Bidens prostate cancer diagnosis, treatment, Gleason score

When I saw that my phone blew up with the message on Sunday afternoon, with which former President Biden was diagnosed with an aggressive form of prostate cancer that had spread to his bones, I immediately turned to my friend Bill Nelson, MD, DSC, Stand Up Cancer Scientific Advisory Council. He is director of the Sidney Kimmel Comprehensive Cancer Center in John's Hopkins, where he is also a professor of urology, medicine, pathology and radiation oncology and molecular radiation sciences. In other words, Bill knows what he is talking about. We agreed that we know a lot about the situation, but here are his first insights into the diagnosis and forecast of the former president.

Katie Couric: How did she react when they heard about the situation of President Biden?

Dr. Nelson: I feel for everyone who hears the three terrible words “they have cancer”. Your world and all of your plans are turned upside down because you are worried instead, what is in stock and ask how the cancer can be treated, how well the treatment could work and what side effects you could confront.

It is reported that the cancer is aggressive, is sensitive to hormone and has spread to its bones. It sounds serious. If you know that you are not his doctor, would you say his treatment options?

The reports indicate that he has metastatic prostate cancer, which is a life -threatening illness that is able to cause significant bone pain. His doctors can use several treatment approaches, in particular the reduction of the male hormone testosterone and the tendency to grow and progress cancer and radiation therapy that aims at disease points. Several other treatments can also be used if necessary.

Many people wonder why no prostate -specific antigen (PSA) tested this earlier?

The screening on prostate cancer using blood tests on prostate academic antigen can save lives so that prostate cancer can be diagnosed at an early stage if surgery or radiation therapy is most effective. Most recommendations are that PSA screening is only taken into account after consultation with a doctor about risks and advantages and if they are chosen, at the age of 50 (or earlier for black men or men with a family history of prostate cancer).

When the screening should be set can be an annoying question. The US Task Force of the US preventive services recommends that men and their doctors continue to pursue PSA screening in the 70s and, including other health problems, life expectancy, etc.

Even despite a routine screening regime, aggressive cancer between planned screening tests can arise.

Is a Gleason number of 9 serious? And what exactly is a Gleason game?

The Gleason score is assigned by a pathologist that diagnosed prostate cancer by examining prostate biopsy samples under a microscope. The score (named after a pathologist named Donald Gleason, who worked in Minneapolis VA Medical Center in the 1960s) ranges from 6 to 10 and reflects the growth pattern observed by the pathologist, with higher values ​​indicating a more aggressive cancer behavior.

What are some of the side effects of the treatment of prostate cancer?

The side effects associated with the antagonization of the effects of the male hormone testosterone include hot flashes, loss of libido, fatigue, reduced muscle mass and strength, osteoporosis and an increased risk of cardiovascular diseases.

The main name effects associated with the prostate radiation therapy are the result of damage to the nerves that run along the prostate and are responsible for erections and the damage to the rectum. The prostate surgery may also damage the nerves required for erections and risks of urinary incontinence.

Can prostate cancer be treated by President Biden, and if so, how long?

According to what has been reported, President Biden's prostate cancer can definitely be treated with the promise to keep his prostate cancer under control for many months, or hopefully longer.

So many men get prostate cancer. How often is it when you get older?

Autopsy studies of men who die from other causes indicate that more than half of the men have cancer in their prostate when they rise to their 80s. These days, 1 out of 8 men will eventually receive a diagnosis in their lives, while about 1 of 44 die from the disease.

One of my old mentors, the deceased Donald Coffey, always argued that the important challenge for screening and diagnosis is to find the aggressively behavioral disease that he described as “tiger” early enough to enable the treatment of healing, while what he described “Pussycats” was left alone. This has slowly improved: the prostate -MRI is now used more often to ensure that prostate biopsies aim at the more aggressive lesions of the prostate so that they are not overlooked.