Biden will be here soon: Former President metastatic prostate cancer

Posted by peterj116 @peterj116, 2 days ago

"On Friday, he was diagnosed with prostate cancer, characterized by a Gleason score of 9 (Grade Group 5) with metastasis to the bone."
"While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive which allows for effective management. The President and his family are reviewing treatment options with his physicians," the statement continued.

As a non-American watching the last 4 years from afar, I make no comment.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

@peterj116

Wow. They're right.

I checked a number of NZ urology sites & they all agree.

Above the age of 75 we do not recommend routine screening as the risks of investigation and treatment outweigh the potential benefits.

Being tested for prostate cancer is your choice. Your decision depends on:
whether you have a family history of prostate cancer in your father or brother (this doubles your risk of prostate cancer).
your age and life expectancy – if you're over 75 years of age, or expect your lifetime to be less than 10 years, you shouldn't be tested for prostate cancer as the harm is higher than the benefit.

There is no strong evidence to suggest that testing men over the age of 70 years reduces
mortality from prostate cancer in this age group. Generally men aged over 70 years, who have a normal-feeling prostate on digital rectal examination (DRE) and who have had ‘normal’ PSA tests in the past, should be advised they are not likely to benefit from any further PSA testing.

Maybe a subsequent biopsy is too invasive a procedure at that age, or recovery is more painful/difficult?
Must be the whole 'do no harm' thing.

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different rules for the President of the US. It is the same for women and pelvic exams but you can continue to request them.

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@kathy49

as president and a man considering another run for president he should have had full exam including digital rectal exam and the PSA blood. test. I simply don't understand if he did not.

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He seemed averse to taking tests. (the infamous "Why the hell would I take a test? C'mon, man".

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@brianjarvis

In the early 2000s, many men were getting routine PSA tests. Unfortunately, so many men panicked when they heard that “you have prostate cancer,” and jumped quickly to getting a prostatectomy when it wasn’t medically necessary (for low-grade, localized disease). (Sometimes the cure is worse than the disease.)

As a result, the USPSTF recommended against routine prostate cancer screening (assigning the screening a “D” recommendation: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening-2012).

You are correct - at that point many doctors stopped recommending, and many insurance companies stopped covering, routine PSA tests. (I started having annual PSA tests in 2000; my doctors never stopped.)

A few years later (in 2018) they revised that 2012 recommendation —> But, the current USPSTF guidelines still recommend against PSA screening after age 70 (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening).

Unfortunately, the damage had already been done. It will take a few more years for the impact of that 2012 USPSTF decision to work itself out of the system.

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Exactly. It was such a wrong-headed response. If there's a risk of overtreatment, change the *treatment* guidelines, not the *screening* guidelines (and in fact, treatment guidelines have changed dramatically since 2012, essentially nullifying the concerns at the time).

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@ava11

Why do you think they would have put him on ADT couple of months ago, if he was just diagnosed PC last Friday? I have all the respect for President Biden, and I hope he has many more years of healthy life.
It is just confusing the information his team is putting out. He is retired and the public doesn't have to know every detail of his health. But, if they are putting out information it should be accurate and helpful to fellow PC patients.

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It would be a pretty normal path. Maybe he had trouble peeing, then they detected elevated PSA, and tried ADT to see if it worked, then maybe scheduled some imaging (especially if there was bone pain). Since he's 82, they would have gone at it more lightly than they did with me when I was diagnosed at 56. But I went from not knowing I had prostate cancer to learning it was castrate-sensitive in a month, for whatever that's worth.

We really don't need to dig for a conspiracy here. I don't ask any of you whether you're Democrats, Republicans, Independents, Libertarians, Socialists, or members of the Undecided Cow Party (yes, it exists). We're all here in this forum because we're living with prostate cancer or supporting someone who is. President Biden doesn't have to share in detail what his journey's been like the past couple of months — we all know how traumatic the first months are — but if he ever chooses to, I know we'll be as supportive as we are for any other prostate cancer patient.

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I had a full physical in late 2020, PSA was 2.0 and otherwise very healthy. 16 months later, around July 2022 I was diagnosed with denovo high volume metastatic prostate cancer - bone only. I feared prostate cancer because a friend at church became metastatic at 53 and he urged me to get my prostate checked. At that point I got my PSA checked about every year.

The idea that it takes 10 years for this cancer to grow and become metastatic is just not true for every male. Something in my body caused what seemed to be a cytokine storm that advanced the cancer. The only events in my life that occurred prior were 3 COVID shots, which made me very sick and catching COVID. My prostate cancer symptoms came 3 days after I had COVID.

My understanding is that Biden has recently admitted to not having a PSA check since 2014. Plenty of time for cancer to grow.

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@kathy49

as president and a man considering another run for president he should have had full exam including digital rectal exam and the PSA blood. test. I simply don't understand if he did not.

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DREs and PSA screening are not standard recommended treatments above the age of 70 or 75 (depending on where you live). Should they be? In many cases, I think yes. But really, this isn't the place for political conspiracy theories. We're all dealing with prostate cancer, either as patients or as caregivers, and that's what we're here to talk about.

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@peterj116

He seemed averse to taking tests. (the infamous "Why the hell would I take a test? C'mon, man".

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report says he had not had a test since 2014.

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We will likely see some ramifications from a high profile man getting this, such as delays in testing and treatments from the volume of requests. Probably more goods than bad.

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@oldoz

We will likely see some ramifications from a high profile man getting this, such as delays in testing and treatments from the volume of requests. Probably more goods than bad.

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Definitely good. It's the best publicity PSA tests have ever had.

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