That PSA test that didn’t happen
I hate to belabor this point about Biden and his lack of a PSA test, but I find I need to make a couple more things clear.
Just as I had speculated, it turns out that Biden hadn’t had a PSA test in many years – since 2014, actually. So many people are shocked by this, but in fact he was simply following current guidelines.
And the advice not to have the test after the age of 70 – something I wrote about in 2011 – isn’t some craziness. Although I personally would suggest that older men have them anyway, that’s not necessarily the best idea and there are valid reasons to disagree. Having the test when very elderly is a gamble, because it is not at all certain that the test saves lives in terms of outcomes, and the interventions put men through a lot. And by “a lot” I mean a high incidence of serious urinary pain and/or incontinence, bowel and rectal injuries, infections from the biopsy process, impotence, and cognitive problems from the hormone therapy.
It’s a sobering situation and a grueling treatment at that age, and it had better be worth it in terms of added years of quality life. Is it worth it? Difficult to predict, but here’s a lengthy article on the pros and cons. The situation is complicated, as you might imagine. A few key excerpts (from 2010, but it’s not all that different today, from what I’ve learned according to the several older men I know with prostate cancer):
Although advanced age alone should not preclude effective treatment for prostate cancer, it is necessary to assess the risks and benefits of treatment in each patient to avoid interventions that might decrease health-related quality of life (HRQL) without prolonging survival. …
Life-expectancy is a major determinant of the potential for benefit from therapy beyond palliative care, yet it varies substantially between individuals within a given age group. Life-expectancy estimates apply to a population and represent a useful tool for public healthcare, but are not valid for a given individual. For example, 75-year-old men are expected to live for a further 8.3 years (median), but 25% (the upper quartile; likely to represent healthy individuals) will live for at least 14.2 years, whereas another 25% (the lower quartile; likely to represent frail individuals with significant comorbid conditions) will live for 4.9 years. Thus, although it is not possible to calculate the exact chance of survival for an individual, variables such as the number and severity of comorbidities and the extent of functional impairment can be used to predict the chance of surviving within an age group. Hence, it has been shown by Tewari et al. that comorbidity evaluated by the Charlson index was the strongest predictor of death from other than prostate cancer in men with localized prostate cancer treated with radical prostatectomy (RP). Age was also a significant predictor of outcome, although to a lesser extent than comorbidity …
Health status influences patient survival and might affect the ability to tolerate treatment-related side-effects. …
The benefits and harms of ADT [androgen deprivation therapy – in other words, testosterone blockers] for localized prostate cancer should be carefully balanced in older men. Attention is drawn to an increased risk of diabetes, cardiovascular complications, and osteoporosis and bone fractures. …
Screening in older men with prostate cancer is highly controversial. Individualized screening decisions should be based on patient health status but not on chronological age.
You can find more information on the topic here.
However, this article from 2016 recommends that men over 70 should have PSA testing:
But PSA can’t be interpreted if a man doesn’t get his PSA tested. Population studies have shown that “men diagnosed at 75 years or older account for 48 percent of metastatic cancers and 53 percent of prostate cancer deaths, despite representing only 26 percent of the overall population,” says Tran, Clinical Director of Radiation Oncology and Molecular Radiation Sciences.
Why are older men more likely to die from prostate cancer? To find out, the team studied 274 men over age 75 who underwent radiation therapy for prostate cancer. “We found that men who underwent PSA testing were significantly less likely to be diagnosed with high-risk prostate cancer, and that men with either no PSA testing or incomplete testing (either a change in PSA was not followed up, or a biopsy was not performed when it was indicated) had more than a three-fold higher risk of having high-risk disease at diagnosis, when adjusted for other clinical risk factors,” says Tran.
Although this was a small study and more research is needed, Walsh says, “we believe that PSA screening should be considered in very healthy older men.”
When I started learning about prostate cancer from the older men I know who were diagnosed with it and treated for it, I was very surprised to learn that aggressive cancer is not uncommon in that age group. I had previously thought it was almost unheard of, but that is certainly not true. And yet it’s apparently a common misconception.
This is the case concerning aggressive prostate cancer in general:
“It’s a very common scenario,” said Dr. Matthew Smith of Massachusetts General Brigham Cancer Center. Men can “feel completely well and a diagnosis of metastatic prostate cancer could come as quite a surprise.”
Guidelines recommend against prostate cancer screening for men 70 and older so Biden may not have been getting regular PSA blood tests, Smith said. What’s more, while the PSA test can help flag some cancers in some men, it does not do a great job of identifying aggressive prostate cancer, Smith said.
That conforms with what I’ve personally learned, prior to Biden’s news. I believe a lot of people either think a PSA for older men is worthless, or they think it’s a panacea. It’s neither; it’s somewhere in between.
There is no reason to credit anything coming out of the media with regard to our former president, so I’m thinking-
Biden’s cancer has been known to his inner circle for 2-3 years, probably more.
He has been getting hormone treatments (standard) for all this time.
The cognitive problems that neo describes as resulting from the treatments have made a bad situation worse.
People are free to believe that the President of the United States did not get a common blood test that, while somewhat controversial as neo accurately notes, is by default taken by old men every year or so; few doctors will omit this test without specific instructions from their patient. The difficult decision is not whether to take the test. The difficult decision is what to do with the results- if the result is positive for likely cancer, do you want a painful biopsy (yes, in Biden’s case- that’s how you get the Gleason score). If it’s already metastasized (as in Biden’s case again), no use for major surgery, but medical and radiation treatments can prolong life and relieve symptoms.
Biden started thinking about running for president in 2018 at the latest. I do not believe that he did not get a thorough medical evaluation at that time, in preparation for a job that he would hold until Jan 2025 if he was successful. They probably learned about the cancer then, and planned to have him release the information halfway + 1 day through his term and resign then, allowing Kamala Harris to become president and run for 2 full terms later. The plan did not work out, due to a combination of Doctor Jill loving herself some power and glory, the sums that the Big Guy was getting, and Kamala being as terrible at real politics as the California voters knew she was.
And that how you get more Trump.
If Biden and his doctor were following protocol in not doing the PSA tests since 2014, this was a calculated risk, according to these helpful links from Neo. Biden lost the bet. Given his other apparent health problems, including the dementia, I imagine his time on earth is fairly short.
“we believe that PSA screening should be considered in very healthy older men.”
So the test is indicated for seniors whose default for settling personal disputes is pushup contests?
We will never know “the truth” about Biden’s health, because so many lies have been spread on that topic that everything is suspect. But more universally, the divergence of opinion about prostate cancer and the testing/treating for it is kind of a companion piece; how is one to know what is the preferred course of action when there are so many competing streams of opinion about them? It seems that we swim in a sea of lies and there is little on which we can depend to be truthful. Well, except for The Truth. So instead of fretting about whether or not I am likely to get prostate (or any other, for that matter) cancer, I have decided to spend more of my remaining time on this mortal coil reading God’s Word in order to prepare me for the world to come. And, of course, reading this blog, whose proprietress is among the closest of the friends I have never met.
It’s probably just turbocancer. Joe was probably OK in re prostate cancer 12 months ago. It’s probably the Vax. This is the explanation that passes all the Ockham’s Razor tests. Way simpler than all the conspiracy theories that hang upon the slow progress of old fashioned prostate cancer.
@ Steve > “I have decided to spend more of my remaining time on this mortal coil reading God’s Word in order to prepare me for the world to come. And, of course, reading this blog, whose proprietress is among the closest of the friends I have never met.”
Excellent plan.
Our former occupant of the White House has been known to spontaneously spill the beans and tell the truth. Several years ago he announced that he had cancer. Once that is known, there’s no incentive to get PSA tests. We’d have to know when he stopped getting the tests to know when he was initially diagnosed. Since his doctor was apparently in on the deception we may never know.
Paul in Boston:
Biden had several bouts of skin cancer and removals, both prior to becoming president and during his presidency. So he did have cancer.
But PSA tests are specific to prostate cancer. I’ve explained in some detail why Biden and his doctor might have decided to follow the CDC recommendations and not have that test.
In addition with a very aggressive cancer (Gleason 9), although regular PSA tests would not have guaranteed diagnosing and treating it before it ever metastasized – and therefore preventing metastasis – it’s probably would have made it more likely it might have been arrested and never reached the stage it has.
West TX Intermediate Crude:
Do you have some special knowledge of the percentages of men in their 70s and 80s who continue to have PSAs done? It’s not necessarily standard to have it. It depends on the doctor and the patient. Here are the numbers:
Kristor:
I’m always amazed at the need of many people to blame everything bad that happens to anyone, health-wise, on the COVID vaccine. It’s as though there never were fast-moving cancers or even death prior to the development of the COVID shot. I’ve known many people with fast-moving cancer who died many many years before COVID or the shot. And I’ve studied tons of supposed evidence for “turbocancer” as a result of the shot and found nothing of any validity.
neo-
non-melanoma skin cancers, as in Biden, are cancers in name only. Puhleeze!
One does medically what one can for the individual; one is not managing a population, though that is the way the Left delivers medical care.
The cure rates for prostatectomy versus radiation are virtually identical, stage for stage. The adverse effects and times to onset differ, sooner for surgery, which should be obvious. There is the emotional component to treatment selection: a quick surgical fix despite operative morbidity, versus a gradual external beam radiotherapy course while continuing to work and play.
High Gleasons often metastasize early, and their earlier detection does not mean the microscopic horse has not already left the barn.
You cite Walsh. Patrick is getting on, but at one time he was THE surgeon of prostate cancer, doing lots of -ectomies at Johns Hopkins, two or three a day 3-4x per week, and kinda anti-radiation whether by radioactive seed implants or external beam.
neo-.
I was vaguely familiar with the study you refer to.
That study is of all men, not limited to the ones who see a doctor every year. > half up to age 80 still had the test. That number is necessarily higher if only men who see doctors at least annually for general physicals are considered.
I’ll agree that the number who forego the test is higher than I thought. I do believe that it’s highly unlikely that Joseph R Biden had a discussion with his physician, and, having considered the pros and cons, elected to forego the test. I have no confidence that any substantive and reliable information on this point will be available in my lifetime.
Supporting my point, I read somewhere that the cancer was discovered when Biden developed problems with urination, and a rectal exam revealed a suspicious nodule. This led to a biopsy and a cancer diagnosis, and, apparently plans to treat with hormone therapy. This is a lot to do in a patient who has made an informed decision not to screen for the disease the he has now undergone a thorough evaluation for.
I have mentioned that I had Prostate Cancer. I watched my PSA clime over several years. Gleason hit 5.5, had biopsy, not really that bad. About 9 yrs ago, I had Brachytherapy, radiation seed implants. I still get a PSA every yr. I ask for it and so far no Doc has objected. Oh, I am now 78. My Doc said (don’t know if it is true) that often other cancers show up in the PSA.
( I have an interesting story about Me, my radiation, and Homeland Security)
No “need … to blame everything bad that happens to anyone, health-wise, on the COVID vaccine” on my part. I’m just noticing, but not with any prior ax to grind. People obviously died unexpectedly and suddenly throughout all history prior to the vaccine. *And* things are happening now, after the vax, that are unprecedented. Ask any life insurance exec.
Joe might have had prostate cancer for years and his docs said, no big deal, don’t worry about it, you’ll die with it but not of it. And they simply turned out to be wrong, as happens to even the most sapient from time to time. Sure, that could be true.
If it were, NB, it *would not rule out turbocancer due to the vax.*
Whatever, doesn’t matter. Compared to the dementia + autopen scandal, this is nothing.
Kristor:
There is no valid evidence that cancer is more rapid in people who’ve been vaccinated, compared to before COVID or before the vaccine existed. What you are experiencing, I believe, is confirmation bias. You are noticing the rapid deaths now and attributing them to the vaccine.
I have crunched the numbers over and over and written many posts and comments about them. Here are two: this and this.
SHIREHOME:
I’m puzzled by one thing you wrote. You say you watched your PSA climb, then your Gleason was 5.5 and you had a biopsy. But a person doesn’t get a Gleason score except by having a biopsy. So, which came first? Didn’t you have a biopsy and then get a Gleason score?
Glad you’re doing well. A Gleason of 5 has an excellent prognosis.
West Texas Intermediate Crude:
You write, “I do believe that it’s highly unlikely that Joseph R Biden had a discussion with his physician, and, having considered the pros and cons, elected to forego the test.”
I have no trouble believing such a conversation could have happened in 2014 or 2015. Biden was quite competent then to have that discussion. Once he made the decision when he was mentally competent, it wouldn’t need to be reviewed every year as he became more mentally incompetent. His real cognitive decline started years later.
As far as his diagnosis and treatment goes: once they found the nodule, they probably did a special prostate MRI that’s only been available since about 2017. That test gives a score from 1 to 5 that tells a person what their chances of having prostate cancer might be. My guess is that Biden received a high score (probably 5), and it was only then that they went ahead with a biopsy. The decision not to have a screening PSA which might be misleading is quite different than the decision not to treat (or not to do a biopsy) when a cancer is LIKELY. At that point, you do a biopsy in order to get a Gleason score, which tells you how aggressive the cancer is. If it’s not all that aggressive, you don’t have to treat. If it’s in-between, you can get treatment that doesn’t interfere all that much with quality of life. If it’s aggressive, you might get radiation to prolong life or to postpone pain from metastases. It might not afford a cure, but might improve quality of life. I have no problem understanding why someone might not want a screening PSA but might want a biopsy and treatment.
I also read that Biden (and/or his family) have not yet decided what treatment to accept. He was offered radiation and androgen blockers, as far as I know, but has not yet decided what treatment to undergo.
Cicero:
PUL-eaze yourself.
You know the difference and are an oncologist. I also know the difference. But Biden was speaking colloquially, not medically as a doctor.
I’ve read – for example – statistics about the chances of a person getting cancer in a lifetime, and they often include skin cancer as cancer, inflating the statistics. I am almost certain that’s the way Biden would talk, since he’s not exactly known for medical precision in his speech (for example, how he talks about Beau’s illness ).
I don’t quite understand. If one has the test every year and the score rises sharply from one year to the next wouldn’t that be an indication of an aggressive cancer?
The PSA test is a simple blood test typically done either before or just after an annual physical exam and as part of a broad panel of blood based tests (iron, chloresteral, and others). This test is non-invasive, other than the taking of a vial or two of the patient’s blood. There is no reason, other than some small cost avoidance, to skip this test.
The story of this diagnosis coming out as it is now just doesn’t add up. Biden’s people are either hiding something or trying to distract us, or both.
@steve walsh:There is no reason, other than some small cost avoidance, to skip this test.
False positives do harm. Getting treated for a cancer when really old can also do harm. I had an elderly relative who nearly died because she got chemo after surgery (at the suggestion of her doctors “just to be sure”). They had to stop it after two days and she never really recovered, and was never able to live independently again. The cancer never came back, but the other damage was plenty.
Just one person, true, but there are no risk-free choices.
If the false positive rate is that high then the test is of no value and should be abandoned.
Cupidity?
Stupidity?
(Or maybe it’s just the principle of “No one’s gonna tell ME what I should or shouldn’t do”…)
Whatever…
Seems to be contagious!
https://nypost.com/2025/05/21/us-news/last-8-congressional-deaths-were-all-dems-boosting-gops-razor-thin-vote-margins/
When the coverup and the lie become official, unassailable, top-down POLICY…
Surprise!
“Biden Officials Hid Deadly Health Risks Of COVID Vaccines, Bombshell Congressional Report Reveals”—
https://blazingcatfur.ca/2025/05/21/biden-officials-hid-deadly-health-risks-of-covid-vaccines-bombshell-congressional-report-reveals/
Not to worry overly, though…since they’re doing it for our own good!!
+ Related?
“France Finally Admits Muslim Brotherhood Threat After Decades Of Silence”—
https://blazingcatfur.ca/2025/05/21/france-finally-admits-muslim-brotherhood-threat-after-decades-of-silence/
To be sure, Marine Le Pen’s been convicted, Israel’s being roundly chastised…and all’s well with the world.