Truth about Biden’s Cancer, by top doctor Karol Sikora: what I believe about ‘cover up’ theory about incurable, resistant tumor

Joe Biden’s rather sudden diagnosis of aggressive prostate cancer – who has already spread to his bones – is something of a medical mystery.

Doctors announced the rather grim diagnosis (because it is distributed to the bones, it was no longer healed yesterday), only a few days after the 82-year-old former president of the United States complained about ‘urinary destination symptoms’ high-rise problems with puddles as a result of the tumor that the urethra wears out of the body that urethra.

But during his exit time and indeed, it is almost certain that he would have regularly had health controls that would have taken blood tests every few months.

These blood samples would have been used, among other things, to test at levels of prostate -specific antigen or PSA, a protein that can increase in the blood when prostate cancer is present.

At the first sign of a peak in PSA, his doctors would probably have recommended a biopsy (where small samples of prostate tissue are removed, using a long needle, which is investigated under a microscope for signs of cancer), as well as an MRI scan to see if a tumor was visible on the prostate.

This is the standard practice in the US, where the American Cancer Society recommends that every man older than 50 has an annual PSA test.

It means that there is a better chance to catch cancer early, to treat it successfully and save lives.

So the question is – has his cancer missed or covered?

The cancer has already spread to the bones of the 82-year-old, which means that it is no longer medicinal

I do not buy the theory that the White House officials kept it in Wraps while he was president, to ward out even more public concern about the health of a leader who was clearly ill.

I worked in the US and the culture.

Yet there is no clear medical explanation for this apparently very sudden start of widespread cancer.

One possibility is that the regularly monitured PSA scores of Mr Biden did not show sufficient variation to worry about his medical team or to increase suspicions that cancer could be present.

PSA levels do not only go up if cancer is nearby. Aging is also a factor, as well as urinary tract infections.

A ‘healthy’ score in men younger than 50 is about 2.5 nanograms per milliliter (a measure of how much of the protein is found in a milliliter blood). But in those older than 70, doctors are probably not worried, unless it surpasses 6.5ng/ml.

PSA tests is the best method we currently have for detecting possible cancer, but it is not perfect.

Studies even suggest that a maximum of one in seven men have the diagnosis of prostate cancer a ‘normal’ PSA level. And this can explain why Joe Biden’s tumor by the net seemed to slip.

The other possibility is that this is an ‘interval’ cancer-an aggressive and fast-growing tumor that pops up between PSA tests or scans.

The term is usually used in the context of breast tumors that appear in women who have not had any signs of cancer during their three-year NHS screening appointment, but develop a tumor before the next check is due.

It may be that the last PSA lecture of Mr Biden was normal and his cancer was only detected after he developed symptoms such as back pain, which led to an X-ray that shows tumors in the bone.

To appear an aggressive cancer of this nature within a few months – perhaps even weeks – is not impossible (although cancers tend to grow slower in older men), but the opportunities are stacked against it as closely as President of the US.

Anyway, his cancer cannot be cured.

Doctors have assigned it a Gleason score (a sliding scale of the severity of the prostate cancer) of nine out of ten.

They did this by analyzing countless prostate tissue samples under a microscope. Each would have been scored for cancer -like appearance, in other words, how different they look like normal cells and their behavior or aggression – then they add the two most common figures to give an overall score of the ten.

The total of Mr. Biden of Nine means that his cancer has taken a fixed guard and no medicines – even modern immunotherapy – medication that has transformed some areas of cancer treatment – cannot reverse this.

However, it seems that its specific type of tumor will respond to medicines that suppress its levels of the male sex hormone testosterone, which is known to feed the growth of some types of prostate cancer. This will delay the expansion of the tumor in the prostate and beyond and give him some quality of life, but the reality is that his life expectancy is probably no more than 18 months.

It is a reminder that prostate cancer is primarily a disease of older men – the average age at which men are diagnosed in the UK is 72.

But it is important to remember that for most men who get it, this is not how it usually takes place.

Many prostate cancer patients have slowly growing tumors that do not cause poor health or unpleasant symptoms and do not kill them of something else before the tumor gets a chance.

We call these tumors ‘pussycats’.

Joe Biden’s, I’m sorry to say, seems to be more of a tiger.

• Karol Sikora is the former head of the cancer program of the World Health Organization and an NHS oncologist for 45 years.

Interview: Pat Hagan