Former President Joe Biden’s prostate cancer diagnosis raises new awareness about the disease. Biden is among hundreds of thousands of American men who will be diagnosed with prostate cancer this year.
A spokesperson for Biden revealed on Sunday the former President has an aggressive form of prostate cancer that already has spread to his bones.
Cancer Cases Each Year
The American Cancer Society estimates more than 310,000 men will get prostate cancer this year. About 35,000 will die from the disease.
The number of prostate cancer cases dropped between 2007 and 2014. But in the years since, the number of people diagnosed has increased 3% a year. Researchers say better screening tools account for the increase.
Prostate cancer is the second leading cause of cancer death in American men. Lung cancer is number one. Prostate cancer can strike a man at any time; however, most cases occur in men who are 65 or older.
Determining Severity Of Cancer
MCM spoke with Dr. Syed Shahid Mahmood, who is Medical Director at Adventist HealthCare Shady Grove Aquilino Cancer Center. He also is a physician at Maryland Oncology Hematology in Rockville.
He said once prostate cancer metastasizes it is considered Stage 4 of the disease.
“We think these cancers are not really curable, but they’re manageable and that’s from everything that we’re hearing about former President Biden’s case,” Mahmood said.
A measurement known as the Gleason scale determines the aggressiveness of prostate cancer. A spokesperson from Biden’s office said the former President had a Gleason score of 9. Ten is the highest. The Gleason score shows the cancer is aggressive, but does not determine the spread of the disease. Further testing showed Biden’s cancer had spread to his bones.
Typical Treatment
Mahmood said the typical treatment for someone with an aggressive form of prostate cancer is hormonal based therapy with shots and pills. The goal of hormonal therapy is to stop a patient from producing testosterone which can help fuel the cancer.
However, doctors also could recommend chemotherapy and radiation to treat the cancer especially if it has spread.
Mahmood says prostate cancer usually grows slowly. A patient with prostate cancer can live for years with the disease.
“There’s a general saying that most men will die with prostate cancer, not from prostate cancer. It’s very much a very common cancer. It’s one of the most closely associated cancers with age. The older you are the higher risk of getting prostate cancer,” Mahmood said.
Possible Symptoms
Men will not always present symptoms ahead of a diagnosis. However, in Biden’s case he was experiencing urinary problems.
Mahmood said doctors often discover prostate cancer after they give their patients a blood test that measures the prostate specific antigen (PSA). The prostate gland produces this protein. When an individual’s PSA level is elevated, Mahmood said that often requires further testing.
“It’s quite common for men to have lower urinary tract symptoms, such as urgency, frequency, or nocturia, waking up multiple times at night to urinate. These are most commonly associated with an enlarged prostate, which is a benign condition. Typically, prostate cancer does not actually present like that. But it can happen up to 6% of the time. People also can present with back pain. This is pain from the cancer being in the bone. That can be the initial presentation too, but it is less common,” Mahmood said.
PSA Test For Men
It is unclear when Biden last had a PSA test. The U.S. Preventative Services Task Force recommends against screening in men 70 years and older. Mahmood said the group believes younger men should have a discussion with their doctor about testing. However, the American Cancer Society and the American Society of Clinical Oncology both recommend PSA screening for men starting at 50 years old. The groups say testing should happen earlier if a patient has a family history of prostate cancer.
Have A Checkup
Mahmood said prostate cancer often has a genetic link. However, he recommends men follow a healthy lifestyle to possibly ward off prostate cancer.
“We generally would say whatever is good for the heart is good for the prostate. So if you think of heart health in terms of diet, not smoking, those general rules will probably serve you well to prevent prostate cancer,” Mahmood said.
He recommends men see their doctors. He said that is an important first step.
“I do see a lot of men shy away from this subject. That it is often taboo and they don’t want to see the doctor. But men should really take the opportunity to regularly visit their doctor because prevention is far better than being reactive. And we’re trying to be very proactive about prevention.” Mahmood said.
