It’s highly unlikely Biden didn’t already know he had cancer: Doctor

Should the American public automatically believe that former President Biden did not know until now that he has a life-threatening aggressive metastatic to bone prostate cancer?

No.

Especially since the Biden White House and medical team were hiding his cognitive decline and obscuring it in glowing physical reports throughout his term, until it became painfully apparent during his debate against President Trump, and on the just released tapes with special councel Robert Hur.

We’ve been given no reason to believe anything said about Biden’s health.

Prostate cancer does not occur overnight, and proper screening with yearly Prostate Specific Antigen tests and a digital rectal exam should pick it up the vast majority of the time. A medical team as advanced as those who treat the US president also would use advanced MRI imaging and targeted biopsy when indicated.

There are also newer personalized screening approaches that are emerging, including genetic testing, liquid biopsy, urine-based biomarker tests and the use of artificial intelligence.

Keep in mind that 80% of men over 80 years old have some amount of prostate cancer cells. Though the American Urological Association and the US Preventive Services Task Force don’t recommend routine PSA screening in men over the age of 70, I believe they are wrong.

Could it be that the president didn’t have even a PSA during his yearly physical? That would be disturbing, and difficult to believe.

The test is not pointless. With today’s advanced treatments, from robotic prostatectomy to targeted radiation to advances in hormone treatments, there is no reason not to know that an 82-year-old president has prostate cancer these days, or anyone for that matter.

Further, since prostate cancer spreads first to lymph nodes and then to the bone, a patient who isn’t effectively screened could first present this way. His doctors would have seen obstructive urinary problems as the cancer advanced. Even if a PSA test wasn’t taken, it’s unlikely Biden showed no symptoms.

We are making a lot of progress in terms of treatment and most men who are diagnosed with prostate cancer don’t die from it.

Unfortunately, when the cancer is as aggressive as Biden’s, and metastatic, the chance of living five years is under 40%.

It is worth considering that it is possible he could have undergone initial treatments (perhaps targeted radiation) and is now facing a treatment failure necessitating systemic therapy.

If this is true, it would be a public service to admit it in the name of increasing prostate cancer awareness where early detection is key to an effective response. Either way, Biden’s advanced prostate cancer is a wake up call for early cancer screening no matter what the patient’s age.

The health of the US president has traditionally been shrouded in secrecy and obfuscation, from Woodrow Wilson’s Spanish Flu and stroke to FDR’s heart failure to Eisenhower’s heart attacks. We need more transparency, not less.

President Biden is a tough fighter, he has already lost his son Beau to cancer, and we wish him well in his own cancer fight for his life.

But questioning when Biden and his team knew when he had cancer is not in bad taste, nor unwarranted. Americans should know what challenges a president faces. It’s become increasingly clear Biden and his team hid many if not all of them.

Marc Siegel, MD, is a clinical professor of medicine and medical director of Doctor Radio at NYU Langone Health and a Fox News medical analyst.