Joe Biden diagnosed with ‘aggressive’ prostate cancer: Know all about signs and stages

Former US President Joe Biden, 82, has been diagnosed with an “aggressive” form of prostate cancer that has spread to his bones, raising serious concerns about his health. Joe Biden’s office announced the diagnosis, highlighting that the cancer appears hormone-sensitive, which may respond to therapy for treatment.

“Last week, President Joe Biden was seen for a new finding of a prostate nodule after experiencing increasing urinary symptoms. On Friday, Joe Biden was diagnosed with prostate cancer, characterised by a Gleason score of 9 (Grade Group 5) with metastasis to the bone,” Joe Biden’s personal office said in a statement, as per the Associated Press.

The Gleason score is a system used to grade prostate cancer based on how
abnormal the cancer cells appear under a microscope. A low score denotes that the cancer cells look more like normal prostrate gland cells and a high score underscores aggressive abnormal looking cells. The score ranges from 6 to 10 and scores 9 and 10 constitute grade group 5, which means very aggressive nature of the cancer, explains Dr Ritika Hinduja.

A score of 9 out of 10, as in Joe Biden’s case, indicates that the cancer is growing rapidly.

Joe Biden’s office adds: “While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive, which allows for effective management.”

What are the treatment options for Joe Biden’s prostate cancer?

“Hormone sensitive signifies sensitivity of cancer cells to testicular testosterone/androgen suppression (male hormones). This provides a label of being responsive to androgen deprivation therapy (ADT) which forms the backbone of treatment of hormone sensitive prostrate cancer. This leads to a plethora of treatment options including conventional ADT along with novel androgen blockers (like abiraterone acetate, enzalutamide ) or chemotherapy or both. This has been shown to impact outcomes in a multitude of clinical trials,” adds Dr Hinduja.

What is prostate cancer?

The prostate is a small gland in the male reproductive system. It is about the size of a walnut, located just below the bladder and surrounding the urethra. It plays a vital role by producing fluid that forms part of semen.

According to the World Health Organization, prostate cancer is the fourth most common among all cancers in the world and the second most common cancer type in men. In 2022, the WHO reported 1.5 million cases of prostate cancer worldwide.

The American Cancer Society notes that about 1 in 8 men will be diagnosed with prostate cancer during their lifetime. But the risk may differ case-to-case, depending on factors such as age and ethnicity. Age is the most significant risk factor for prostate cancer — the risk increases as men get older.

While this disease is considered the second-leading cause of cancer death in American men, the prostate cancer death rate is said to have dipped from 1993 to 2022, driven by increased awareness, earlier detection, and advances in medical treatment.

Is Joe Biden’s prostate cancer diagnosis age-related?

“Both prostrate cancer and its benign counter part (benign prostatic hyperplasia) are age-related where increased age is a significant risk factor. Prostate cancer is rare in men younger than 40, but the chance of having prostate cancer rises rapidly after age 50. About 6 in 10 prostate cancers are found in men older than 65,” says Dr Hinduja.

Stages of prostate cancer

As most cancer types, prostate cancer is grouped into multiple stages. The diagnosis determines which of the four stages of prostate cancer a patient has.

Stages 1 and 2: This is considered an early stage, in which the tumor has still not spread beyond the prostate. In medical terms, it is “localised”.

Stage 3: A locally advanced stage of prostate cancer, which indicates the cancer has spread outside the prostate, but only to nearby tissues, according to the Urology Care Foundation.

Stage 4: This is an advanced stage of prostate cancer, signifying that the cancer cells have multiplied and spread to other parts such as the lymph nodes, bones, liver or lungs.

Symptoms of prostate cancer

Some men may not have any symptoms of prostate cancer at all. However, some men may seek a diagnosis depending on their symptoms. A few of the most common prostate cancer symptoms, according to urologists, include:

• Difficulty in urination, marked by weak or interrupted flow of urine
• Frequent urination, especially at night
• Pain or burning during urination
• Blood in the urine or semen along with pain in the back, hips, or pelvis

Regular screenings after the age of 40 can be helpful in early detection and diagnosis.