On Sunday, the office of former President Joe Biden announced that he is confronting an aggressive form of prostate cancer, characterized by a significant Gleason score of 9. This diagnosis also indicates that the cancer has metastasized to the bone, underscoring the seriousness of his condition. The alarming news follows the discovery of a small nodule in Biden's prostate during a routine physical exam conducted earlier in the week. According to his spokesperson, this finding prompted further medical evaluation.
In February 2023, while Biden was still in office, he underwent a procedure to remove a cancerous lesion from his chest, as revealed by the former White House physician. Prior to his presidency, Biden had several instances of non-melanoma skin cancer, which were effectively treated using Mohs surgery. As the world absorbs this significant medical update, major news outlets like ABC News have begun to analyze what this diagnosis entails and what potential treatment options are available.
Prostate cancer develops in the tissues of the prostate gland, a small organ responsible for producing semen in men. According to the National Institutes of Health (NIH), this form of cancer is the most frequently diagnosed and stands as the second leading cause of cancer-related deaths among men in the United States. It is projected that in 2023, approximately 313,780 new cases of prostate cancer will be identified, accounting for over 15% of all new cancer cases in the nation.
Tragically, it is estimated that 35,770 men will succumb to prostate cancer this year, which represents 5.8% of all cancer deaths. Fortunately, the prognosis for prostate cancer is relatively optimistic; the five-year relative survival rate stands at about 98%. Typically, prostate cancer progresses slowly, and early detection and treatment may not significantly enhance overall health or longevity. Nevertheless, it is generally considered a more manageable form of cancer, even when diagnosed at advanced stages.
Statistically, around 12.9% of men will receive a prostate cancer diagnosis during their lifetime. In 2022, an estimated 3.5 million men in the United States were living with this disease. The median age for diagnosis is 68, while the median age for death from prostate cancer is 79. Although new cases have increased by an average of 1.8% per year from 2013 to 2022, death rates have seen a decline of about 0.6% annually from 2014 to 2023.
The Gleason scoring system serves as a method to evaluate the aggressiveness of prostate cancer, indicating how likely it is to advance and spread, but it does not predict individual outcomes. This system assesses prostate cancer based on the appearance of cancer cells in a biopsy under a microscope and their expected growth rate. The Gleason score is determined by adding the two most prevalent grades of cancer cells found in the biopsy sample, with scores typically ranging from 6 to 10.
Biden's Gleason score of 9 signifies that his cancer is aggressive, as this score indicates that the cancer cells exhibit significant abnormalities compared to normal prostate cells, suggesting rapid growth and dissemination. This classification places his cancer in Grade Group 5, the highest risk category, associated with a greater likelihood of metastasis and a more challenging prognosis. Nonetheless, the hormone-sensitive nature of his cancer presents potential avenues for treatment.
While the specifics of Biden's treatment plan have yet to be disclosed, several options typically considered for such cases include hormone therapy, also known as androgen deprivation therapy (ADT). This treatment can lower levels of male hormones that may contribute to prostate cancer growth, effectively slowing disease progression and alleviating symptoms, even when the cancer has extended to the bones. Regular monitoring of prostate-specific antigen (PSA) levels is essential, as rising PSA levels can indicate cancer activity and help evaluate treatment efficacy.
Surgery is generally not a feasible option in cases like Biden's, where the cancer has spread beyond the prostate. In light of the former president's diagnosis, the American Cancer Society issued a statement highlighting the significant implications of prostate cancer in the U.S. They emphasized that early detection is critical and expressed concern over the 5% annual increase in advanced diagnoses among men. The organization called for more robust efforts to prevent late-stage diagnoses and reduce mortality rates associated with prostate cancer.
