That PSA test that didn’t happen

The New Neo Posted on by

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.

How much of the Biden administration was Biden and how much was the work of others manipulating him or his autopen?

The New Neo Posted on by

The Biden administration was a terrible mess. But we still on’t even know for sure who was in charge of the mess, although we’re getting more information on that. For example, about that autopen:

The investigation, led by House Oversight Committee Chairman James Comer (R-KY), gained traction after the Washington Examiner first reported on Friday about Comer’s plans for the committee to investigate whether Biden personally authorized all of his clemency orders and executive actions or whether his aides, acting on his behalf, used the autopen without valid authority. …

In a statement after his closed-door announcement of the investigation at the annual Republican National Lawyers Association event, Comer said his panel would commence its investigation into “the cover-up of President Biden’s mental decline and use of autopen,” even teasing that he believes he knows which former Biden staffer operated the device.

Comer said he plans to subpoena former Biden aides Annie Tomasini, Anthony Bernal, and Ashley Williams, who he says “ran interference” for the president and may have coordinated the use of the autopen.

I wonder if they’ll claim they can’t remember.

And who was chief of staff, at least during the last year or two? Apparently it was the smartest person Joe Biden knew, his son Hunter – at least, according to our newest truth-teller Jake Tapper:

Not the least bit surprising. But extremely dismaying, just like almost everything else that happened during Biden’s tenure.

Diplomacy, Trump style: murders in South Africa?

The New Neo Posted on by

The president of South Africa, Cyril Ramaphosa, has been visiting the White House, and he and Trump were having a press conference when Trump resorted to some audio-visual aids to make a point:

President Donald Trump confronted South African President Cyril Ramaphosa with a video of South African communists calling for the murder of white farmers.

Just watch. You’ll notice Ramaphosa sometimes just listening to the video, not watching it. …

The video includes a video of burial sites of murdered white farmers.

Ramaphosa asked Trump is anyone told him the location of the burial site: “I’d like to know where that is.”

Trump did not have the exact location.

“We need to find out,” Ramaphosa responded.

So, is this happening? When I’ve looked it up in the past, I get a lot of sites saying it’s not directed at white farmers per se; it’s just a high murder rate in South Africa as a whole. Great. Fabulous.

You can find that argument here, for example:

Yet Wandile Sihlobo, chief economist of the Agricultural Business Chamber of South Africa, said that the spirit of NAMPO this week reaffirms that “genocide” of white South African farmers “was imaginary and not happening in our country.”

“We’re all disturbed that the U.S. side is alleging that there’s genocide and mistreatment of white farmers in South Africa. It is incorrect,” said Sihlobo, who is also co-author of the book “The Uncomfortable Truth About South Africa’s Agriculture.”

“If anything, the sector continues to flourish. [Trump’s] comments are misinformed and not mirroring the reality on the ground in the country,” he said.

The New York Times reported 225 people were killed on South African farms over a four-year period ending in 2024. Of those deaths, 101 were Black current or former workers living on farms, and 53 were farmers, who are usually white.

That doesn’t add up to the total of 225, but let’s just assume it’s more whites than blacks. Is this racial ratio representative of the farm population as a whole? And why are farmers being targeted? Isn’t that targeting whites, if whites are overrepresented in that group? And what of the open incitement to murder of whites by certain public figures, who are promoting an old song entitled “Kill the Boer”? That’s pretty explicit:

Dubul’ ibhunu”, translated as shoot the Boer, kill the Boer or kill the farmer, is a controversial South African anti-Apartheid song. It is sung in Xhosa or Zulu. The song originates in the struggle against apartheid when it was first sung to protest the Afrikaner-dominated apartheid government of South Africa. It gained new prominence after 2010 following its use at political rallies held by the African National Congress (ANC) and Economic Freedom Fighters (EFF).

South African courts ruled it to be a form of hate speech in 2010, a ruling that was later overturned in 2022. Supporters of the song see it as a song that articulates an important part of South Africa’s history, is an important part of political discourse, and that its meaning has been misconstrued as advocating killing Boers or farmers. Opponents of the song argue that it can be seen to bear a literal interpretation and therefore constitutes an incitement to violence and hate speech.

Any song that advocates shooting and/or killing a racial group is a call to violence against that group, and it’s ridiculous to claim it’s not. The question is what to do about the song in terms of free speech versus incitement, and whether white farmers are indeed being disproportionately killed because of their race. There’s a great deal of verbiage on both sides of this, and I certainly don’t know what’s actually happening in terms of murder statistics and I despair of ever getting the truth. I doubt the South African government is telling the truth, however (they’re much too concerned with the supposed “genocide” Israel is committing against Gazans).

I wrote a post in 2018 on the subject of laws allowing the confiscation of land from South African farmers, likening it to the even worse situation in Zimbabwe. Here’s an excerpt:

Also, when you read the words of leaders of the more radical party, the [EFF], it is not reassuring, either about the financial future of South Africa or about the situation not escalating in a Zimbabwe-type direction:

“There have been concerns among South Africa’s white minority that the motion will encourage attacks on farmers, and the EFF’s leader Julius Malema has previously been convicted of hate speech for singing anti-white songs like ‘Shoot the Boer [Farmer]’…

“’In this process, white people ought to accept the crime of apartheid and colonisation and how these crimes impacted on black people’ Mr Ndlozi said. Whites could ‘show remorse by ceding land they inherited through anti-black racist dispossession’, he suggested, adding: ‘Justice leads to reconciliation.'”

“Justice”—for example, the “justice” in the US known as affirmative action—does not always lead to reconciliation. The people who own the South African farms now have certainly benefited from what happened in the past—the exclusion of black people from land ownership in most of the country, among other rights that were denied—but the present-day farmers were for the most part not the perpetrators of apartheid and they are the legal owners of their land. What’s more, they have skills in developing and tending that land.

This past January, Ramaphosa signed a land seizure law that allows seizure to occur without compensation, under certain conditions. There’s no question that the atmosphere, combined with the threats in the song, is ominous for white farmers, and that it makes sense for them to want to leave. But what’s actually occurring there in terms of murders is very difficult to ascertain.

Roundup once again

The New Neo Posted on by

(1) Here’s the latest development in the sad story of the killing of Ashli Babbitt on January 6, 2021:

The Trump administration will pay nearly $5 million to the family of Ashli Babbitt, a supporter of the president who was fatally shot by police when she tried to storm the House Speaker’s Lobby during the Capitol riot on Jan. 6, 2021, according to multiple reports.

After settling with the family earlier this month, the Justice Department agreed Monday to pay a principal of just under $5 million to Babbitt’s estate, which was originally seeking $30 million, the Washington Post reported.

Outgoing US Capitol Police Chief Tom Manger said he was dismayed at the decision to settle the lawsuit …

I bet he was.

I’m not going to rehash this particular death, but I think the family absolutely deserved compensation.

(2) Female track athlete bested by a biological male gets on the 1st place podium for a moment:

The audience erupted when Reese Hogan posed for pictures on the first-place podium after the California Interscholastic Federation (CIF) Southern Section Finals.

That’s because Hogan won the triple jump…not the male athlete from Jurupa Valley who defeated her by four feet.

FOUR. FEET.

The male also won in the long jump.

(3) The UK virtue signals by siding with Hamas and against Israel – which is an awfully strange way of virtue-signaling but a common one these days:

British Foreign Secretary David Lammy announced Tuesday that the United Kingdom is suspending free trade agreement negotiations with Israel and taking other punitive measures, including the imposition of sanctions on West Bank settlers, in response to Israel’s wartime policies during its conflict with Hamas in Gaza.

The announcement followed comments by British Prime Minister Keir Starmer earlier on Tuesday, saying he was “horrified” by Israel’s expanded ground campaign in Gaza.

If they’d been around during WWII, they would have been horrified by the UK’s offensive against the Nazis.

(4) In a 7-2 decision, SCOTUS rules that the Maine legislature must reinstate a member who criticized a trans athlete:

The Supreme Court of the United States (SCOTUS) handed Maine state Rep. Laurel Libby (R), not to mention free speech, a huge victory Tuesday afternoon by restoring her voting privileges in the Maine House of Representatives. In a 7-2 ruling, with Justices Ketanji Brown Jackson and Sonia Sotomayor dissenting, SCOTUS ordered the Maine legislature to revoke the February 15th censure of Libby, which saw her unable to vote on behalf of her 9,000 constituents.

As RedState has previously reported, Libby first got into trouble with some of her Democrat colleagues when she posted to social media the photo of a biological male celebrating his win in a girl’s track and field event. Libby noted that the boy had come in fifth place a year earlier when competing in the same event in the boys division, but emerged the victor when he decided to compete as a girl. Despite the fact that Libby had used a photo that was publicly available, Maine Speaker of the House Ryan Fecteau (D) censured Libby and demanded she apologize for her actions … or else.

That “or else,” as reported earlier in May be our own Bonchie, was stripping Libby of her voting privileges and banning her from speaking on the record.

The dissenters? Jackson and Sotomayor. Wasn’t it Jackson who felt unqualified to determine what’s a woman?

(5) Trump says Moscow is ready to negotiate with Ukraine about a ceasefire, while Putin is hedging. I have my doubts about whether this will bear fruit.

Kash Patel and Dan Bongino say that Epstein committed suicide

The New Neo Posted on by

Well, well, well:

Disgraced financier and convicted sex offender Jeffrey Epstein died by suicide in a New York prison in 2019, FBI Director Kash Patel and Deputy Director Dan Bongino reaffirmed Sunday, countering conspiracy theories that have lingered since Epstein died while awaiting trial on sex trafficking charges.

“As someone who has worked as a public defender, as a prosecutor who’s been in that prison system, who’s been in the Metropolitan Detention Center, who’s been in segregated housing, you know a suicide when you see one, and that’s what that was,” Patel told Fox News’s Maria Bartiromo on “Sunday Morning Futures,” adding that those who believe something nefarious happened “have a right to their opinion.”

“I have seen the whole file. He killed himself,” Bongino added in their joint interview at the FBI’s Hoover Building.

Of course, this won’t put to rest the very popular notion that Epstein did not kill himself. There’s no question his death was suspicious and that he was not properly monitored. The failure of the video surveillance system only intensified the suspicions that his death was not the result of suicide.

However, I’ve written many posts on this subject already, and I have always leaned somewhat towards the idea that Epstein was a suicide. My reasons are explained at length in those posts. If you’re interested, please take a look at this, this, this, and this.

I fully expect most people to disagree with me on this. But Patel and Bongino do not, and they are far more unequivocal in their statements about the chances of his suicide than I am – in fact, their statements are definitive. Plus, they’ve seen a great deal more about the case than I have, or than almost anyone has.

Clearing up a few more things about Biden’s cancer diagnosis; plus Scott Adams

The New Neo Posted on by

A sad note: Scott Adams says he has terminal prostate cancer. Adams is only 67 and a big voice on the right, and I’m certainly sorry to hear it.

He says he has “the same cancer” as Biden, and although that’s certainly true in the basic sense, it’s impossible to know exactly what similarities they share because we don’t know too much about when Adams was diagnosed or how (except he says it wasn’t recent), what his Gleason score and metastatic status were at the time of diagnosis, and what treatments he’s undergone in the past. At this point, however, he seems to have run out of effective treatments and is in serious pain. He says he’s probably going “to be checking out from this domain sometime this summer.” The article goes on to say he’s indicating it might be an assisted suicide.

Now, back to Joe Biden.

I wrote a lengthy post yesterday on that topic, and there was plenty of discussion in the comments. Some of it indicated to me that some of what I was saying may have been misunderstood. So I’m going to clarify here.

In yesterday’s post I was not saying that for sure the announcement about Biden’s diagnosis, and especially its recent timeline, was the truth. I said this:

Of course, there’s zero reason to trust anything that is said about his health, due to past experience with coverups of Biden’s state. But what we’re reading about his prostate cancer diagnosis could certainly be true …

I wrote that because a great many people, some of them doctors on cable news shows, are saying for various reasons that Biden had to have gotten the diagnosis much earlier. I very much disagree with that and I continue to say it’s possible that Biden’s diagnosis was in fact very recent. What are the odds? I’d need more information, such as whether he was being given regular PSA tests, and that information hasn’t been released yet.

I began yesterday’s post by saying I’m not a doctor. One of the commenters in the thread wondered why I was criticizing the opinion of one of the doctors who spoke about Biden’s diagnosis. I criticize doctors at times because I find flaws in what they’re saying (or what they’re reported to be saying; the two are not always the same).

For example, there’s this observation:

A handful of medical experts were quick to question how the former president could be diagnosed at such a late stage — especially given that prostate cancer can be detected early with routine bloodwork, which is recommended for men over the age of 50.

“It is inconceivable that this was not being followed before he left the Presidency,” Dr. Howard Formman said in a post on X.

Not in the least inconceivable. In fact, the PSA test (the screening blood test) is not routinely recommended for someone of Biden’s age. I wrote an entire post about that back in 2011 and linked to it yesterday; I’ll link to it again here. The directive about that is still in place; see this for more details, as well as this from ye olde CDC. From the latter site:

Men who are 70 and older should not be screened for prostate cancer routinely.

Of course, many men do continue to be screened by having the PSA test after 70. Unless Biden had some extra reason to be screened – such as, for example, a family history – his doctors may just have been following these recommendations and not screening him that way. Have you noticed there’s not been any mention of his PSA level (at least, I haven’t located anything that mentions it)? We merely read that his diagnosis began with a palpable nodule. He was probably being screened that way for something like prostate enlargement, very common in elderly men, and that precipitated the rest of the testing and the discovery of the cancer.

I’m not a doctor, but I know these things because I follow them and have followed them for years. And I know them also from the personal experience of people I know who have had prostate cancer diagnoses at advanced ages. The person I know who had a diagnosis of aggressive prostate cancer at a similar age as Biden was told by his urologist that he shouldn’t pay any attention to a slightly elevated PSA and shouldn’t have any testing, although his internist had already ordered it and recommended a special MRI. The MRI showed a very high likelihood of cancer and his biopsy showed it was very aggressive. When the biopsy results came back, the doctor who did it told him that it was a very good thing that his alert internist had done the testing because it may have been caught before it metastacized, which it almost certainly would have in fairly short order and that it might even be metasticized now on the cellular level. The point of that story is that his urologist would have missed it, and he probably would have been in Biden’s shoes if the urologist had been in charge. Plus, the urologist would just have been following the guidelines.

My guess is that Biden’s doctors followed the guidelines and he wasn’t having PSA testing.

More from Dr. Foreman on Biden:

“Gleason grade 9 would have had an elevated PSA level for some time before this diagnosis. And he must have had a PSA test numerous times before. This is odd,” he added. “I wish him well and hope he has an opportunity for maximizing his quality of life.”

I have no idea why this doctor says that, but it’s not “odd” for an 82 year old man not to be tested.

Let me repeat that the person I know with Gleason 9, who is about Biden’s age, had a PSA of only a tiny bit over 4 when diagnosed. He was having his PSA tested every year, and a year before his PSA was 2.3. As I already indicated, his urologist didn’t even think he should be tested but his internist was doing it anyway, and the internist decide this jump in a year needed further investigation. The urologist disagreed and recommended ignoring it, but the MRI and then biopsy was done and the surgeon who did the biopsy praised the internist’s decision because of the very aggressive nature of the cancer.

In addition – and any doctor should be aware of this – there’s a group of men who have prostate cancer and whose PSAs are not elevated:

A false-negative result means that the test shows that the PSA level is normal even though prostate cancer is present. Not all prostate cancers cause a high PSA level. PSA testing misses about 15% of prostate cancers.

Lastly, I know some men who were very conscientious about getting PSA testing and yet who had sudden elevations and were already metastatic at diagnosis. I’m not saying this is common, but it’s possible.

This article mentions:

“Prostate cancer can develop between screening tests,” Morgans said. “It doesn’t necessarily grow super slowly. It can develop between screenings, and it can be aggressive when it does develop; that doesn’t mean it’s not treatable.”

That is what I already knew, and it could apply to Biden if he has in fact been getting regular PSA testing.

And there’s also this:

However, in hormone-resistant aggressive subtypes, PSA may be at a low level in the initial stages. …

There’s no single timeline, but aggressive prostate cancer progresses in the body rapidly. This tendency is in stark contrast to traditional adenocarcinomas of the prostate gland, which tend to progress very slowly for years. …

Aggressive prostate cancer tends to present with metastasis in the bones and lymph nodes in the pelvic region despite a low PSA level.

The announcement of Biden’s diagnosis, however, said that his cancer is not hormone resistant, which would give him a somewhat better prognosis.

Yesterday, commenter “Alan” wrote:

I was listening to Dr. David Samadi – a fairly famous urologist – on Megyn Kelly this evening and he made an interesting point: The only way to determine whether prostate cancer is hormone sensitive is to administer hormone blockers and watch whether the PSA decreases over time. No way they could have gone from nodule discovery to this point in a few weeks or months.

I responded that what that doctor said isn’t strictly true. It may be the only certain way to tell if a cancer is hormone-sensitive, but there are other ways to see if it’s most likely hormone-sensitive and therefore whether hormone blockers are a good idea. Here’s a description of one such test.

Put all of that together and I think it’s very possible the story being put out about Biden is the truth, although an incomplete one. I’d like a more specific timeline as well as information on whether or not he had regular PSA tests, and if not why not, and if so what his figures were over time.

And of course it’s also possible they’re lying; wouldn’t be the first time. But at the moment I see no reason to assume it.

SCOTUS acts to end block on Trump’s policy reversing Biden-era exception

The New Neo Posted on by

SCOTUS has ruled in support of a Trump policy this time – for the moment:

The Supreme Court on Monday agreed to lift a lower court injunction that blocked President Donald Trump’s decision to terminate the protected legal status of hundreds of thousands of migrants living in the U.S., in a win for the administration as it looks to deliver on its hard-line immigration enforcement policies.

The decision clears the way for the Trump administration to move forward with its plans to terminate Biden-era Temporary Protected Status (TPS) protections for roughly 300,000 Venezuelan migrants living in the U.S. and allows the administration to move forward with plans to immediately remove these migrants, which lawyers for the administration argued they should be able to do.

This is one of those many cases in which a lower court had issued a nationwide injunction. However, SCOTUS hasn’t yet ruled on the general and very important question of whether lower courts can issue nationwide injunctions.

In this case:

At issue was the TPS program, which allows people from certain countries to live and work in the U.S. legally if they cannot work safely in their home country due to a disaster, armed conflict or other “extraordinary and temporary conditions.” …

The protections were extended during the end of the Biden administration, shortly before Homeland Security Secretary Kristi Noem in February abruptly terminated the program for a specific group of Venezuelan nationals, arguing they were not in the national interest.

In March, U.S. District Judge Edward Chen of the U.S. District Court for the Northern District of California agreed to keep the protections in place, siding with plaintiffs from the National TPS Alliance in ruling that the termination of the TPS program, which is extended in 18-month increments, is “unprecedented” and suggested that the abrupt termination may have been “predicated on negative stereotypes” about Venezuelan migrants.

So it was another instance of a lower court saying Biden could do something on an issue and saying that Trump couldn’t undo it. SCOTUS today ruled that Trump can undo it, at least in this instance. And one very interesting aspect of this decision is that it was 8-1, which surprises me. Justice Jackson was the holdout. However, today’s decision is only temporary and the ruling is very terse as well, with the following being the heart of it:

The March 31, 2025 order entered by the United States District Court for the Northern District of California, case No. 3:25-cv-1766, is stayed pending the disposition of the appeal in the United States Court of Appeals for the Ninth Circuit and disposition of a petition for a writ of certiorari, if such a writ is timely sought. Should certiorari be denied, this stay shall terminate automatically. In the event certiorari is granted, the stay shall terminate upon the sending down of the judgment of this Court.

My interpretation of that is that the case may end up going back to SCOTUS for a more definitive hearing on the merits.

My 2-cents on Biden’s prostate cancer

The New Neo Posted on by

No, I’m not a doctor, much less an oncologist. But I happen to have a more-than-average amount of information about prostate cancer, due to the fact that I know – and am even close to – quite a few men with it. And by “close to” I mean that I even know many details about their diagnoses and subsequent medical treatment. Much of this information is also very current, one person having been diagnosed extremely recently and in Biden’s age category.

I used to think that prostate cancer in the elderly was almost never aggressive, and that if left untreated almost all those men will die of something else. However, as you can see from this article, aggressive prostate cancer is far from rare in elderly men, although their prognosis without treatment is less clear as to the time frame:

Brassell and colleagues reported on the clinicopathologic features and the survival outcomes in 12,081 men diagnosed with prostate cancer between 1989 and 2009, from the Prostate Disease Research database. …

Men aged 70 years (n = 3350, 30.2%), had a significantly higher clinical stage and biopsy Gleason grade. Older men also had higher prediagnosis PSAV (P <.0001), which has previously been shown to be a marker for more aggressive prostate cancer. Among patients aged 70 years, 49.4% had external beam radiation therapy (EBRT), 24.6% had RP, 18.7% received primary hormonal therapy, 6% had brachytherapy, and 1.2% had cryotherapy. Among patients who underwent RP, pathologic stage, upgrading, and positive surgical margin rates were all significantly higher in older men.

That’s an article from 2013, and I’m sure there are plenty of others but I’m not about to spend hours and hours on this at the moment. I will add that the person I know who is about Biden’s age and who was recently diagnosed with aggressive prostate cancer (Gleason 9, the same score as Biden) but without metastases, was told that without treatment the cancer would probably kill him before anything else just going by his type of cancer versus his average life expectancy at that age. Other doctors may have advised him differently, of course, but the one who did his biopsy was a very well-known and highly-respected prostate cancer expert who wasn’t gung-ho for treatment of the elderly with prostate cancer in general.

The men I know who have prostate cancer, including the one with the very recent diagnosis, all had had regular prostate screenings and yet several had small bone metastases when diagnosed, and their PSAs had only recently elevated. So I don’t have a problem with the idea that Biden was only diagnosed recently. It’s even possible that he had stopped having PSA screenings because of his advanced age; a lot of doctors no longer do them routinely in men of his age. I have read that Biden was diagnosed because of a physical exam in which a nodule was felt, and I don’t find that so strange. I’ve read that his metastases are treatable as well, and that was true for the several men I know who had small bone metastases at diagnosis.

I’ll add that the elderly person I know who was recently diagnosed with aggressive prostate cancer and is being treated had only had a very small PSA elevation and no nodules present that could be felt, and yet had fairly extensive although localized aggressive prostate cancer. The lack of metastasis was determined by PET scan, although it could not be ruled out at the cellular level. It was recommended that he take androgen-blocking injections and have localized radiation therapy.

Prostate cancer, even with bone metastases, is usually very treatable. From what I’ve read it’s likely Biden will have androgen-blocking drugs, plus possibly radiation. As I said, the person I know with a disease profile something like Biden’s is getting those treatments, although he was first diagnosed through a slightly elevated PSA rather than nodules that could be felt. These decisions are not cut-and-dried, and not all doctors would make the same recommendations.

The usual pathway to diagnosis goes like this: suspicion raised by elevated PSA or felt nodules, special MRI to determine the likelihood of cancer and if the likelihood is in the much higher range it is followed by a biopsy. The biopsy gives the diagnosis and the Gleason score, which helps determine a treatment plan. The MRI is a more recent development (a doctor told me that it became widely available for this purpose in 2017) that greatly facilitates the decision about whether or not to have a biopsy, particularly in elderly men. Therefore it prevents unnecessary biopsies compared to in the past, and makes it more likely that biopsies are only done in men who have a good chance of needing treatment. After the positive biopsy and Gleason score, there’s usually a PET-scan to determine if metastases are present.

So I have much less difficulty than most people in assuming that Biden really has been diagnosed only quite recently. Of course, there’s zero reason to trust anything that is said about his health, due to past experience with coverups of Biden’s state. But what we’re reading about his prostate cancer diagnosis could certainly be true; prostate cancer is an odd beast for many reasons.

NOTE: Here’s one of several posts I’ve previously written on prostate cancer.

Elusive muse: Suzanne Farrell

The New Neo Posted on by

All dancers are unique. But some are more unique than others.

Suzanne Farrell may have been the most unique of all – that is, I’ve never seen another dancer who reminds me of her in the least. The closest would be Galina Ulanova, who shares the interior-ality (is that a word?) of Farell’s presentation as a dancer; that is, the sense that she is lost in her own world and not performing or posing. I’ve seen interviews where Farrell has been asked whether, when she was growing up, she wanted to be a ballerina, and she has answered that she only wanted to dance. She is a highly unusual person.

There is a documentary about Farrell made in 1996, about seven years after she retired from her performing career, a career that began when she was a teenager and the New York City Ballet was under Balanchine’s direction. He was about forty years older than she was and became enthralled with her, not just as a dancer but in the romantic sense. They had a complex relationship that was never sexually consummated and which Farrell discusses in the documentary. I think that even in the film’s first few minutes you can see why she enchanted Balanchine so.

Unfortunately it’s not possible to embed the video, but you can watch it here. You don’t have to see the whole thing to get the flavor, although I certainly watched it in its entirety. Watch as much as you like.

Farrell also has said that you reveal your personality when you dance. That is very very true. It’s revealed in a million ways both subtle and unsubtle. The audience may not be able to describe or list them, but the audience perceives them. A dancer is relaxed or tense, self-centered or not, risk-taker or cautious – but it’s all there for the world to see. Farrell herself always seemed relaxed, in her own dreamworld but it was not at all about her, and a physical risk-taker. Although she was never flashy or show-offy, she nevertheless knocked people’s socks off.

Another thing Farrell said in another interview was that a dancer must fascinate the audience even before the dancer starts to dance. Just standing still onstage, he or she must fascinate. The strange and uncanny thing is that Farrell did exactly that, although I don’t know how she did it. Even when she was dancing as part of a group, which she didn’t usually do, one could always spot her not just through her looks or body proportions but through her unique and riveting – that is, fascinating – quality of movement.