Health. Joe Biden Diagnosed with "Aggressive" Prostate Cancer: What Is This Disease?

Former U.S. President Joe Biden's office announced Sunday, May 18, that he has been diagnosed with aggressive prostate cancer.

This cancer is the most common in men in France, with nearly 58,000 new cases diagnosed in 2022. It is ahead of lung cancer (32,800 cases).

Biden aides said the 82-year-old former president was examined Thursday after a prostate lump was discovered and he had experienced worsening urinary symptoms.

"On Friday, he was diagnosed with prostate cancer, characterized by a Gleason score of 9 (grade 5) with bone metastases," the statement said.

What is the Gleason score?

The Gleason score determines the prognosis of prostate cancer based on the architecture of the tumor.

The score is based on examination, under a microscope, of the architectural structure of the gland and is based on three rules:

• the existence of several tumor populations within the same prostate;
• tumor populations that may be of different grades;
• The more damaged the architecture of the gland is, the worse the prognosis.

The score ranges from 6 to 10, with levels 8, 9 or 10 corresponding to highly differentiated and very aggressive tumors.

An impaired quality of life

Metastatic prostate cancer is the most advanced form of the disease. Metastasis means that cancer cells have spread, either through the blood or lymphatic systems. The cancer then spreads elsewhere in the body.

While different organs can be affected, bones are affected in 90% of metastatic prostate cancers.

These metastases often manifest as bone pain, pathological fractures and spinal cord compression and can have a significant impact on patients' daily lives, notes Professor Aurel Messas, urological surgeon.

"Although this is a more aggressive form of the disease, the cancer appears to be hormone-sensitive, allowing for effective treatment," the statement from Joe Biden's office continued.

The treatment of prostate cancer metastases is based on hormonal treatment which aims to lower the level of testosterone in the blood.

According to the Gustave-Roussy anti-cancer center , "this hormonal treatment is based either on subcutaneous or intramuscular injections of medication (every month or every three months), or on a surgical intervention on the testicles. Treatment in the form of anti-hormonal tablets (peripheral anti-androgens) can be associated."

Complications and pain associated with bone metastases should also be managed to improve the patient's quality of life.

With a poor prognosis, metastatic prostate cancer has a 5-year life expectancy of approximately 50%.

Source: CNN, AFU, Gustave-Roussy, urologue-paris-messas.fr