Adam’s Journal
Former President Biden has been diagnosed with a form of prostate cancer that has been described as “aggressive.” Obviously, that’s not good news for him and his family, but what does it mean in terms of prognosis and treatment options?
Dr. Scofield Prescribes
Former President Biden’s cancer is aggressive. Pathologists who examined his cancer cells gave them what’s known as a Gleason score of 9 out of 10 for their likelihood to advance quickly. They have already moved, or metastasized, from his prostate to his bones, which means his cancer cannot be cured; it can only be controlled.
That said, this diagnosis of metastatic or Stage 4 prostate cancer, especially with only bone metastatic disease, is much more hopeful than it would have been even a decade ago. In that time, recent advances in treating this form of cancer – based in large part on research funded by the National Institutes of Health – have notably brightened the treatment picture.
Where life expectancy might once have been measured in months, prostate cancer patients with a Stage 4 diagnosis typically live 5 to 10 years. Survival rates have almost tripled over the past decade.
The first line of defense will likely be a drug that blocks his body from making testosterone, which feeds the growth of his cancer. He will probably also receive a second drug that absorbs any testosterone that his body still manages to produce.
Depending on how much cancer has spread to his bones, he may also receive chemotherapy or radiation treatment.
It’s worth noting that, as an 82-year-old, Biden hadn’t received a prostate-specific antigen (PSA) test in more than a decade, and this is the primary means of detecting prostate cancer. However, current guidelines don’t recommend this testing for men 70 and older, and even if Biden had continued testing, he might still be exactly where he is today.
The reason the guidelines recommend discontinuing testing at 70 is that about half of men over that age have at least some cancer in their prostates. Most of these cancers grow slowly and cause little harm. But if all of them were screened, many would end up with unnecessary surgery or radiation that can carry devastating side effects.
Plus, screening isn’t a magic bullet. Some cancers spring from nonexistent to metastatic in the year between screening tests. Others elude PSA tests.
For the former president, this is far from welcome news. Still, given all the strides we’ve made – quite a few resulting from Biden’s own cancer “moonshot” initiative – a diagnosis like his comes with much more hope than it ever has before.
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Dr. Hal Scofield is a physician-scientist at the Oklahoma Medical Research Foundation, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.
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This article’s header image is from former President Biden and former first lady Jill Biden in an image shared after his diagnosis was announced. (@JoeBiden / X)
