News of former President Joe Biden’s advanced prostate cancer didn’t just spark concern — it left many in the medical field, including myself, with serious questions.
After decades as a board-certified urologist, I’ve seen firsthand what this kind of diagnosis can mean for patients and their families.
It’s heartbreaking, life-altering, and understandably private.
But when the subject is a former President of the United States, and the details don’t quite add up, it’s hard not to take a closer look.
How Could an Aggressive Cancer Go Undetected?
According to the statement released by Biden’s office, a routine physical led doctors to discover a small nodule on his prostate.
That turned out to be an “aggressive form” of cancer that had already spread to his bones.
But here’s where it gets complicated — this kind of widespread progression typically takes years to develop, not weeks or months.
Which raises a critical question: How could this have gone unnoticed?
I’ve never evaluated President Biden and, of course, respect his right to privacy.
But since his diagnosis is now public, I feel compelled to speak honestly as a medical professional.
It seems highly unlikely that this cancer was only just discovered, especially given the pace at which it has spread.
Medical Records Don’t Match the Timeline
The last time Biden released a public health report was in February 2024, and there was no mention of a routine prostate screening.
Interestingly, five years before that, his doctor noted that he had an enlarged prostate but explicitly stated he’d never had prostate cancer.
Now, suddenly, we’re being told he has a Gleason score of nine — nearly the highest possible score for prostate cancer, indicating an extremely aggressive and fast-moving disease.
In my experience, even in men who skip checkups, cancer of this magnitude doesn’t appear overnight. It develops gradually.
Which leads to a puzzling inconsistency in the timeline.
Why Weren’t Screenings Performed Earlier?
Screening for prostate cancer is routine — especially for someone in their 70s or 80s.
We typically begin PSA testing around age 50, and even in patients up to 80, these screenings are commonly done.
For someone like Biden, who has had access to world-class healthcare for decades as a senator, vice president, and president, it’s hard to believe that such critical testing would be skipped.
While it’s true that guidelines from the U.S. Preventive Services Task Force don’t recommend PSA testing after age 70 due to the risks of overdiagnosis, exceptions are often made — especially for high-profile individuals.
After all, the President’s health is a matter of national interest.
Could Biden Have Hidden a Previous Diagnosis?
There’s another possibility that can’t be ignored: maybe President Biden had already received some form of treatment for this cancer in the past and chose to keep it private.
If that’s the case, and the treatment stopped working — which can happen after a few years — that would explain the current situation.
His office did say that the cancer “appears to be hormone-sensitive,” which suggests he may be receiving hormone therapy like Lupron.
This kind of medication reduces testosterone levels and slows cancer growth — but it usually stops being effective after about two years.
Mobility Issues May Have Been a Red Flag
If Biden’s diagnosis is as severe as reported, it may also explain some of the mobility issues we’ve seen over the past few years.
Advanced prostate cancer can spread to the bones, causing weakness and pain.
If the condition had been progressing quietly, it’s not out of the question that it contributed to his difficulty walking and increased frailty.
Tragically, when prostate cancer reaches this level of advancement, the five-year survival rate drops to between 30 and 40 percent.
A Hard Truth with an Important Takeaway
Whatever the real story is behind the former president’s diagnosis, one thing is certain — this is an incredibly sad and serious situation.
Whether the cancer went unnoticed, untreated, or unspoken, the impact is profound not just for Biden and his family, but also for the public.
But if there’s one silver lining here, it’s this: every man should take prostate cancer screening seriously.
Caught early, it’s highly treatable. Ignored or missed, it can become a silent killer.