letter that the polyp was a “slow-growing, but thought to be precancerous lesion” for which no more action was required. Biden had a similar polyp removed in 2008, he said

I'm sad. Because it's not Trump that has it.

That's sad news. I hope the doctors and nurses do everything that they can to save him.

That's sad news. I hope the doctors and nurses do everything that they can to save him.

The late-stage cancer diagnosis of former U.S. president Joe Biden has some medical professionals wondering how the disease was able to go undetected when his health had been under intense scrutiny near the end of his presidency.

In a statement on Sunday, Biden's office said the 82-year-old has been diagnosed with prostate cancer and that it's spread to the bone. He was diagnosed with Stage 4 cancer, which is considered to be the most advanced.

Prostate cancer cells are usually graded on a scale of 1 to 10 under the Gleason system.

This grading system involves looking at cells under a microscope and measuring how abnormal they are and their likelihood of spread. The higher the grade, the more aggressive the cancer.

According to Biden's office, he scored a 9, which would suggest that his cancer is among the most "aggressive."

It's sad, of course," Dr. Peter Black, director of the Vancouver Prostate Centre, said about Biden's diagnosis.

"It's something that we can still control for a few years, but it's definitely going to impact his quality of life and maybe his longevity."

Considering all of the debate around Biden's health during his presidency and the start of his second presidential campaign, before he pulled out of the race last summer, the diagnosis has raised questions about why this wasn't caught sooner and what it means for his long-term health..

What is prostate cancer, and what are the symptoms?
The prostate, a gland in the male reproductive system that makes a fluid that is part of semen, is below the bladder. Cancer starts in the cells of the prostate and can grow into nearby tissue. The cancer can also spread to other parts of the body, including the bladder, nearby lymph nodes, bones and the brain, according to the Canadian Cancer Society.

"There's a broad spectrum of prostate cancer," said Black, who is also a urologist at Vancouver General Hospital. "From very early, relatively harmless disease, to something that's high risk and has already spread."

Symptoms can vary from person to person, said Dr. James Dickinson, a professor of family medicine and community health sciences at the University of Calgary.

But most often, he said, there are no symptoms at all. Some uncommon symptoms include trouble urinating or blood in the urine.

"It may develop and spread quite widely before anybody notices," he said

How are people screened for it?
There are two methods used to screen for prostate cancer, though research finds that each one has its downsides.

There's the prostate-specific antigen (PSA) test, which is a blood test that looks at the levels of PSA — a substance made by the prostate. As people age, PSA levels tend to increase.

Levels that are higher than normal could mean there's an issue with the prostate, but cancer isn't always the culprit. Other reasons could be an enlarged prostate or inflamed prostate gland due to an infection.

There's also a digital rectal exam (DRE), which involves a health-care provider inserting a gloved finger into the rectum and feeling for anything unusual, like lumps, the cancer society says.

But Black, of the Vancouver Prostate Centre, said while health-care providers frequently used this method in the past, they've "drifted away" from it as it's not very helpful. As a result, PSA testing is more commonly used.

When is screening recommended?
Prostate cancer screening has been controversial, Black said, adding that he would recommend PSA testing for otherwise healthy men between the ages of 50 and 75.

"I'm pro-screening because I see the benefit and I see what happens if we don't screen," he said.

People older than 70 or 75 are generally not actively screened because experts say the disease is usually slow growing.

More than a decade ago, the Canadian Task Force on Preventive Health Care recommended against PSA screening because "the potential harms of screening outweigh the benefits."

It maintains this stance, saying that the main problems are false-positive results and overdiagnosis, the review indicated. A positive PSA test result often leads to more tests such as a biopsy, which carries risks of bleeding, infection and urinary incontinence.

At this time, the task force says there are "no screening tests that have been proven to accurately identify prostate cancer." But, it adds, there are several tests being developed to improve the accuracy of PSA screening.

Meanwhile, the U.S. Preventive Services Task Force recommends that men between the ages of 55 and 69 speak with their health-care provider about whether they should get screened.

Why wasn't Biden's cancer spotted sooner?
Experts say because there aren't many obvious symptoms, it's easy for prostate cancer to fly under the radar.

In February 2024, Biden had his last annual physical as president. At the time, his doctors said that "this year's physical identifies no new concerns."

Dr. Dana Rathkopf, a medical oncologist at New York's Memorial Sloan Kettering Cancer Center, said while she doesn't know the specifics of the case, she doesn't believe this diagnosis was missed during an earlier exam.

"Cancer cells are chaotic," she said in an interview with CBS News. "There are many people that have access to [the] highest levels of care and undergo regular screening and still get diagnosed with advanced disease."

Black said if Biden had been tested, it's possible his PSA levels were "normal."

"Sometimes the aggressive prostate cancers don't make as much PSA," he said.

What does treatment include?
Prostate cancer that is in the early stages and not spreading will likely only be monitored, said the University of Calgary's Dickinson. It might not end up being harmful, he said, and so treating it wouldn't be helpful to the patient.

Meanwhile for higher-risk cases, where the PSA is high but the cancer is limited to the prostate, Black said surgery or radiation is usually recommended.

In cases where the disease has spread, he said radiation is often used alongside hormone therapy.

Hormone therapy lowers the amount of certain hormones in the body that would usually help prostate cancer cells grow. By doing this, prostate cancers can shrink or grow more slowly.

This is the type of treatment being looked at for Biden, and while Black said it usually responds in the beginning, it's a matter of how long it will continue to work.

Without knowing all the details of Biden's case, Black said typically men with a similar diagnosis live about five years with current treatments.

The five-year survival rate for people who are in the first three stages of the disease is close to 100 per cent, according to Statistics Canada.

But if diagnosed at Stage 4, which is when the cancer has spread beyond the prostate, the survival rate for the next five years drops to 41 per cent.

As a former President I have no doubt he will get the best care available.