Why Biden may not have known about his “aggressive” prostate cancer until recently

The office of former President Joe Biden announced on Sunday that he was diagnosed with an “aggressive” form of prostate cancer.

Biden’s office also said that cancer had metastasis, extending to its bones.

Although some people wondered why cancer was captured only after reaching a 9 9 Gleason score, oncology experts told ABC News that it is not uncommon for patients with major prostate cancer to receive a diagnosis after the disease has advanced or spread.

“Prostate cancer is something that we always hope that detection identifies early, when all cancer is still inside the prostate,” said Dr. Alicia Morgans, a genitourinary medical oncologist at the Dana-Farber Cancer Institute in Boston and a member of the Board of Diffión Cancer Zero Prostate Non-profit, said ABC News.

“Even if we project everyone perfectly, there will never be a 100% detection of prostate cancer because, in truth, cancer does not follow a rules book,” Morgans continued. “And the fact that we are trying to catch him early does not mean that he is necessarily present when we select.”

It is possible that PSA levels have not been reviewed

A detection test for prostate cancer implies a blood analysis that measures the specific level of antigens of the prostate, which are cell proteins in the prostate gland.

Although there is no cutting level that clearly indicates the presence of cancer, many doctors use a limit of 4 nanograms per milliliter to recommend more evidence with a urologist, according to the American Cancer Society.

For an advanced form of cancer such as Biden, a recent PSA test would probably have shown high levels.

However, the US Preventive Services Task. Recommends against the PSA -based exam For men over 70 years due to damages such as false positives that lead to more evidence or a diagnosis of problems that would not have caused symptoms or death.

Morgans said it is not clear what the former president and his doctor discussed regarding detection, but it is plausible not to undergo a PSA projection.

“It is absolutely possible that President Biden, like so many men older of that age, has decided to stop detecting PSA because they have decided that it is not consistent with their general health objectives and desires, and that is completely reasonable,” Morgans said.

Cancer could have grown up quickly

Morgans said that some 70 and 80 -year -old men still undergo PSA detection for prostate cancer based on conversations with their primary care doctors and what is suitable for them.

Even so, it is possible that the results were normal, either due to a false negative or because their cancer was not present at that time, he said.

“Prostate cancer can develop between detection tests,” Morgans said. “It does not necessarily grow very slowly. It can develop between projections, and can be aggressive when it develops; that does not mean that it is not treatable.”

The results of the detection could have been limit

Dr. Alan Bryce, clinical director of the Cancer Center of the City of Hope, Phoenix, said there may be some patients who receive PSA detection results that show high -limit results that decide not to perform more tests.

“There are absolutely scenarios in which this conversation occurs with a patient or his relative,” Bryce told ABC News. “They could all say: ‘Do you know what? Given where we are in life, we are not so worried about this. We will move on and wait another year'”.

Bryce, a medical oncologist specialized in prostate and testicular cancers, added that shared decision making is important when it comes to deciding if a patient wants to perform a prostate cancer detection, and if you want to try more after the results of the tests that are abnormal.

“As doctors, we present to patients options and recommendations, but, at the end of the day, it is still the patient’s decision,” he said. “Therefore, it is completely possible that a conversation occurs and the patient decides that they do not want to proceed with additional job. They may not want to make a scan, they may not want to do a biopsy.”

No present symptoms

Advanced prostate cancer can present symptoms as a weak urine current; need to urinate more frequently; erectile dysfunction; fatigue; Weight loss; loss of bladder or intestinal control; and pain in the ribs, hips and column when cancer had spread to the bones, according to the Here.

Morgans said that just because a patient has advanced prostate cancer, does not necessarily mean that he will exhibit symptoms.

“I would say that it is more common than not people feeling in my office and tell me: ‘You know, I don’t have any symptoms. I don’t understand how I have this cancer. I certainly don’t understand how I could spread outside my prostate,” Morgans said. “It is very common for people to be completely asymptomatic.”

Bryce added that some symptoms, such as the difficulty of urinating or a current of weak urine, may be due to an enlarged prostate, which is common in older men.

“It is completely normal that in older men, there is a degree of urinary obstruction that occurs with age,” he said. “It is completely possible that a man has normal symptoms associated with aging and nothing about it stands out as related to a cancerous process.”