“Highly likely” Joe Biden had prostate cancer diagnosis in the White House

How does metastatic prostate cancer “suddenly” appear in someone like Joe Biden?

It doesn’t appear overnight, it festers. In rare but dangerous cases, prostate cancer bypasses the usual slow growth and strikes fast, especially in older men. If he wasn’t screened regularly, or had an aggressive subtype that evaded PSA detection, it could have advanced under the radar. But how can we imagine that a President was not screened properly?

Prostate cancer is the easiest cancer to diagnose. The PSA blood test shows the rate of cancer cell growth. Even with the most aggressive form, it is a 5-7 year journey without treatment before it becomes metastatic. Meaning, it would be malpractice for this patient to show up and be first diagnosed with metastatic disease in May 2025. It is highly likely he was carrying a diagnosis of prostate cancer throughout his White House tenure and the American people were uninformed.

Should it have been caught earlier?

Yes. Localized prostate cancer is often curable. Once it escapes the capsule and spreads, we shift from cure to containment. A missed or delayed diagnosis is a critical failure point.

Is this rare?

About 10-15 percent of prostate cancers are diagnosed first at stage IV, when it is in the bones like this is. Among men over 80, especially those with inconsistent screening, it’s more common. Again, for a President of the United States to be diagnosed with metastatic prostate cancer is malpractice, in my opinion.

What is the modern treatment for metastatic prostate cancer, and what should patients expect in terms of side effects?

Today’s treatment for metastatic prostate cancer isn’t your grandfather’s medicine cabinet. It’s a high-tech playbook combining hormone suppression, precision radiation, smart drugs and sometimes immunotherapy. The first step usually shuts down testosterone, because this hormone fuels prostate cancer like gasoline on a fire. That’s done through drugs or injections called androgen deprivation therapy (ADT). Then, a second-line agent, think of it as a smarter missile, is added. Drugs like enzalutamide or abiraterone block the cancer’s ability to rewire itself and keep growing.

But this isn’t without cost. Common side effects include fatigue, hot flashes, weakened bones and a drop in sexual function. Some treatments can affect the liver or raise blood pressure. It’s a trade-off: extra years of life, but with closer medical supervision and adjustments along the way. Still, with today’s tools, many men live for years after diagnosis; active, engaged, and very much still in the fight.

Could political considerations, like running for re-election, have delayed treatment?

That’s the uncomfortable question. The 800-pound gorilla in the room. If early signs were dismissed or downplayed to maintain a campaign image, then yes, treatment could’ve been compromised. Every month matters with aggressive variants. Delaying biopsy, imaging, or therapy to protect political optics may have come at a steep biological price. This is speculation, of course.

The highest probability is that the diagnosis has been known for many years but a calculated decision was made to not announce it, not treat it, and hope after the re-election the treatment could be done when it was still a local disease. An unfortunate turn of events.