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Former President Joe Biden is battling “aggressive” prostate cancer after doctors found a “small nodule” on his prostate during a routine medical exam.
Prostate cancer is one of the most common cancers diagnosed in men, with about 310,000 new cases and 35,000 deaths occurring in the US each year.
The prostate gland is a vital part of the male reproductive system, producing fluid that makes up semen. The gland surrounds the urethra, a tube that carries urine and semen out of the body.
Experts generally recommend that men at average risk start getting prostate exams around age 55. Those with a family history of prostate cancer may need to begin screening earlier.
A standard prostate screening typically involves a digital rectal exam and a test measuring the level of prostate-specific antigen (PSA) in the blood.
The American Urological Association and other organizations generally advise against routine screening in men over 70 because of the increased risk of overdiagnosis.
Biden, 82, had experienced “increasing urinary symptoms,” according to his office.
That’s one of the main symptoms of prostate cancer — here are three others to watch for.
Urinary changes
People with early-stage prostate cancer may not notice anything wrong. Symptoms typically arise as the tumor grows or the cancer spreads.
Tumors in the prostate can obstruct the urethra or cause prostate enlargement, leading to difficulty starting or stopping urination, frequent urination or a weak flow.
An enlarged prostate can also weaken the bladder muscles and prevent the bladder from fully emptying.
Pain and discomfort
Prostate cancer can cause pain or burning during urination or ejaculation because of the urethra obstruction.
Cancer that has spread to the bone, as in Biden’s case, can manifest as a dull ache or stabbing sensation.
An enlarged prostate can sometimes cause pain while sitting for a long time.
Erectile dysfunction
In advanced stages, the tumor can press on or invade the nerves and blood vessels crucial for achieving and maintaining erections.
Erectile dysfunction is also a common side effect of prostate cancer surgery because nerves are often damaged or cut.
Blood in semen
A prostate tumor may irritate the urethra, causing blood in the urine or semen.
What is a Gleason score?
Biden’s cancer was given a Gleason score of 9.
A Gleason score is calculated by examining the two most prevalent patterns of cancer cells in a prostate biopsy.
Each pattern is assigned a grade from 3 to 5 based on its level of disorganization and aggressiveness. The two numbers are added together, resulting in a Gleason score from 6 to 10.
A Gleason score of 9 means the cancer is made up almost entirely of highly abnormal, aggressive cells. It’s considered high-risk and often requires a combination of treatments to manage effectively.
Treatment options
Prostate cancer treatment depends on the stage of the disease, as well as the patient’s overall health.
Early stages may involve surveillance without treatment. When intervention is needed, common options include surgery — such as radical prostatectomy to remove the prostate gland — radiation therapy and hormone therapy to reduce the levels of testosterone that fuel cancer growth.
Advanced or metastatic prostate cancer may require chemotherapy or immunotherapy. Often, treatment plans rely on several approaches to maximize effectiveness while managing side effects.
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