This can be missed

The news was broken yesterday: Former President Joe Biden suffered from prostate cancer. Kirsten Greene, MD, a prostate cancer expert at Uva Health, said his friends and family had called and sent an SMS to him all night. “Everyone wants to know, ‘What does that mean?’ ‘How can this happen?’ ‘How long will he live? ”

Greene also has questions. How is Biden, 82, only one year outside the office, has an aggressive form of prostate cancer and metastasis? Yes, prostate cancer is one of the most common cancers in men: 1 in 8 men will have it during their lives. But lately, most of the prostate cancer was caught 10 to 15 years before any symptoms began. How can this be missed?

Greene has two theories about what might cause prostate cancer of Biden.

Theory #1: Biden stops getting playback at the recommended age

According to Greene, “Prostate cancer screening usually stops around the age of 75, following the recommendations of the US Prevention Services Task Force. At that time, we were involved in making decisions together with patients, discussing the risks and benefits of regular playback.”

If Biden has a lower PSA level than the lower when he is 75-around 6 or 7 years ago it makes sense for him to decide with his doctor to stop being filtered. If so, Greene said, “It could be that prostate cancer grows and is realized, without being known, over time,” after the screening was stopped.

Theory #2: This prostate cancer flew under radar screening

Another possibility, said Greene, is very rare. “He could be screening, but the level of his PSA is below the alarming threshold. Very impossible, but that can happen.”

To understand this scenario, we must reserve a little to understand the prostate gland and PSA itself.

What is PSA & how does it have to do with cancer?

Prostate cells make prostate specific antigens, or PSA, as a normal part of their function. That’s normal. This enzyme, or chemical, breaks other molecules to melt and clean sperm after ejaculation.

In the late 1980s, said Greene, researchers found that too many of these chemicals could show problems. Urologists began to test male blood for the high level of PSA in the 1990s.

What does PSA mean high?

“Increasing PSA – above the threshold 4.0 – not always cancer,” Greene said. “For example, men can have a larger prostate. A very large prostate produces more PSA.”

Other causes include infection, inflammation, and trauma (such as biopsy). All of this can “cause cell changes or cell disturbances, making a little prostate cell explode,” he said. This floods your bloodstream with PSA.

Cancer cells usually do this too, making PSA tests an effective way to filter prostate cancer.

Who brought us back to Greene’s 2^Nd theory. If the cancer causes a high level of PSA, and Biden still gets a PSA test, how could the doctor skip the cancer?

Prostate cells that lose their memories

Greene explained. “While most of the prostate cancer produces high levels of PSA, some cancers are very aggressive so that abnormal prostate cells forget how to make PSA at all. The PSA may not be high at all.” He noted that neuroendocrine prostate cancer also caused cells to lose the ability to make PSA.

“So this is the warning,” Greene said. “PSA is not a perfect test.”

However, this kind of aggressive prostate cancer is still very rare. PSA playback captures most of prostate cancer and saves lives.

Whatever the reason for this late diagnosis, “it is very sad and unfavorable that he was caught at this time,” said Greene, revealed the sentiments we saw on the news.

How bad is Biden prostate cancer?

We know 3 things from this first headline. Biden prostate cancer:

• Has a gleason score 9
• Expanded to his bones, or metastasized
• Sensitive to hormones

What do you say about the diagnosis?

Gleason score

The doctor uses the Gleason Assessment System to determine the numbers for the prostate cell sample they have deleted (biopsied). The amount reflects how much cancer cells vary from healthy cells. A higher amount means a greater difference between cancer and non -cancer cells. The greater the difference, the faster the cancer will grow.

Prostate cancer that grows slowly and does not threaten to get a Gleason 6 score, which is as low as possible. The fastest and most dangerous cancer gets the highest score of 10. Gleason Biden score is 9, making it only one point by being the worst.

Metastasis

When cancer is called metastasis, it means cancer cells that begin in one organ or tissue have spread to another part of the body. Metastasis cancer is usually more difficult to treat for a number of reasons.

“Bone glands and lymphs are the most common place to spread prostate cancer,” Greene said.

Hormone-sensitive

Prostate cancer often develops before testosterone, Greene explained. Doctor Biden noted that he was sensitive to hormones, which could make the treatment results very profitable.

That’s because the first medical line for every prostate cancer is the therapy of androgen deficiency, or ADT. “ADT deceives the body to kill testosterone production. This will often stop cancer completely, slowing down dramatically, for years.” Greene added that many formulations and combinations of drugs related to this hormone, and there is nothing that does not have “medical castation,” because they are not permanent.

Of course, there is no cure for prostate cancer. ADT only serves for a while. Greene said, “All prostate cancer will get the ability to grow in a testosterone -free environment.”

A large number of cancer treatment options

While most of the numbers attached to the diagnosis of biden sounded quite scary, Greene remains optimistic. “There are so many treatments available,” he convinced.

After ADT, he said, came chemotherapy. “If the chemo doesn’t work, there is Pluvicto, a radioactive molecule. Or Prresen, a vaccine made with your own body white blood cells.”

Greene is even positive about the prospects for treating cancer that grows into bone bones. “There is extraordinary radiation,” he said. “Fantastic targeting. There are even genetic tests that can help doctors adjust treatment for specific genetic changes that cause cancer.”

Reason to keep hoping about biden prostate cancer

“People have lived for years with this,” Greene said. “This is not like the brain cancer of the McCain senator.” Also not like Putra Biden himself, Beau, who died of brain cancer.

As for the ability of Biden to undergo one of this treatment, Greene said the best medicine at this time began with a conversation. “The key to all of this is joint decision making,” he said. “Discussion is about whether they will extend the length of life or improve the quality of life. We ask, ‘How can we treat your cancer in a way that is consistent with how you want to live?'”

Finally, Greene noted that some of the questions he asked so far returned to the famous 2024 Presidential Debate. Biden’s clumsy performance makes many people ask questions if he is too old to run for president. Finally Biden came out of the race.

With this prostate cancer diagnosis, some people ask Greene whether he thinks that Biden might have cancer during debate. Maybe the cancer has metastasized to his brain? Can that explain how bad he is?

“It’s not something we know,” Greene said. “But maybe not. Brain metastasis is really unusual with prostate cancer.”