 "President Joe Biden speaks on the cancer moonshot initiative at the John F Kennedy Library and Museum in September 2022. File image/AP")
Former United States President Joe Biden has been diagnosed with aggressive prostate cancer on Sunday (May 18). Soon after his diagnosis, many have accused the former president of covering up his medical condition intentionally.
Biden’s office announced Sunday that the 82-year-old received the diagnosis last week, following the discovery of a prostate nodule and his reporting of urinary issues. The detection of the disease, which is quite common in men his age, has raised questions about how it was not detected earlier.
Let us take a closer look at how the cancer remained undetected for so long.
What is prostate cancer?
Prostate cancer develops in the prostate, a small walnut-shaped gland located below the bladder and in front of the rectum in males. This tiny gland secretes fluid that mixes with semen, keeping sperm healthy for conception and pregnancy.
Typically, prostate cancer grows slowly and is initially confined to the prostate gland, often without causing significant harm. However, some aggressive types, like the one diagnosed in Biden, can quickly spread to other parts of the body, including bones, posing a more serious risk.
How can cancer remain undetected?
The former president’s late detection of cancer has led many to wonder how the disease went unnoticed for so long in a person having access to extensive medical care. Some Republicans led by Vice President JD Vance and Donald Trump Jr shared conspiratorial posts to the effect that Biden and his White House medical team had long concealed his illness for political purposes.
However, oncologists believe that his condition went unnoticed until now due to inherent limitations in screening procedures.
Prostate-specific antigen (PSA) blood tests are a common and affordable method for detecting many prostate cancers in the US before symptoms manifest. Nonetheless, physicians indicate that certain rare and aggressive forms of prostate cancer may not produce sufficient PSA for detection by this test, reported the news website MSN.
Medical experts interviewed by AFP said the late identification of an advanced cancer would not be unheard of, even for a former president receiving top-of-the-line medical care.
“We can’t rule out the possibility that it was an aggressive form that developed quickly,” said Natacha Naoun, an oncologist with France’s Gustave-Roussy Institute.
Who is not recommended to take PSA screening?
Annual PSA screening for individuals over 70 years of age is not universally recommended. The US Preventive Services Task Force, for instance, advises against it, reasoning that the potential for false positives and the inherent risks associated with biopsies and subsequent treatments outweigh the clinical benefits.
“It could be they decided to stop checking PSA annually, and then he had urinary symptoms,” said Russell Pachynski, an oncologist with Washington University in St Louis, Missouri, who said that prostate cancer patients do not always experience telltale pains or signs.
It is also possible that Biden was undergoing routine screenings, but that those checks failed to turn up indications of cancer, Pachynski said.
“Maybe it was just unlucky that his particular cancer didn’t express a lot of PSA and he still had a normal PSA. In that setting, you would not go check the prostate or do a biopsy, etcetera, unless it was driven by symptoms.”
Otis Brawley, an oncologist and epidemiologist at Johns Hopkins University, said studies have shown both PSA testing and rectal exams are imperfect.
“It is not unusual for a man to be diagnosed with metastatic prostate disease despite normal annual screening,” he said. “This is part of the limitations of prostate screening.”
However, Biden was not a typical patient. As the oldest US president seeking re-election, questions concerning his health plagued him throughout the concluding months of his presidency and his ultimately unsuccessful re-election campaign. These inquiries have been renewed in recent weeks, coinciding with the anticipated publication of a book that reportedly describes his declining physical state.
With inputs from AFP