Biden's Cancer renews debate about

Biden’s Cancer Diagnosis Renews Debate Over Prostate Screenings for Older Men

Name: Md. Masaud Bin Quader

In May 2025, the White House confirmed that former President Joe Biden had been diagnosed with advanced, stage 4 metastatic prostate cancer, a development that stunned the nation and reverberated through both political and medical communities. At 82 years old, Biden's diagnosis has not only raised questions about presidential transparency and fitness but also reignited a contentious and long-standing debate: Should older men continue to undergo routine screening for prostate cancer?

A Shocking Diagnosis

President Biden’s condition was discovered after he reported urinary symptoms that prompted further medical investigation. The diagnosis revealed a Gleason score of 9, which signals a highly aggressive and fast-growing form of prostate cancer. By the time it was detected, the cancer had already metastasized to his bones, making it incurable but potentially manageable through hormone therapy, chemotherapy, and other advanced treatments.

What surprised many in the medical field was not just the severity of the cancer—but how late it was diagnosed. Dr. Marc Siegel, professor of medicine at NYU Langone Health, remarked, “It’s highly unlikely that this kind of cancer developed overnight. In a man receiving regular checkups, it raises questions about whether proper screenings were missed—or even withheld from the public.”

Some experts speculate that Biden may have had elevated PSA (prostate-specific antigen) levels years before, a red flag that is often the first signal of prostate abnormalities. If so, it is unclear whether this information was overlooked or intentionally left out of public health summaries.

What is PSA and Why is It Controversial?

The PSA test is a blood test that measures the level of prostate-specific antigen, a protein produced by both normal and cancerous prostate cells. While elevated PSA levels can indicate cancer, they can also be caused by noncancerous conditions like prostatitis or an enlarged prostate. As a result, the test has a high rate of false positives, leading to unnecessary biopsies, anxiety, and in many cases, overtreatment.

To address these concerns, the U.S. Preventive Services Task Force (USPSTF) currently recommends against routine PSA screening for men over age 70, citing that the harms of testing—such as side effects from surgery or radiation—may outweigh the benefits for this age group. This guideline was first adopted in 2012 and reaffirmed with some adjustments in 2018.

However, critics argue that the one-size-fits-all nature of these recommendations may fail older individuals who are otherwise healthy and have longer life expectancies. Biden, for example, was known to be physically active and mentally engaged well into his 80s.

When Guidelines Meet Reality

President Biden's diagnosis brings a real-world lens to the debate. Should men in their 70s or 80s be excluded from cancer screenings simply because of their age? Or should decisions be based on individual health profiles?

Dr. Elizabeth Kavaler, a New York-based urologist, commented in an interview with ABC News, “It’s a tragic irony. We design guidelines to prevent over-intervention in patients with slow-growing cancers, but we risk missing aggressive cases like this.”

Many experts suggest revising existing policies to promote personalized screening protocols. For example:

Men over 70 in good health should be allowed and encouraged to continue PSA testing.

Those with a family history of prostate cancer or African-American men—who face higher risks—should be monitored more closely.

Doctors and patients should engage in shared decision-making rather than blindly following age-based cutoffs.

Public Reaction and Political Implications

Beyond the health implications, Biden’s diagnosis has stirred political controversy. Former President Donald Trump and others have questioned whether Biden’s health disclosures were transparent during his time in office. “Did he know about it while serving? Was there a cover-up?” Trump asked at a rally shortly after the announcement.

The lack of PSA test results in Biden’s publicly released medical records now appears more glaring in hindsight. White House officials insist that the cancer was diagnosed only recently and that Biden had been asymptomatic until a few months ago.

Still, the controversy is feeding a growing demand for more robust health disclosures from elected leaders, especially as life expectancy increases and older individuals remain active in public life.

Understanding Prostate Cancer in the U.S.

Prostate cancer is one of the most common cancers among men in the United States. According to the American Cancer Society:

About 1 in 8 men will be diagnosed with prostate cancer during their lifetime.

It is the second leading cause of cancer death among American men, after lung cancer.

Age is a major risk factor—most cases occur in men over 65, and the average age at diagnosis is 66.

However, not all prostate cancers are deadly. Many grow slowly and may never pose a threat to a man's health, which is why distinguishing aggressive from indolent cancers remains a major challenge in urology.

Balancing the Risks and Benefits

The dilemma around prostate cancer screening can be summed up as a trade-off between two risks:

Overdiagnosis and overtreatment: Finding and treating low-risk cancers that would not have harmed the patient.

Missed diagnosis: Failing to detect an aggressive cancer in time to provide effective treatment.

The Biden case illustrates the consequences of leaning too far toward the first concern. By prioritizing the avoidance of overdiagnosis, healthcare systems may risk missing dangerous cancers in otherwise viable, elderly patients.

“We need better diagnostic tools,” said Dr. Judd Moul, a prostate cancer specialist at Duke University. “PSA isn’t perfect, but it’s the best we’ve got right now. Ignoring it based on age alone is dangerous.”

Moving Forward: A Call for Reform

Biden’s diagnosis could act as a catalyst for reevaluating prostate screening policies. Medical associations such as the American Urological Association (AUA) have already advocated for more flexible guidelines, recommending that men in good health—even into their 70s—should not be excluded from screening automatically.

Technology may also offer a way forward. Advances in MRI diagnostics, genetic testing, and AI-assisted imaging are making it easier to distinguish between slow-growing and dangerous tumors, potentially reducing the risk of overtreatment.

Public awareness is another crucial factor. Men over 60, especially those with risk factors, should be informed of the pros and cons of screening and empowered to make decisions alongside their doctors.

Conclusion

Joe Biden’s prostate cancer diagnosis is more than a personal health event—it is a national wake-up call. It underscores the importance of early detection, individualized care, and greater transparency in healthcare decision-making, especially for older adults.

As policymakers, medical professionals, and patients reflect on this moment, the conversation about prostate cancer screening must evolve. Age should be a factor, but not the sole determinant. Biden’s case may be the catalyst that finally moves us toward smarter, more compassionate cancer screening for all men—regardless of age.