Easily missed signs of prostate cancer every man must know - as Biden is diagnosed at deadly late stage of the disease

Daily Mail​

19-05-2025

Doctors are shocked that former President Joe Biden 's 'aggressive' form of prostate cancer was not caught earlier, given that he was already suffering from tell-tale symptoms.
The office of the 82-year-old announced his diagnosis on Sunday, stating that Biden was suffering from a highly aggressive form of prostate cancer, which has already spread to his bones.
The diagnosis came just days after doctors found a 'small nodule' on Biden's prostate following a physical exam after he complained of urinary problems—a sign that the cancer had already spread, according to Dr Marc Siegel.
The former president's cancer was give a Gleason score of 9, indicating a 'high grade cancer' that cannot be cured.
A Gleason score this high suggests that the cancer will spread rapidly and present more complications, with medical experts speculating that Biden would have known about the disease before it progressed to bone metastases.
In this case, a score of nine indicates doctors found two of the most aggressive cancer cells.
Dr Siegel, senior medical analyst at Fox News, said: 'Everybody knows in the medical community that this is the once cancer in men you really look out for'.
He added that even though Biden doesn't seem to have a lot of risk factors for the disease—his age puts him at increased risk.
'It is very unlikely that someone could get annual checkups and not notice', the doctor added.
While it is not uncommon for men over 80-years-old to be diagnosed with prostate cancer, the severity of Biden's cancer is 'more advanced than most men would encounter at diagnosis', Dr Ryan Cleary, urologist at MedStar Health, told the BBC.
What is prostate cancer?
Prostate cancer affects tissues of the prostate gland, part of the male reproductive system that is located between the penis and the bladder.
Biden was diagnosed with prostate cancer following urinary symptoms, one of the most common symptoms of the aggressive disease.
Whilst prostate cancer develops slowly, meaning there may not be signs for many years, urinary problems suggest that the prostate has become large enough to affect the urethra—the tube that carries urine from the bladder out of the penis.
When this happens, common symptoms include an increased need to urinates, straining while you pee and the feeling that the bladder has not fully emptied.
If prostate cancer has metastasised to the bones, it means that the cancer cells have detached form the original tumour and spread though the blood stream or lymphatic system to the bones.
Here, the cancer cells can form new tumours—resulting in significant bone pain and weakening the bones, increase the risk of fracture.
More than 52,000 men are diagnosed with prostate cancer every year on average in the UK
This condition can also cause the release of calcium from the bones into the blood stream which can lead to further complications.
Prostate cancer is the second-leading cause of death in American men, with 300,000 new cases likely to be diagnosed this year, according to the American Cancer Society.
Around one in eight men in the UK will be diagnosed with prostate cancer in their lifetime.
The easy-to-dismiss symptoms no man should ignore
Because prostate cancer, like other cancers, are best treated in earlier stages, experts say all adult men should be aware of changes that could be a sign of the disease.
Due to the prostate's location, it most commonly causes urinary symptoms. If a man notices these, its important to speak to a GP and discuss whether something called a PSA test might be warranted.
PSA stands for prostate specific antigen, a hormone that's produced by the prostate in higher amounts if there is a problem with the gland.
One of the most common signs something is wrong with the prostate is a change in urinary frequency.
While the amount people urinate can vary widely - anything between four and ten or so times can be seen as normal - it's a noticeable increase that experts say men need to be aware of.
Sudden urges - needing to rush to the loo - may also be a sign of a problem.
This could be coupled with difficulty in starting to pee, known medically as hesitancy.
Straining or taking a long time to empty the bladder, a weaker than normal flow and the feeling that the bladder has not fully emptied are also symptoms.
Blood in the urine or semen should also be checked out by a doctor without delay.
These symptoms generally do not mean a man has prostate cancer - more often than not, it could simply be a sign of benign prostate problems that affect more than half of men.
However they should be investigated by a GP and, if a cause cannot be found, a referral to an experienced urologist should be made.
Signs of advanced cancer that may have spread include bone and back pain, a loss of appetite and unexpected weight loss, fatigue and pain in the testicles.
The former was first diagnosed after doctors performed a biopsy after he was experiencing urinary issues. However, while advanced prostate cancer can cause urinary symptoms, it doesn't always.
In Biden's case, because the cancer is so aggressive in nature, at stage five, and has already spread to his bones, his treatment options are limited.
While there are medical based treatments such as chemotherapy and hormone therapy available, none of them are curative, doctors say.
Biden's cancer is said to be hormone sensitive, meaning that uses hormones to grow inside the body. In the statement released on Sunday, Biden's office said this allows for more effective treatment.
What you should if if you're worried
The NHS states that any man over the age of 50 can request a PSA test from the GP regardless of symptoms.
A PSA test alone can't diagnose prostate cancer - sexual activity, vigorous exercise, certain medications, urinary infections and benign prostate enlargement, all of which are very common, can raise PSA.
However coupled with symptoms it may warrant an examination of the prostate and possibly further testing.
For more information about prostate health visit Prostate Cancer UK.
If the cancer is caught early, and not causing symptoms, doctors may suggests an active surveillance approach.
Some cases of prostate cancer can be cured in the early stages, with treatment including surgically removing the prostate, and radiotherapy.
If the cancer spread to other parts of the body and cannot be cured, treatment is focused on prolonging life and relieving symptoms.
Advanced stages of prostate cancer, such as Biden's, can significantly limit a person's life expectancy and lead to symptoms that will affect daily life
PSA test are also available from private doctors and there are home tests available from pharmacists, costing from as little as £30.
Dr Jamin Vinod Brahmbhatt, a urologist at Orlando Health Medical Group, determines 10-165 years of function when looking at cancer treatments to treat this aggressive disease.
'If there's any inspiration in this, it is to go and get yourself checked out whether you have symptoms or not,' Dr Brahmbhatt told the BBC.