As you all know,  President Joe Biden has been diagnosed with an aggressive form of prostate cancer – but it carries a five-year survival rate of just 30% to 40%.
The cancer has reached an advanced stage, classified with a Gleason score of 9 and Grade Group 5, and has already spread to the bones, according to Dr. Marc Siegel, Fox News’ senior medical analyst, during an appearance on Fox Report.
“It’s the most aggressive type,” Siegel said. “That means it has the highest risk of spread — which obviously he has had.”
In addition to the metastasis, Biden is showing urinary symptoms, which further suggests that the cancer is in an advanced stage. Dr. Siegel noted that prostate cancer typically goes unnoticed in its early phases because it often lacks symptoms.
“This was found by physical examination by a prostate exam,” Siegel said. “A lot of times we find an elevation in prostate-specific antigen, PSA, and then we go after it… I mean, he must have had the best possible care here. I’m a little taken aback that it’s this far advanced.”
Dr. Siegel emphasized that he routinely administers PSA tests to men over 45. The PSA test, which assesses the level of prostate-specific antigen in the blood, is a primary method for screening prostate cancer, according to Mayo Clinic.
Although not always definitive, an increase in PSA levels usually leads to further diagnostics, Siegel explained. “Someone who has a rise in PSA automatically gets an MRI,” he said. Based on those results, a biopsy may follow.
Siegel pointed out that prostate cancer is extremely common among older men. In fact, he said, more than 80% of men over 80 have traces of prostate cancer cells.
“It would be really surprising if they weren’t doing a very close screening on this because everybody knows in the medical community that this is the one cancer in men you really look out for,” he said. “… He doesn’t seem to have a lot of risk factors that I would think about other than age, but age is enough and he’s 82, so that’s a big risk factor.”
Biden’s treatment plan will likely include hormone therapy, and doctors may also consider radiating the bone lesions or surgically removing the prostate, according to Siegel.
“Sometimes they decide to do more than one therapy,” Siegel said. “They might try to take the prostate out, do radiation and the hormone therapy altogether. That’s not uncommon.”
Treatment options for this stage of cancer typically involve drugs like Lupron, which halts testosterone production, and Casodex, which blocks testosterone from attaching to cancer cells. These medications can lead to side effects that make patients feel drained and without energy, Siegel said.
“The other thing I’m concerned about is bone pain, because those metastases to the bone can be pretty painful,” he said.
If prostate cancer is detected before it spreads, the chances of a cure are very high, Siegel noted.
“The goal is to get it before it leaves the prostate,” Siegel said. “When it’s left the prostate, it becomes much more difficult to cure.”
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