The Bane of a Man’s Existence

Despite one’s personal thinking and the absolute chaos of American politics since the start of the Biden administration, it is difficult not to have any sympathetic thoughts about Joe Biden’s recent announcement that he had been stricken with prostate cancer.

The family recently announced that the former president, now has an aggressive, stage-four prostate cancer that has metastasized into his bones. His Gleason* score was a nine, which is considered very high. Like it has not been enough for his humiliation in being thoroughly dismissed and abandoned by his life-long Democratic Party for his advanced case of dementia, he now has to face the possible end of his life on earth. 

This announcement comes on the heels of accusations of a political conspiracy between the mainstream media, the Democratic Party and the Biden family to hide Joe Biden’s declining cognitive condition from the American people for about three years. This raises the $64 question: How long have these conspirators known about his more than likely fatal illness? Men with this diagnosis live no longer than five years. As of now, we do not know how long ago he received his grim medical news.

In their book, Original Sin, journalists Jake Tapper and Alex Thompson detail the blatant cover-up of Biden’s closest aides in hiding the steady decline of Biden’s mental condition. I believe it is likely that if the aides had also known of the diagnosis of his cancer, they would have covered it up as well. 

All this raises other serious questions about Biden’s decision to run for re-election in 2024. On the reports of his last few physicals, there was no mention of any PSA tests, the standard test for prostate cancer. This also raises serious questions about his health and his medical care. Why were his doctors not screening him for prostate cancer, a staple in most men over fifty’s medical examinations? 

In a recent article, The Los Angeles Times found several doctors who down-played any hint of a conspiracy because of the complexities of the screening and the diagnosis of a cancer and its treatment.

The president’s condition revolves around the question of screening, which is another word for testing. I have been going to a urologist for my prostate since I was 50. That is the prime age for a man getting his first PSA test, which is the abbreviation for Prostate-Specific Antigen. This blood test measures the amount of antigen a man’s prostate produces.

It is not a perfect test but it has saved many a man’s life over the years. This organ increases in size as a man grows older, raising the amount of antigen the organ produces. There are many factors that can cause a spike in the PSA score. The most common are an enlargement to the organ, inflammation and cancer. Any strenuous endeavor, including recent physical exercise, including sexual activity could also raise the score. 

My father, who never developed cancer, had an enlarged prostate as I do now. It is a problem that affects virtually all men at some time in their lives, making this small organ the bane of a man’s existence.

However, there is a pill, called Dutasteride, which I take nightly to reduce its size. There is a risk in this. While reducing the prostate in size, the pill can also mask the presence of cancer. As a result, I get screened every year. For many years I was tested 2-3 times. An average score for a 60-year old man is below 4.0 nanograms of antigen. To date I have never been over 3.0. I have friends who have gone over the guidelines and all had to have prostate surgery.

Consecutive elevated scores caused me to have a biopsy in 2006 which was one of the worst experiences of my life. Some comedian once quipped that the location of the gland was proof that God is a woman because it is such a difficult organ to access for medical needs. Fortunately, my biopsy was negative.

I went to my new Urologist in Georgia for the first time a few months ago. She told me that she and many doctors across the country stopped doing a PSA for anyone over 70. Since I was 80, she said I had already had more than my share. Then she gave the reason which still resounds unpleasantly in my ear. Even if you get cancer, you will more than likely die of something else. 

I did not take these as encouraging words. In fact, I read the obituary columns most days in the newspaper and many men, both younger and older than me are still dying of the disease. Could this new reservation against screening have caused President Biden’s doctors to refrain from testing him for this disease?

Many doctors have wrestled with this question for many years. Like Hamlets in white coast, they keep going back and forth on the question to screen or not to screen. Fortunately, my internist believes in testing me during my annual physical. Many other doctors have decided to completely stop testing. They cite that the test carried with it several problems, such as false negatives and expensive biopsies. Some come with serious side effects, such as incontinence and erectile dysfunction.

Prostate oncologists say there has been a shift in how they manage lower risk prostate cancers. Their research data suggests it is safe for patients with slow-growing cancers to be carefully monitored instead of rushing into treatment. Other tests, such as an MRI and biomarkers, can now help to cut down on the number of false positives. This will aid doctors in deciding when to risk a biopsy.

The statistics on prostate cancers are mixed. While the death rate from this type of cancer has declined by half since 1993-2022, mostly from screening and newer treatments, the decline has stagnated in recent years. Many doctors suspect the decrease in screening is the main reason more men are getting diagnosed at a later stage. This has resulted in an increase of prostate cancer rates of 5% each year since 2011. 

In an article for the Wall Street Journal, Brianna Abbott argues that this issue is far from settled. As doctors continue to debate this, the incidence of cancer at a later date has increased, probably because of reduced screening. As the late cancer findings increase, doctors seem to be electing to keep testing for cancer because there are so many more tests they can do to actually catch cancers and eliminate false positives.

The Science Editor for the WSJ, Allysia Finley began her recent essay Biden’s Prostate Cancer and the Tyranny of Experts with the rhetorical question, Why a U.S. President with access to the best healthcare in the world didn’t have routine blood screenings that could have caught the disease before it became deadly? Finley proceeds to answer her own question. One possible culprit is an excessive deference to so-called experts, many of whom believed older people shouldn’t be screened for cancer because they are likely to die in short order anyway. 

She cites liberals like oncologist Dr Ezekiel Emanuel, the architect of the infamous Affordable Care Act, popularly known as Obamacare. Finley describes him as an opponent of a long life. He is opposed to screening at any age. He says: even if we aren’t demented, our mental functioning deteriorates as we grow older. He was an Obama and is a Biden adviser who wants to put government in control of all healthcare. Emanuel also gave false signals after Biden’s terrible debate performance, when he said Biden was sharp and perceptive. If he thinks old people should be phased out, then why did he support Biden in 2020 and 2024? And why did he not perform any PSA’s on the  president?

The incidence of advanced prostate cancer notably soared after the preventive Services Task Force recommended against PSA screenings. A 2020 survey in the Journal of the National Center Cancer Institute found that advanced cancers rose 5.2% between 2010-2016 among men 75 and older, with a much sharper increase among white men. Finley wants to know why they haven’t changed their recommendations. We may never know what the whole truth is, given his aides’ penchant for secrecy during Biden’s years in the White House.

One of the ironies in this situation is that Biden’s prognosis is not all that bleak. This is thanks to treatments such as Pfizer’s pill Xtandi. Yet the Biden administration has chosen this drug as a candidate for price controls under the Inflation Reduction Act because of its success seven years after hitting the market. It was first approved in 2012 but its label was only extended to metastatic hormone-sensitive prostate, the kind that Biden has now. 

I think it has been a good thing that this story about Biden’s cancer has surfaced because it will expose the anti-aging philosophy that exists among far too many physicians who know only too well that a government-run Health Care System can never fulfill all the promises politicians have made. This is true because the doctors also know that the only way to avoid a collapse of the Health Care System is for them to ration health care services. This will inevitably fall heavily on the elderly.

Prostate cancer should never be taken lightly. It is a malady that we should never wish for even our darkest of enemies. I think it is time to follow the lead of our last two popes, and that is drop our political labels and extend the olive branch of peace and forgiveness to Joe Biden. I also pray that the former president may live long enough to repent and ask forgiveness for the lost lives his abortion policies have caused during his administration. 

*This is a grading system for expressing the seriousness of prostate cancer. Traditionally prostate cancers are graded by the Gleason Score, named after the psychologist, Donald Gleason, who developed it in the 1960s. In the scoring 8-10 would be considered very high. Biden is a 9.