When the news of President Biden’s aggressive form of prostate cancer broke, it could have been a teaching moment, an opportunity for the media to educate Americans about prostate cancer and the confusing, conflicting guidelines on PSA screening via an annual blood test. As a prostate cancer survivor who deeply delved into the research three and half years ago when I was diagnosed, I committed myself as a journalist to breaking through the fog and misinformation.
But when the Biden cancer story broke, our corporate media was already swirling in sensationalism regarding a book that claims Biden had lost his mental capacities while president—or, even more dubiously, before that—and everyone around him covered it up. That one of the authors is a CNN anchor meant that rather than an interview with the authors, which might be expected, it has been wall-to-wall 24/7 coverage.
Of course, that had MAGA ginned up and firing off conspiracies, and then came the news of the cancer diagnosis. That only further fueled the claims of a cover-up. He had to know he had cancerand everyone covered it up!
That is factually incorrect.
But too much of the media allowed this idea to be propagated in the first 24-hour news cycle. Right-wing outlets interviewed MAGA Republican members of Congress, from Senator Rick Scott and Rep. Mike Lawler to Rep. Warren Davidson and Rep. Ronnie Jackson, Trump’s former White House doctor. Donald Trump Jr. promoted the conspiracy on social media and then Donald Trump himself jumped into it in a press conference, showing his mental decline and why he should be the subject of scrutiny, falsely and idiotically claiming Biden had “stage 9” cancer and delayed sharing his diagnosis. (Biden has Stage 4 cancer. His Gleason score for prostate cancer is 9.)
Even on MSNBC and other networks, doctors were interviewed who implied Biden had to have known. Oncologist Ezekiel J. Emmanuel did this on MSNBC, saying Biden “probably” had cancer for a long while (only later clarifying to the Washington Post that he did not necessarily mean that Biden “knew” he had cancer.)
Here are the facts to cut through the lies and misinformation. The US Preventative Services Talks Force has for years offered antiquated guidelines on prostate cancer screening—the PSA test, which is a blood test that measures prostate-specific antigen. USPSTF nonetheless is the gold standard of the U.S. government medical establishment’s prevention efforts—at least before RFK’s tenure and the havoc he is wreaking and will continue to wreak.
According to USPSTF, anyone with a prostate should begin screening at 55 and stop at age 69—well under Biden’s current age of 82.
Cancer groups like the American Cancer Society, the Prostate Cancer Foundation—as well as many doctors—disagree, and advise screening beginning in the mid-forties and even advise some groups, like Black men and those with a family history, to begin at age 40. The groups also advise making individual decisions with your doctor if you’re in your 70s and if you’re healthy and active. Clearly, if you’re likely to live a long time, you should be screened continually.
Why the discrepancy?
There’s a fear of over-treatment and harms caused by unnecessary treatment. If people test when too young, the critics of testing believe, they may find something that will never grow—a Gleason 6 on a scale of 6 to 10, the measure of prostate cancer advancement—and might be driven to have treatment at a young age that causes more harm than good. (PSA testing can sometimes be elevated for other reasons too, even repeatedly, meaning unnecessary biopsies sometimes happen.) And if you’re over 69, and you develop a tumor, because the vast majority of prostate cancer is slow-growing, you’ll likely die of something else before prostate cancer becomes life-threatening.
But honestly, let people make up their own minds with their doctors. The advice from the government is paternalistic and seem to deny that we have the medical science to make sure people catch it early and won’t have to undergo severe, intensive treatments to beat it back if they only find out later.
So, all of that said, it’s quite possible that Biden was following the USPSTF guidelines and had stopped testing at age 69. This would have been following a US government medical authority in consultation with his doctors, and not an act of negligence.
But it’s also quite possible Biden was testing regularly after 69—as many do—and that there was no rise in PSA. In the rare, aggressive form of prostate cancer, PSA often doesn’t rise, and even if it does, the cancer is so fast that it can develop rapidly between screenings—within a year—and go undetected. Some of the media—only on the second day of coverage—are focusing in on that, when this should have been something at their fingertips from the beginning.
We don’t have a lot of facts from Biden’s team and don’t know if he was still testing annually. We know from what they’ve told us he had urinary problems, which, if caused by prostate cancer, usually means the disease has progressed. A digital exam by a doctor was then performed and a “nodule” was detected. (People should always get both a PSA blood test and a digital exam annually, by the way, because something might be detected in one that is not detected in the other.)
That could mean PSA testing showed nothing concerning, or that Biden had not tested in a few years.
Either way, the physical exam obviously warranted further testing that included a biopsy, which found the Gleason 9 cancer and the metastasis to the bone. They may also have done a genetic test on the cancer to measure the aggressiveness.
That Biden was covering this up is also belied by sheer logic. If Biden had Gleason 9 metastatic prostate cancer four months ago or 8 months ago or two years ago, would he not be going for treatment immediately? Why on earth would he wait until after Trump took office or after the election or whatever, and put his life gravely at risk? It makes no sense.
And no, before some MAGA nutbag says he must have been secretly getting treatment, let’s be real about the treatment he’s going to receive. Androgen deprivation therapy, administered for more advanced cancer, is withering, bringing fatigue and many other side effects. And followed by radiation or chemotherapy or both for a man Biden’s age, it’s terribly intense and exhausting. He’d not be sitting on “The View,” as he did two weeks ago, laughing and carrying on, showing great energy.
Now, one last word, about that book. The saturation of coverage across all the media is over-the-top—and for CNN, it’s an abuse of the platform for an anchor to sell books—and shows how our media is so ghoulish and sensational.
Yes, it’s a story to consider, regarding questions about Biden, and whether Biden should have dropped out sooner. But the melodramatic claims that it somehow is a blow to the Democratic Party for decades (as some pundits have stated) is ludicrous.
This is an inside-the-media story—from the very same media that constantly tells us the American public has a short attention span. The GOP, after all, nominated a four-times indicted, twice-impeached, convicted felon who clearly has his own mental incompetence—and the American people elected him—seeming to have forgotten he did much more horrible stuff than anything Joe Biden and Democrats did in some sort of “cover up.”
Actually, I don’t want that to be the last word. Because the last word here should be about what lessons Joe Biden will now teach us, and the one good thing that can come out of the very challenging reality he now faces: Educating the public. If you have a prostate make sure you get tested—and urge those you know to get tested—beginning in your 40s and throughout your life. Information is power, and we all should be informed to make your own medical decisions.
UPDATE, 5/20/25, 7:06 pm ET: Biden’s spokesperson today confirmed that Biden didn’t have prostrate cancer prior to his announcement nor PSA-test since 2014, following the USPSTF guidelines. This blows out of the water the MAGA extremist conspiracies. It also rightly calls into question the USPSTF guidelines on not testing over the age of 69.