Yale oncologist: Biden's marker should have been picked up ‘years ago'

Yahoo

19-05-2025

NEW HAVEN, Conn. (WTNH) — Doctors nationwide are responding and breaking down former President Joe Biden's recent cancer diagnosis.
News 8 sat down with Dr. Isaac Kim, a urologic oncologist at Smilow Cancer Hospital and chief of urology at Yale School of Medicine. Kim tells us he was surprised when he heard the news of the former president's diagnosis because there is such a good screening marker for it.
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'If President Biden was getting that marker checked on a regular basis, it should have been picked up years ago,' Kim said.
Biden's office released a statement on his diagnosis and included that the cancer has metastasized to his bones, indicating it is an aggressive form of prostate cancer.
Kim tells us it is likely his doctors could have stopped testing for PSAs, or prostate specific antigens years ago.
'There is a guideline that says, in patients over the age of 70 we should discourage PSA,' Kim said. 'Especially over 75, PSA often times is abandoned. So that may have happened with President Biden in this case.'
PSAs indicate a disturbance in the body through a blood test. The normal flow of PSA gets disturbed and leaks into the bloodstream, causing a spike in the blood level. The harm in not testing for PSAs, blood tests would usually pick up the prostate cancer before it reaches a metastatic level. Kim tells us if little to no antigens are picked up, it could mean the prostate cancer is already in an aggressive state.
While it is not clear if Biden's doctors tested for PSAs, we know they identified a nodule on his prostate which led to his diagnosis. The physical exam is the second part of the common two-part screening.
After identifying the cancer, Kim says the pathologist will then give a Gleason score.
'So the Gleason score is actually addition of two areas, two largest areas of cancer that the pathologist finds and those would be added up,' he said.
They will grade the areas on a scale of one to five. One showing the cancer cell resembles a normal cell and five indicates it is completely abnormal and does not look like a regular cell.
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Kim says the lowest score you can get is a two and the highest score is a 10. Biden has a Gleason score of nine.
Normally, a Gleason score will help dictate the treatment course for the patient but in Biden's case, because it has metastasized his team will likely pursue the most aggressive form of treatment. Lower Gleason scores would require radiation whereas higher Gleason scores would require radiation and hormonal therapy.
For patients, Kim recommends getting in a screening routine with your primary care doctor. He says you want to get prostate screenings every other year starting around the age of 50 years old, unless you are high risk.
'Like an African-American man, I recommend to get checked at age 40 as a baseline,' Kim said.
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