Doctors Say Biden's Cancer Diagnosis is Uncommon, Not 'Unheard Of' As Questions About Timing Mount

Former President Joe Biden was recently diagnosed with an aggressive form of prostate cancer, which has spread to his bones, raising questions about the transparency of the announcement and his health while he was in office. But doctors say that while his case is uncommon, it is not unheard of.

Biden was diagnosed with an aggressive form of prostate cancer Friday, following the discovery of a "small" nodule on his prostate, his personal office said in a statement. The cancer, they explained, quickly spread to his bones and the family is currently reviewing treatment options.

While his family or office have revealed little details about his condition, some of his strongest critics have baselessly claimed that the former president delayed sharing his cancer diagnosis for political gains. Leading that discussion is President Donald Trump, who has been open about his disdain for the Democratic leader.

"I'm surprised that the public wasn't notified a long time ago because to get to Stage 9, that's a long time," Trump said, when a reporter asked for comment about the diagnosis at an unrelated event at the White House.

"I think that if you take a look, it's the same doctor that said that Joe was cognitively fine," he continued. "And that's being proven to be a sad situation."

But medical experts have dismissed these theories, arguing that it is not impossible for the cancer to have gone unnoticed, or to have spread quickly, NBC News explains.

"Most prostate cancers are slow-growing, but some people can develop a high-risk cancer that happens relatively quickly and can spread quickly," said Dr. Alon Weizer, a urologist and chief medical officer of Mount Sinai Medical Center. "Is that super common? No. But it can occur and it all depends on the underlying biology of that individual cancer."

On the other hand, most cases of prostate cancer are diagnosed at an early stage, often with the help of routine screenings involving blood tests or rectal exams. But in around 8% of cases, the cancer has already metastasized by the time it's diagnosed, NBC News explains. At that point, the patient has likely had prostate cancer for several years to a decade.

It is not publicly known whether Biden, 82, had been getting regular screenings before his diagnosis. Medical organizations across the country disagree on when and how often men should get tested for this cancer. Nevertheless, it is uncommon for men in their 80s to get routinely screened for the disease.

The American Cancer Society recommends that men in their 50s and 60s get screened every two years. But current guidelines from the U.S. Preventive Services Task Force— an independent panel of experts whose recommendations often determine whether screenings are covered by insurance— say that men ages 55 to 69 should merely discuss getting a blood test with their physician.

"It's in many ways unsettling that someone who has what is undoubtedly fantastic medical care could suddenly be diagnosed with aggressive, metastatic prostate cancer," said Dr. Todd Morgan, co-director of the Weiser Center for Prostate Cancer at Michigan Medicine. "On the other hand, this is often how prostate cancer presents. We typically don't do PSA screenings beyond 75 or late 70s."

Around 37% of patients whose prostate cancer has metastasized survive at least five years after their diagnosis, according to NBC News. Dr. Peter Nelson, vice president of precision oncology at Fred Hutch Cancer Center, said patients like Biden have a more than 90% chance of responding to therapies that lower testosterone, a hormone that can feed the cancer's growth.

"Most likely, he will get multiple medications at the initiation of his therapy, and could expect several years of response to that therapy before that cancer becomes resistant," Nelson said. Some patients receive chemotherapy or radiation at the same time or following hormone therapy, he added.