Biden will be here soon: Former President metastatic prostate cancer

The standard of not checking your PSA after 70 or 75 is not political. It is just plain wrong. It is not just a standard of checking after 70-75. It is also not checking in your 30's and 40's. I ask my son who is now 34 to get checked every year. I remember going to my doctor and him telling me that PSA blood tests give false positives and that the medical community does not want to have men's PSA checked before 40 years of age. That was garbage information. I remember that my doctors would check my testosterone and they would consistently say my free testosterone levels were dropping. Because prostate cancer cells were taking their energy from my free testosterone. I am not bitter, but I am more informed. I would not wish this disease on the worst person in the world. The only good that might come out of this is maybe more money will be available for cancer research - which will lead to more treatments and hopefully a cure. Not just prostate cancer but for all cancer types. Because right now - I do not see much progress being made for the treatment of metastatic prostate cancer. It feels like after Pluvicto treatment, approval of Nubeqa and other ARSI's for castrate sensitive prostate cancer patients, and a few additional medications used to treat men with BRAC1 and BRAC2, there has not been much progress. We need a safe medication that reverses or prevents Castrate Resistance.

Yes, the advances in treating metastatic prostate cancer are many small tweaks instead of a big breakthrough:

- recognising oligometastatic cancer as a distinct category and treating with curative intent

- radiating the prostate and (for oligometastatic) each of the metastases

- for polymetastatic, hitting the cancer with triplet therapy (including chemo) up front instead using just one treatment until it fails then progressing to the next

- using one of the -lutamides together with ADT right from the start instead of waiting for castrate-resistance

- using Pluvicto to radiate polymetastatic prostate cancer

No one of these changes alone is a silver bullet, but together they've brought us from expecting to live just just a few years to studies no longer lasting long enough to reach median overall survival (e.g. well over half of participants are still alive after 5–7 years, and a good number still have had little or no progression in that time).

All these little tweaks aren't as exciting as a big dramatic breakthrough, but in combination they've massively changed the survival prospects for many (not all) with metastatic prostate cancer during the past 5–10 years.

Unfortunately, you might not yet get this newer standard of care outside of a major cancer research centre. It depends on whether your local urologist is keeping up on the literature, or still doing the same things they were doing in 2015 or 2020. 😕

The political conspiracy theories I mentioned were speculating on so-called "coverups" in President Biden's medical history. This forum isn't the place for partisan political bickering (there's plenty of that in social media like Twitter-X and Facebook, if people feel the need).

On the other hand, the reduction in PSA screening and subsequent surge in de-novo cases of metastatic prostate cancer are, as you rightly mention, documented facts that have affected many of us here in the forum. 😢

At my annual physical in Feb 2022 my PSA was 1.9. doc said I was fine. From 2016 to 2022 my PSA was around 1.4, doc was not concerned about it increasing to 1.9. I skipped my annual physical in 2023, thinking I was just fine and why bother. My doc retired and the new doc at my clinic suggested I come in for my physical, this was Feb 2024, I put it off until July 2024, blood work done, doc recommended PSA even with be being 71 at the time. My PSA came back at 62. Doc sent me to urologist the next day, during a DRE found a large mass at the rear/top of my prostate. Biopsy the next week, Gleason 9 cancer, He put me on dual ADT right after the biopsy results came back. PSMA scan 2 weeks later, Mets to one lymph node and pelvis. My current PSA is less than 0.10 and recent MRI indicates my tumor has regressed back into the prostate. Scheduled for radiation soon to kill off the remaining cancer. I was lucky my new doc did the PSA test when he did, or most likely I wouldn’t be telling this story. So, maybe I had the cancer earlier, but it progressed very quickly.

I hope so. Maybe it will encourage elected politicians to restore full funding to the U.S. National Cancer Institute soon, since they support a huge portion of the research that's keeping us alive right now, and we're counting on them for the next big breakthroughs. Cancer affects people of all political persuasions

But also, as a Canadian, I recognise that the rest of the rich world needs to step up and pay a bigger share of cancer research funding. And whatever happens, we're immensely grateful for all the breakthroughs the U.S. funded (in research labs around the world) up to 2024. Your country has pulled way more than its own weight getting us to where we are today.

I assume the stopping of tests at 70 or 75 is a risk benefit analysis driven by insurance companies. AS a w oman posting on here I equate it to no more pap smears or pelvic exams after a certain age. I personally know women who that decision did not work out well for. People need to know they can request these tests. For a man I would think a doctor would order it with a simple request such as "urinary frequency or urgency" etc. A routine physical would easily include a DRE that takes just a minute. Clearly it is reasonable to think that Biden's PSA was gradually climbing more than average aging numbers and further testing could have been done. It is unlikely that this came out of left field but it seems it is possible he did not know until recently.

thanks everyone for the wonderful hugs. Just what I needed!

Here is a link to an article in this morning's NYT that has all the facts about the dates of Biden's last PSA test and of his recent diagnosis. This clears up the conspiracy theories out there.
https://www.nytimes.com/2025/05/21/briefing/biden-cancer-diagnosis.html?unlocked_article_code=1.I08.0EJM.W2Fia1vQOTGl&smid=nytcore-ios-share&referringSource=articleShare

My older brother got aggressive PCa around age 50. Consequently, I got the "get your psa test every year" talk from him back then and that's how I found mine before it got out of the prostate (even though I had both cribriform and IDC). Since I've been diagnosed, I've spoken with several of my friends and the general response is they're pretty ignorant of PCa and aren't even sure if they're getting a psa test during routine blood work. I certainly don't know, but I strongly suspect unless Biden had someone in his circle who had prostate cancer, he probably was just like everyone else; generally ignorant of it and just assuming their doctor was doing whatever was needed at annual physicals. Since it's now been revealed his last psa test was in 2014, it seems his providers were following the "stop testing over 70" guideline. Frankly, without my brothers experience I suspect I'd have done the same. Let's hope Bidens story helps generate more awareness of the changes needed going forward.

Peter I understand what you are saying about it being intrusive! But how simple is a PSA Test? I had not been checked in several years! I just wanted to ease my mind! I had gone through Stage IV colon cancer 25 years ago, so cancer is always on my mind!
Don't you think a simple PSA Test would have caught Biden's cancer long before it got worse!
Thanks,
Sundance, aka, RB