Reflections on Former U.S. President Biden’s Diagnosis of Advanced Prostate Cancer
Today headlines worldwide carry the news that former U.S. President Biden has been diagnosed with advanced prostate cancer. His office said in a statement Sunday (May 18) that the 82-year-old Biden visited doctors last Friday (the 16th) for worsening urinary symptoms; a new nodule was found in the prostate and confirmed as cancer. Further checks showed bone metastases—in other words, advanced disease.
Biden had been out of the presidency for only a little over a hundred days when advanced cancer was found, which surprised many. It also says something: with U.S. medical resources and the quality of care available to a U.S. president, and annual physicals, Biden’s cancer was not caught early—showing how hard cancer is to detect at an early stage.
Patients often tell me they are diagnosed at an advanced stage, astonished: they had a physical not long ago and everything was fine, so how did it reach stage IV so fast? This reflects a problem: routine physicals are not actually cancer-focused and do not easily detect cancer. There are also very many types of cancer, and it is neither realistic nor affordable to screen for every one at a checkup. So it is no surprise that routine checkups miss early cancer. The White House physicians are far more senior and skilled than those at ordinary checkup centers, and they still missed it; our own missed detections are therefore not surprising.
Biden’s cancer was graded Gleason score 9 (Grade Group 5). Under American Cancer Society standards, Grade Group 5 is the highest: cancer cells “markedly abnormal,” indicating a highly aggressive tumor. After the results, U.S. medical experts said that because Biden’s cancer had metastasized to bone, cure was unlikely; they shifted to discussing how to use hormone therapy and chemotherapy to control progression and maintain his quality of life.
Strictly speaking, prostate cancer is not among the most aggressive cancers; it is far less lethal than lung, liver, pancreatic, or gastric cancer. Even so, the medical establishment of the world’s most medically advanced country openly says Biden’s cure is unlikely. This shows cancer is truly extremely hard to cure, especially at an advanced stage.
In my daily work I deal mostly with patients and families earnestly hoping for cure—and almost all are advanced cancer patients and their families. Their feelings are understandable, but such hopes are so unrealistic that many become victims of exaggerated medical advertising; their high expectations open the door to scammers. In this regard, the less educated the patient and family, the more unrealistic their hopes and the easier they are to deceive.
The cure rate for advanced cancer is extremely low; only a tiny number of lucky patients are cured, and their regimens cannot usually be reproduced in others. For advanced patients and families, adjusting psychological expectations and setting more scientific, reasonable treatment goals is the wise course. This avoids losing both money and life, and, honestly, it actually improves the patient’s final quality of life and prolongs survival.
Excessive expectations often lead patients and families to blindly try unreliable treatments, most of which carry side effects—some severe. In the end things backfire: quality of life is low and survival markedly shortened.
Had Biden’s prostate cancer been caught early, with U.S. medical standards and his status, cure would have been possible. But once advanced, little more can be done. I think Biden must have had some clinical symptoms earlier, because early prostate cancer has fairly obvious signs; he and those around him simply did not notice. Otherwise it should not have progressed this far before detection.
Biden’s diagnosis is a wake-up call for everyone: cancer has no eyes and does not spare anyone for status or wealth. Staying attentive, consulting reliable doctors for minor symptoms, and undergoing targeted early screening for specific cancers can avoid Biden’s tragedy.
Note: Early prostate cancer symptoms usually include frequent urination (especially at night), urgency, dysuria, hematuria, difficulty urinating, and a feeling of incomplete emptying. Those with a family history of cancer or a prior diagnosis of benign prostatic hyperplasia who develop these symptoms should be examined to rule out early prostate cancer. Biden himself has a family history: a son died of a brain tumor, and this is not his own first cancer diagnosis.