The diagnosis of biden emphasizes the slight increase in prostate cancer in the late stage

The cancer diagnosis that former President Joe Biden received was difficult – prostate cancer in stage 4 – has become increasingly common in recent years. This trend line, according to Cancer, is not generally known to doctors and indicates that myths have to be dispersed through prostate cancer screening.

If it is caught early, prostate cancer can achieve very good results. The 5-year survival rate in earlier stadiums is almost 100%. In the metastatic environment, this falls to 37%. Current guidelines recommend that men aged 55 to 69 have a discussion with their provider about screening, which can prevent advanced prostate cancer. Nevertheless, this increase in diagnoses in the late stage seems to have continued in the past decades and a half.

Experts said that this may be due to the fact that prostate cancer screening was once entangled in controversy about whether it caused more damage than benefits. This may have led to a decline in the prostatacreaeter years ago, which could lead to an increase in metastatic diseases today, although experts no longer debate the advantage of prostate screening.

“In the past 10 years there has been this uncertainty and people ended up on one side or the other,” said Ruth Etzioni, a cancer researcher and biostatistic, the cancer screening in Fred Hutchinson Cancer Center. “Today the news has to come out that this is an advantageous intervention, and we all basically agree.”

In the annual report of the American Cancer Society in 2023, the researchers found that cases of advanced prostate cancer, including cases that spread to nearby or distant tissue, rose around 4 to 5% per year from 2011 to 2019. This year, the investigators of the University of California in San Francisco found in a paper opened in Jama Network that cases of advanced prostate cancer between 2004 and 2021 in California rose an average of 6.7% per year. The national sea database also reflects an increase in metastatic prostate cancer diagnoses between 2012 and 2022 for all age groups and ethnic groups.

“It is enormous for cancer. We see that the cancer rates do not change very often. Many people have taken on the hypothesis that the PSA -SCREENING guidelines change,” said Erin van Blarigan, epidemiologist and cancer researcher at UCSF and senior author of the Jama paper. “The change that we observed began in 2011 to 2014.”

This was about the time when the prostate cancer screening test, which was called PSA or prostate -specific antigen -test -falled in favor of. The landmark study, which examined the effectiveness of the PSA test, was referred to as prostate, lung, intestinal and ovaries -Cancer -Crening study (PLCO) as a study on cancer screening, and in 2009 men who were assigned PSA tests, compared to men who were not assigned to the PSA Had mortality advantage. This started the controversy around PSA tests and ultimately also led the Task Force of the United States Preventive Services to downgrade the recommendation of the test in 2012.

Later prostate cancer experts pointed out that almost 90% of the men who were assigned to receive no PSA tests carried out the test anyway. This made it difficult to take over the study results at the nominal value, since patients received screening in both low -study screening. A European study later showed that PSA tests actually achieved a mortality advantage, which, however, had not convinced the medical community that the screen was worth.

This is because prostatumors can vary greatly in their aggressiveness and prognosis. Overall, prostate cancer is one of the most common types of cancer in men, with over 300,000 men in the United States being diagnosed every year. Most of them are found early. It is also often diagnosed in older men, and many types of prostate cancer are viewed as “sluggish” – tumors that grow slowly enough that they do not cause any problems for the patient in his life. Less than 7% of the cancer species in the newspaper of UCSFS van Blarigan were identified as advanced or aggressive forms of prostate cancer.

“That is the challenge. If you are diagnosed with non-aggressive prostate cancer in your 70s and other comorbidities such as cardiovascular diseases can be a higher risk for you, this additional diagnosis only harms your health and does not help you,” said Van Blarigan.

Doctors still cannot always recognize which prostate cancer diseases are aggressive and metastasized, but if they meet every cancer, these negative compromises during screening were sufficient that many experts were not convinced that PSA tests were worth many years.

But some things have changed that. On the one hand, active monitoring is a standard option for many patients whose tumors do not seem to have certain aggressive characteristics. These patients can do without medical interventions and simply “observe and wait”. The use of MRI in screening has also played a major role in reducing the damage from PSA tests, since a study showed in 2024 that the use of MRI with PSA tests reduces the prostate biopier system and the diagnosis of clinically recorded types of cancer no longer has the diagnosis of “clinically not significant” crab types on MRI -ating.

“We had active surveillance,” said Etzioni from Hutch. “Then we had the MRI that really restricted the funnel to the diagnosis. We now have a way to see these types of cancer that would give such a dilemma. There are also new biomarkers. The ratio of damage advantages looks much better.”

All of this has led to experts in recent years to have a new consensus that PSA tests are worth the compromise-this is what men who were not demonstrated after 2012 when the USPSTF did not examine its PSA test recommendation. Biden, who would have been 69 years old at the time, would have agreed from the current general guideline that patients should take their personal health and comorbidities into account when thinking about PSA tests (a strong 80-year-old could benefit more from the test than a very sick 70-year-old). Bidens Last PSA test was, according to a spokesman, in 2014. The Task Force later changed this guideline in 2018 to recommend men to talk to their doctor about PSA screening.

“It was an unfortunate time in which men didn't get a screening,” said Tanya Dorff, a medical oncologist who focuses on prostate cancer at the City of Hope. “This has probably contributed to this significant increase in the advanced diagnoses, in which the cancer is determined at a later date but is less curable.”

There are some other potential reasons why more men are diagnosed with prostate cancer in later stages, emphasized Dorff. On the one hand, clinicians have helped in recent years that PSMA -PET scans, a technique that helps with the use of a frequent prostate protein with the use of a binding to the diagnosis and stages of prostate cancer helped by determining a more metastatic illness. However, Dorff said that this became more popular in the 2020s and may not explain the increase in advanced prostate cancer from 2011.

“This is a conversation that has been taking place in our prostate cancer community for some time,” said Dorff, adding that they were of the opinion that clinicians have observed more advanced cases. “I think that's worrying and important, and we should be very hardworking in emphasizing the prostate screening to try to correct this situation.”

In particular, it is important that people who already have a higher risk of prostate cancer – to whom people with family history or African descent can belong, since black Americans are more likely to diagnose prostate cancer and have worse results – to discuss screening with their doctor.

The Task Force website indicates that an update for these guidelines is underway. A revision could help reverse the increase in diagnoses for advanced prostate cancer, according to experts, as well as continued support for understanding the early detection and monitoring of cancer.

“We would not know anything about this without investing in cancer research. Therefore, it continues to invest and prioritize that research will be important,” said van Blarigan.