The recent announcement regarding former President Joe Biden’s diagnosis of advanced prostate cancer has raised many eyebrows, particularly concerning how this significant health issue went undetected for so long. Given that Biden is an 82-year-old man who had access to the highest levels of healthcare while serving as president, such a late-stage diagnosis catches the eye and triggers speculation about the adequacy of medical screening protocols.
Having held the highest office, Biden benefited from extensive medical care through the White House Medical Unit, which provides around-the-clock access to medical personnel. These comprehensive health evaluations typically delve deeply into a president’s physical and mental conditions, with presidents often choosing to share relevant medical details with the public. Despite this high level of medical scrutiny, questions linger about how Biden could develop stage IV prostate cancer, which has metastasized to his bones, especially in light of his recent public health assessments.
Experts have weighed in, suggesting that while the diagnosis may prompt concern and speculation, the circumstances of Biden’s situation are not entirely unheard of. They note that prostate cancer screenings, particularly the use of the prostate-specific antigen (PSA) test, are discouraged for older men, especially those like Biden who are 70 years or older. This change in recommendations is a reflection of escalating risks of false positives and the slow-growing nature of most prostate cancers.
Dr. Oliver Sartor from Tulane University received calls about Biden’s diagnosis, with some questioning whether it was a cover-up. Sartor emphasized that such assumptions might be premature, noting that there is a myriad of explanations for Biden’s situation. The former president’s health, since he took office, has garnered considerable attention, and reports suggest that signs of his declining health were ignored or downplayed by aides prior to his decision to withdraw from the 2024 election.
Even though prostate cancer is a significant health concern—ranking as the second leading cause of cancer-related deaths in men in the United States—the connection between Biden’s recent diagnosis and his state of health during his presidency remains tenuous. After stepping down, Biden has been relatively private, except for a recent appearance on “The View,” where he addressed rumors about concealing his health issues, asserting that claims of a health cover-up are baseless.
Prostate cancer disproportionately affects aging men, and while George W. Bush, Barack Obama, and Donald Trump have publicly reported their prostate cancer screening results, Biden’s medical records did not indicate undergoing such assessments during his presidency. Trump expressed surprise that Biden’s diagnosis had not been disclosed sooner, noting that he has had regular physicals that included prostate health assessments.
Cancer specialists, like Dr. Bilal Siddiqui from MD Anderson Cancer Center, speculate two reasons could explain Biden’s late-stage diagnosis. The first is that he may not have been screened at all, an entirely plausible scenario given evolving medical guidelines favoring a shared decision-making approach between a physician and patient about the necessity of such tests. Many medical authorities advise against routine prostate cancer screenings for men over 70 as the majority of cases tend to be slow-growing, prompting concerns that treatment could cause more harm than good.
The second scenario presented involves the concept of “interval cancer,” which refers to cases where the cancer develops between scheduled screenings and can manifest swiftly beyond what conventional surveillance would typically capture. In rare instances, some aggressive cancers might even evade detection by producing very low levels of PSA.
Experts like Dr. Otis Brawley from Johns Hopkins University highlight that they have seen instances where patients received normal PSA results even as the disease advanced. Understanding the distinctions between various prostate cancer types is becoming increasingly feasible as medical advances allow physicians to analyze tumor genetics.
Biden’s health history includes dealing with benign prostatic hyperplasia (BPH), a common prostate condition that raises questions about the interrelation between BPH and prostate cancer. While noteworthy research indicates that certain medications may help mitigate prostate cancer risk, the definitive link remains uncertain.
Medical professionals generally agree that if Biden had undetected prostate cancer while in office, it would not have impaired his cognitive abilities since prostate cancer typically does not affect cognition directly. However, the treatment necessitated by metastatic prostate cancer could lead to side effects reminiscent of low testosterone levels, which might influence cognitive functions, among other physical issues.
While Biden’s prognosis is challenging, with current standards classifying metastatic prostate cancer as not curable, experts like Sartor remain cautiously optimistic, noting that prostate cancer can often be well-managed for extended periods despite being at a late stage. This nuanced understanding of prostate cancer highlights the complexities surrounding early detection, treatment, and the political ramifications of a public figure’s health discourse.