Biden's diagnosis points to imperfect screening By HPN Staff Former President Joe Biden’s recent prostate cancer diagnosis — and the revelation that his last known screening was more than a decade ago — highlights the double-edged sword of prostate testing. Prostate cancer is the second most common cancer in men, after skin cancer. And it’s the second-leading cause of cancer death in men, after lung cancer. When caught early, it's highly survivable. But testing regimes are imperfect, the cancer often grows slowly and treatment means side effects. Why it matters Scrutiny has arisen following Biden’s diagnosis, particularly regarding whether information about the former president’s overall health was concealed while he was in office. The former president’s office has said his “last known” prostate cancer screening came in 2014. Biden is 82, and doctors recommend against prostate cancer screenings in men 70 and older. Since this cancer often grows slowly, there’s a risk of overly aggressive treatment for a disease that may never cause problems within a man’s lifetime, the American Cancer Society reports. The bigger picture There are two main screening tests: PSA (Prostate-Specific Antigen) blood tests and the DRE (Digital Rectal Exam), which involves a manual examination. The American Cancer Society recommends men talk to their doctors about these tests: At age 50, for most men. At age 45 for men at high risk. This includes Black men and men with a father or brother who was diagnosed with prostate cancer before the age of 65. At age 40 for men with more than one brother or father who had prostate cancer at an early age. Unfortunately, reliability is an issue with PSA tests. They can produce false positives that lead to needless biopsies, as well as false negatives that fail to detect cancer. It’s not clear from studies whether regular PSA screenings actually lower prostate cancer death rates, the ACS reports. Additional context The prostate is part of the male reproductive system. It’s a gland that makes fluid for semen and, during sex, the prostate contracts to aid ejaculation. Prostate cancer treatments carry the risk of erectile dysfunction, but that too is treatable. “Nearly all men will experience some erectile dysfunction for the first few months after prostate cancer treatment,” Johns Hopkins reports. “However, within one year after treatment, nearly all men with intact nerves will see a substantial improvement.” More details In Biden’s case, the cancer has spread to his bones. His cancer is treatable and may be slowed by drugs, but it’s not considered curable at this point. Even after the cancer has spread like this, though, patients can live for years, doctors have told media outlets reporting on the former president's condition.
