Biden Followed Doctor’s Orders – And Still Got Cancer

When former President Joe Biden announced his aggressive prostate cancer diagnosis, conspiracy theories immediately started swirling. How could he not have known? Was this a cover-up? As someone who has studied prostate cancer, let me tell you why his story makes perfect medical sense.

The facts are straightforward: Biden has an aggressive cancer that, by reports, has already metastasized outside his prostate. His last prostate cancer screening was in 2014, when he was 71. Critics are asking how he could have gone undiagnosed for so long. Here's the thing – he followed exactly what doctors recommend.

The U.S. Preventive Services Task Force — our gold standard for medical screening advice — explicitly recommends against routine prostate screening for men over 70. Biden was following the science, not ignoring it.

But wait, you might say, what about other politicians? President Trump, at 78, gets regular prostate screenings. Doesn't that prove Biden should have one, too? Not necessarily. Individual choices vary, but the medical evidence is clear: for most men over 70, prostate screening often leads to more harm than good.

Let me explain why. Any worthwhile screening test needs three things: it must reliably diagnose the disease, the test shouldn't be dangerous or painful, and there must be an effective treatment if the test comes back positive. For men over 70, prostate screening fails on all three counts.

First, the PSA test — our main screening tool — is notoriously unreliable; it gives both false negatives and positives. Even if Biden had been tested last month and had a normal result, he could still have had aggressive cancer diagnosed a month later.

Second, if the test comes back positive, which it often does incorrectly, the next step would be an invasive biopsy that often causes bleeding and discomfort.

Third, and most importantly, if the biopsy is then positive, it often leads to overtreatment. A recent report from JAMA shows that older men are getting surgery and radiation at alarming rates. Those treatments are unlikely to extend their lives. But they very well might destroy their quality of life through incontinence and sexual dysfunction. Biden has said he is not getting surgery or radiation.

For men between 55 and 69, the decision becomes more nuanced. Screening might make sense depending on family history, race, overall health, and personal preferences about the trade-offs between potential benefit and harm.

But for men over 70? The math simply doesn't add up.

The chance of finding a cancer that screening can meaningfully address gets smaller, while the risks of overtreatment get larger.

Here's the reality: most men who test positive for prostate cancer will die with it, not from it.

Biden's situation illustrates another crucial point: even perfect adherence to medical guidelines can't prevent every cancer. That’s just biological reality.

The real story here isn't about missed screenings or cover-ups. It's about a man who followed evidence-based medical advice, got an unfortunate diagnosis anyway, and chose transparency over silence. By sharing his diagnosis publicly, former President Joe Biden has opened a conversation millions of American men need to have with their doctors about a disease that affects one in eight of us.

– Dr. Michael Wilkes with a Second Opinion