Why wasn’t Biden’s prostate cancer diagnosed sooner?

Former President Joe Biden is probably one of the most famous people in the world. Why wasn’t his advanced prostate cancer, which has metastasized to his bones, diagnosed earlier? He had the best medical care there is to have in the United States. As president, he was thoroughly examined from head to toe.

I hear about it frequently. A friend had back pain. He was told it was muscle pain. Later, it turned out he had pancreatic cancer.

In an article on the high cost of medication, a ProPublica reporter described having a pain in his side for weeks. When the pain became unbearable, an emergency room diagnosis was multiple myeloma, cancer.

Why did it take so long to diagnose President Biden’s cancer?

Kirsten Greene, M.D., chair of the University of Virginia Department of Urology, said in a Q&A on the university's website that it sounds like Biden’s cancer was detected because of a rectal exam, and they felt a nodule.

“That’s very uncommon nowadays because most prostate cancer is detected with the PSA test,” Greene said. “And a PSA blood test can usually diagnose you with prostate cancer 10 to 15 years before you’d ever have a symptom.”

She said she has two speculations about why Biden’s cancer was detected at such an advanced stage:

One is that prostate cancer screening guidelines in the United States recommend stopping prostate cancer screening after age 75. It’s uncommon to continue to check a PSA every year beyond the age of 75 if your PSA has been fine prior to that.

The other possibility could be that his prostate cancer is so aggressive or de-differentiated that it actually stopped making PSA. It’s an unusual situation. Now, another (possibility) is … maybe he’d had biopsies in the past that didn’t show cancer, and the biopsy just happened to miss it.

Perhaps, we’ll learn more about what happened in later announcements.

For seniors who think that their health care practitioners aren’t paying enough attention to their symptoms, here are some suggestions from Psychology Today:

• Keep a symptoms journal.
• Research your symptoms and possible diagnoses.
• Bring a trusted advocate to appointments.
• Request a second opinion.
• Speak up and assert your concerns.
• Request further testing.

Remember, it’s O.K. to advocate for your health.