Former President Joezuf Biden has what a spokesman describes in his prostate as a “small nodule.” The extent to which patients should worry about such findings depends on the situation, the urologist said.
In some cases, nodules are caused by inflammation. This can lead to a more stiff prostate or calcification. These are benign.
It can also result from nodular benign prostatic hypertrophy, a common condition in older men. This prostatic hypertrophy involves the formation of a threatless nodule in the prostate and expanding it. These do not pose any risk either.
But at worst, they can lead to cancer.
Dr. Scott Edger, a urologist at the University of Chicago, said when a urologist feels nodule in a man's prostate, it is not always clear what to make.
“There's absolutely when it's vague and vague and you don't know what it is,” he says, adding that growth might feel like “a big bulky rock that's almost certainly cancer.”
But Dr. Eggener said he wondered why doctors were manually examining Biden's prostate in the first place. Perhaps he had new symptoms like urinary problems, pain, or increased levels of prostate-specific antigens, or blood proteins that increase levels with prostate cancer.
If the exam is part of a routine screening, it violates guidelines issued by professional organizations opposed to Biden's age's prostate screening, unless they are in an unusually healthy state.
That's because prostate cancer tends to grow slowly, if any, and is very common at Biden's age, Dr. Egner said.
“At least 50% of his age has cancer in his prostate,” Dr. Eggener said. “The overwhelming majority are better not to know about it.” They may not die of slow-growing cancer. They may not have symptoms and may not be threatened with their lives.
Dr. Judd Mull, a urologist at Duke University, said screening men of male age is “very controversial.”
But he's been screened, so “I think it's the water under the bridge at this point,” Dr. Muru said. “Someone did a digital rectal test and found what they deemed abnormal.”
Now the question is how to evaluate the findings.
One of the usual methods is to do a PSA test. Alternatively, they could have had a new urine test to look for cancer genetic signals.
The doctor was able to examine Biden's prostate using an MRI or ultrasound.
“In the end, if they think this nodule is prostate cancer, the final step is a biopsy,” Dr. Muru said.
And if it's cancer, Biden will face a difficult decision on whether to treat it or not.
“When you're facing an elderly gentleman with prostate nodule or other health issues, simply watching it can be appropriate,” Dr. Muru said.
Dr. Moul said he will first discuss long-term patients like Biden about what this will lead to before moving on to the testing path. If a patient is found to have prostate cancer, they should decide whether to seek treatment.
“I will try to make a decision shared with him before moving on to further testing,” Dr. Muru said.
A Biden spokesman said he spent time at Philadelphia Hospital on Friday and received additional reviews.
