Former US President Joe Biden’s diagnosis of Stage 4 prostate cancer has thrown a global spotlight on one of the most common, yet often overlooked, cancers affecting men. The tumor, described as “aggressively reactive” and having spread to his bones, places Biden among the 60% of advanced prostate cancer patients who are diagnosed only after metastasis.
What is Prostate Cancer?
Prostate cancer originates in the prostate — a small gland in the male reproductive system located just below the bladder. It plays a role in producing seminal fluid. Globally, prostate cancer is among the top three cancers in men, with millions affected each year.
In its early stages, prostate cancer is highly treatable. However, because early-stage prostate cancer often presents no symptoms, it can silently progress until it spreads beyond the prostate — a condition known as metastatic or Stage 4 prostate cancer.
Why Biden’s Case Matters
Joe Biden’s case is significant not only because of his public stature but because it exemplifies a larger trend: late diagnosis. According to reports, a prostate nodule and urinary symptoms led to further investigation, revealing that the cancer had spread to his bones. A Gleason score of 9 (Grade Group 5) — one of the most aggressive forms — was confirmed.
Though Biden’s health update is a reminder of the deadly potential of late-stage prostate cancer, it also underscores hope: advances in treatment now allow for significant life extension and quality of life improvement even in advanced stages.
The Global Prostate Cancer Landscape
United States, Prostate cancer is the second most common cancer in American men after skin cancer. According to the American Cancer Society, about 1 in 8 men will be diagnosed during their lifetime. Regular PSA tests and Digital Rectal Exams (DRE) have led to earlier detection in many cases.
India: The situation is more critical. Prostate cancer accounts for 3% of all cancers, but incidence is projected to double by 2040 to around 71,000 new cases annually, according to the International Agency for Research on Cancer (IARC). The lack of widespread screening and awareness means 65% of patients are diagnosed at advanced stages, with an estimated 18,000–20,000 deaths each year.
Africa & Low-Income Countries: Prostate cancer remains underdiagnosed due to poor healthcare infrastructure, stigma, and limited access to routine screening. Many patients present with symptoms only in later stages, resulting in higher mortality.
Risk Factors Beyond Age
While age is the primary risk factor (most cases occur in men over 65), several others play crucial roles:
Family history: Having a first-degree relative with prostate cancer doubles the risk.
Genetic mutations: Genes like BRCA1/2 are linked with a higher risk.
Diet and lifestyle: Diets high in red meat, dairy, and low in fruits and vegetables increase risk.
Obesity, smoking, and lack of physical activity also contribute.
Symptoms to Watch Out For
Early symptoms are often absent. However, some warning signs may include:
Frequent urination, especially at night
Difficulty urinating or weak flow
Blood in urine or semen
Painful ejaculation or urination
Advanced cancer may cause:
Back or bone pain
Weight loss
Erectile dysfunction
Leg weakness or urinary incontinence
Screening and Detection
The two most common tests:
PSA Test (Prostate-Specific Antigen): Measures protein levels in blood; elevated levels may suggest cancer but can also be due to benign conditions.
Digital Rectal Exam (DRE): A physical examination to detect prostate irregularities.
When to Screen?
Men with high risk (family history, African ancestry, obesity) should start screening between 45–50 years.
For most men, routine screening every 1–2 years is recommended, depending on PSA levels and other risk factors.
Conclusion: A Treatable Yet Deadly Disease
Joe Biden’s diagnosis underscores both the dangers and hope around prostate cancer. Though Stage 4 is considered incurable, modern treatments — including hormone therapy, chemotherapy, radiation, and targeted therapies — can help manage the disease and extend life.
Globally, increased awareness, better access to screening, and lifestyle changes remain critical tools to fight the rising tide of prostate cancer, especially in low- and middle-income countries. Early detection not only saves lives but also preserves the quality of life.
