Prostate cancer experts say former President Joseph R. Biden's diagnosis is serious. Announced by his office on Sunday, but the cancer spread to his bones. And it is Stage 4, the most deadly stage for illness. It cannot be cured.
However, prostate cancer experts say the good news is that recent advances in prostate cancer diagnosis and treatment have changed what was once a very harsh picture for men with progressive disease, based primarily on studies sponsored by the National Institutes of Health and the Department of Defense.
“We've seen a lot of different ways to get into the world,” said Daniel W. Lynn, a prostate cancer expert at the University of Washington.
Dr. Judd Mull, a prostate cancer expert at Duke University, said that men with prostate cancer spreading in the bones can “live five, seven, ten or more” with current treatments. In the '80s, men like Biden could “want to die from natural causes, not from prostate cancer,” he said.
Biden's office said the former president had urinary symptoms, which led him to seek medical attention.
However, Dr. Lin said, “I don't think his symptoms were due to cancer.”
Instead, he said the most likely scenario was that doctors had tested, noticed nodule in Biden's prostate, performed blood tests, and prostate-specific antigen tests. PSA tests look for proteins released by cancer cells and can follow blood tests and MRIs that point to cancer.
At this moment, Biden and other patients developing a metastatic prostate cancer diagnosis are more fortunate than past patients. There are around ten new treatments for the disease, and they have changed the picture significantly.
The first line of attack is to block testosterone that is supplied to prostate cancer. When Dr. Muru began as a urologist in the 1980s, it was done by removing the male test circle. Today, men choose two drugs given in injections that prevent them from making testosterone, or pills that do the same thing.
However, those medicines alone are not enough. So your doctor will add one of three or four so-called androgen blockers that block testosterone.
Some men are receiving additional treatment with chemotherapy or radiation, depending on the amount of bone cancer that the cancer is likely to progress.
There were also improvements in the diagnosis.
Until recently, doctors determined the amount of cancer in the bones on scans looking for inflammation. Now they have a more accurate scan called the Prostate-Specific Membrane Antigen (PSMA) PET scan. Use a radioactive tracer that adheres to markers on the surface of prostate cells. Doctors can detect cancer much faster. In other words, men with prostate cancer cells in their bones often have a much better prognosis than men who had a bone scan just a few years ago.
Finally, there are medications that block testosterone, and other medications that can be used to quell cancer if chemotherapy and radiation therapy stop working.
Dr. Lynn noted that infusions of federal research funding, along with Biden's efforts to moonshot cancer, led to this advancement. Biden was “one of the first presidents to put cancer at the forefront,” he said.
Regarding Dr. Muru, he said that men regularly see the age of stage 4 prostate cancer in men, and are now more optimistic than ever.
“There are even more tools in the toolbox,” Dr. Moul said. “The survival rate has almost tripled over the last decade. We can't estimate how much change has happened.”
