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Fox News
20-05-2025
- Health
- Fox News
Biden's prostate cancer is ‘hormone-resistant' — doctors break down what that means
Joe Biden's recent diagnosis of "aggressive" prostate cancer has sparked concerns about how far the disease has advanced. The former president's prostate cancer has been characterized by a Gleason score of 9 (grade group 5) with "metastasis to the bone." The score of 9 indicates "high-grade" prostate cancer with very abnormal cells that are likely to grow quickly, experts say. "While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive, which allows for effective management," the statement said. "The president and his family are reviewing treatment options with his physicians." The fact that Biden's cancer has been classified as "hormone-sensitive" means it could be more responsive to hormone therapies, and thus more treatable. Hormone-sensitive prostate cancer needs androgens (male hormones) to grow, according to the National Cancer Institute. When those androgens are reduced or blocked, the cancer stops growing. Dr. Marc Siegel, clinical professor of medicine at NYU Langone Health and Fox News senior medical analyst, said the hormone-sensitive designation doesn't necessarily mean Biden has already been taking hormone therapies, which is unknown. "You can tell under a microscope if this is the type of cancer that could respond to hormone therapy, but no matter what it looks like, you don't know until you try it," he told Fox News Digital. "And sometimes it looks like there will be an effect, but it ends up being resistant to therapy." Prostate cancer has long been known to feed on the male hormone testosterone, according to Dr. Bilal Siddiqui, M.D., a medical oncologist and prostate cancer researcher at The University of Texas MD Anderson Cancer Center. "The overwhelming majority of prostate cancers — 99% plus — are hormone-sensitive and dependent on testosterone in the beginning," he told Fox News Digital. "I would say it's a very reasonable assumption [of hormone sensitivity], but we would know definitively once hormone therapy has started." "The overwhelming majority of prostate cancers are hormone-sensitive and dependent on testosterone in the beginning." The backbone of treatment for any metastatic prostate cancer is "androgen deprivation therapy," which is geared toward decreasing the body's level of testosterone. "Typically, when you start the androgen deprivation therapy, testosterone levels will decrease and the PSA levels will decrease along with it, and that's your definitive proof that the cancer is hormone-sensitive," Siddiqui said. Historically, androgen (hormone) deprivation therapy was done surgically through removal of the testes — but today's typical methods include pills or injections, according to the oncologist. "That eliminates about 80 to 85% of the testosterone that's produced in the body," he said. In many cases, doctors may add other drugs to block testosterone from secondary sources in the body, such as the adrenal glands that sit above the kidneys. North Carolina family physician Dr. Alexa Mieses Malchuk reiterated that prostate cancer that shrinks or slows in progression after blocking testosterone qualifies as hormone-sensitive. "This means that it grows or shrinks in relation to how much androgen or testosterone is circulating in the body," she told Fox News Digital. "If you suppress testosterone and the cancer does not shrink and continues to grow or spread, then the cancer is independent of the amount of hormone circulating in the body." There are a number of different ways to monitor disease progression, but it's most commonly done by a combination of PSA blood tests and imaging studies, the doctor noted. Eventually, metastatic prostate cancer will progress to become hormone-resistant, which means it no longer responds to hormone therapy, according to Siddiqui. "It can vary in how long it takes to get to that point," the oncologist said. "It's usually a couple of years before it evolves from hormone-sensitive to hormone-resistant." The "ultimate test" of whether cancer has become hormone-resistant is to lower testosterone levels and observe where the cancer goes, he noted. "It's usually a couple of years before it evolves from hormone-sensitive to hormone-resistant." There may also signs of the disease getting worse. "That might mean a rising PSA (prostate-specific antigen) test, new pain or symptoms, or new tumors that show up on the scan," Siddiqui told Fox News Digital. The U.S. Preventive Services Task Force states that men aged 55 to 69 years should have the option to undergo periodic prostate-specific antigen (PSA)-based screening to monitor for prostate cancer. "Before deciding whether to be screened, men should have an opportunity to discuss the potential benefits and harms of screening with their clinician and to incorporate their values and preferences in the decision," the USPSTF states. Siegel questioned this guidance to skip screening for older men. For more Health articles, visit "I don't agree with guidelines to not test over 70 years of age, especially with so many treatments to offer for prostate cancer," he said. In addition to hormone therapy, some men may be candidates for robotic prostate surgery, chemotherapy and radiation, Siegel added.
The Sun
19-05-2025
- Health
- The Sun
Top medics ‘taken aback' by how advanced Biden's ‘aggressive' cancer is – as potential treatment next-steps are revealed
TOP medics have said they are shocked that Joe Biden's "aggressive" cancer was not picked up earlier and allowed to advance so far. Physicians also revealed some of the potential treatment options ahead of the former president, 82, who is likely to suffer "bone pain". 7 7 7 Biden's office confirmed he had advanced-stage prostate cancer which has spread to his bones after a lump was discovered during an examination. His case is rated with a Gleason score of 9 and Grade Group 5, which "represents a more aggressive form of the disease". Dr Marc Siegel, senior medical analyst for Fox News, told the channel: "It's the most aggressive type. That means it has the highest risk of spread - which obviously he has had. 'This was found by physical examination by a prostate exam. A lot of times we find an elevation in prostate-specific antigen, PSA, and then we go after it." Seigel explained that he tests all of his male patients over the age of 45 for the disease - and is surprised Biden was not diagnosed this way. Seigel said: "He must have had the best possible care here. I'm a little taken aback that it's this far advanced. "It would be really surprising if they weren't doing a very close screening on this because everybody knows in the medical community that this is the once cancer in men you really look out for." Doctors only performed a biopsy on Biden after noticing symptoms in his urine - which display when the cancer is relatively advanced. The medic also explained that Biden's doctors will likely treat him with hormone therapy, but may also try to use radiation against the lesion on the bone or remove the prostate altogether. He said it is "not uncommon" to "do more than one therapy". Joe Biden diagnosed with 'aggressive' form of prostate cancer Dr Howie Forman, a professor of radiology at Yale, was also shocked that Biden's disease had not been picked up by routine blood tests. He said: "It is inconceivable that this was not being followed before he left the Presidency." Forman said that the test for specific prostate antigens would have shown the cancer "for some time before this diagnosis" - so it could have been picked up earlier. He noted Biden "must have had a PSA test numerous times before", and concluded: "It's just so odd to discover this with bone [metastasis] in a man of his stature and [with his] access to care." Similarly, on News Nation, urologist Dr David Shusterman said it is "unheard of" for cancer to develop with far without it being picked up. He said: "It's very unlikely that someone could get annual checkups and not notice," - particularly true for Biden who had "state-of-the-art care". He continued: "It's unusual to hear that someone has prostate cancer when they're annually being followed up. The fact that we find it at a Gleason 9 is unheard of." Shusterman also suggested Biden "most likely had it for a long time", and that there is "definitely evidence that he knew about this for a while". 7 7 Some have even claimed a deliberate cover up is at play. Dr Steven Quay wrote online: "It is highly likely he was carrying a diagnosis of prostate cancer throughout his White House tenure and the American people were uninformed." He explained prostate cancer is the "easiest [...] to diagnose when it first starts and to watch it progress to bone metastases". "For even with the most aggressive form, it is a five to seven year journey without treatment before it becomes metastatic," he said. Pushing the point home, Quay said it would amount to "malpractice for this patient to show up and first be diagnosed with metastatic disease in May 2025". Donald Trump Jr joined also suggested the Bidens could have willfully held back the diagnosis. He wrote: "How did Dr Jill Biden miss state five metastatic cancer or is this yet another cover-up?" The former first lady is not a medical doctor. His father, President Trump, was more restrained, sticking to a simple well-wishing message. He took to Truth Social to say: "Melania and I are saddened to hear about Joe Biden's recent medical diagnosis. "We extend our warmest and best wishes to Jill and the family, and we wish Joe a fast and successful recovery." 7 7 Other tributes have poured in for the former president since the announcement, with Republicans and Democrats alike wishing Biden well. Former President Barack Obama said he and Michelle were thinking of the entire Biden family. He said: "Nobody has done more to find breakthrough treatments for cancer in all its forms than Joe, and I am certain he will fight this challenge with his trademark resolve and grace. We pray for a fast and full recovery." Biden's Vice President Kamala Harris said: "Joe is a fighter — and I know he will face this challenge with the same strength, resilience, and optimism that have always defined his life and leadership. "We are hopeful for a full and speedy recovery." Seigel explained that if the cancer is caught early while it's still localized to the prostate gland, it's curable 'most of the time". He said: 'The goal is to get it before it leaves the prostate [...] When it's left the prostate", as Biden's has, "it becomes much more difficult to cure".
Daily Mail
19-05-2025
- Health
- Daily Mail
Easily missed signs of prostate cancer every man must know - as Biden is diagnosed at deadly late stage of the disease
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.
