Doctor: There is treatment but no cure available for former President Biden's prostate cancer
Prostate cancer specialists said former US President Joe Biden's announcement that he has been diagnosed with an "aggressive form" of prostate cancer that has spread to his bones means the cancer is no longer curable, but there are treatments that can control it, possibly for years.
Dr. Chris George, the medical director of the cancer program for the Northwestern Health Network, said prostate cancer is no longer curable once it spreads to the bones but that there are treatments that can control it.
Biden, 82, was diagnosed on Friday after experiencing urinary symptoms, and he and his family are reviewing treatment options with doctors, according to the statement.
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00:03There's some things about this presentation that are that are worrisome.
00:09Number one is under under a microscope, the cancer cells appear to be aggressive.
00:14And the way they describe that is that there's a high Gleason score, a Gleason score of nine.
00:20It's on a scale up to 10. So a Gleason score of nine or a great group five.
00:24That's two ways of saying the same thing, which is the cancer cells appear to be aggressive.
00:29What what concerns me more than how the cancer cells look on our microscope is the fact that the cancer has been reported to have already spread beyond the prostate to the bones.
00:41And when the cancer has spread to the bones, that makes it stage four.
00:45That that means that the cancer is not curable. There's no treatment available that can cure the cancer.
00:52There's definitely treatment available that can control the cancer.
00:55There's really good treatment to control the cancer.
00:58And I would assume that the doctors caring for the former president are thinking that way right now.
01:04So so with prostate cancer, this metastasized to the bone, you could control it for years.
01:09Two or three years is very realistic.
01:11And some lucky patients get control for four, five, six and even longer.
01:16So I would assume that the president or former president gets a very thorough physical every year.
01:25One of the best screening tools that we have to detect cancer is called the PSA.
01:30That's a blood test that looks for cancer.
01:33I would be interested to know what his PSA was the last time it was checked.
01:39It's it's it's sort of hard for me to believe that he's had a PSA within the past year that was normal.
01:45It's possible. It's definitely possible.
01:48But that would surprise me.
01:50Usually prostate cancer doesn't, you know, go full throttle like this too often.
01:57When it when it does, that's usually a bad, bad sign.
02:00That's that's an aggressive cancer for sure.
02:02But it does seem odd when you lower that amount of testosterone, we call that androgen deprivation.
02:09It's very effective controlling the cancer.
02:11It almost always works.
02:14You can expect the patient to feel better, have a lower PSA.
02:17The scans look better.
02:18But what it doesn't do is cure the cancer.
02:20So at some point, that strategy will stop working and we can cross our fingers and hope that it works for many years.
02:27If we're unlucky, it might only work for six months, 12 months.
02:31But that would really be disappointing.
02:32Well, the cancer, it it might not be causing any symptoms right now.
02:38If it was, sometimes patients have weight loss, fatigue, bone pain, sometimes urinary symptoms sometimes.
02:44But it it might be asymptomatic.
02:48The treatment, the hormone therapy that I I'm pretty confident the president will get.
02:53It lowers the testosterone.
02:55And when that happens, it can cause hot flashes for sure.
03:00It can cause fatigue.
03:01It can affect your heart.
03:03It can affect the strength of your bones.
03:06Those side effects are likely in someone who may have some baseline frailty or baseline cognitive dysfunction.
03:13You know, I would worry that the hormone approach might make those symptoms a little bit worse.
03:18You know, the question I was expecting is whether this diagnosis might explain the president's decline over the last two or three years.
03:28And my belief is probably not.
03:30I don't think he had cancer the last two years.
03:34And that's why we saw physical decline on television.
03:37I think probably that happened from something else.
03:40And this cancer just happened to be diagnosed.
03:42For individuals that have metastatic prostate cancer, the five-year survival is about 37 percent.
03:50In individuals that we diagnose with low risk or average prostate cancer that's localized, that hasn't spread anywhere, that gets treated, it's close to 100 percent.
03:59In a lot of patients that get diagnosed with metastatic prostate cancer, the treatment usually starts the day of the diagnosis.
04:05So patients may start on their androgen deprivation therapy, which is pretty much like hormone castration.
04:13So we're trying to, like, slow down the cancer, which can be fed by hormones or testosterone.
04:18So the treatment starts there.
04:20And then as more evaluations are being given and as they see more specials, as we're expanding the team, more things may be added based on what that specific patient needs.
04:35So we're trying to, like, slow down the cancer.
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