It may be that it has simply been missed in previous tests. My Google Fu suggests PSA can miss some cancers.
From Cancer Research UK:
The PSA test can also miss some prostate cancers. A major study showed that:
around 15 out of 100 men with a normal PSA level (around 15%) have prostate cancer - this is a false negative
around 75 out of 100 men (around 75%) with a raised PSA do not have prostate cancer - this is a false positive
Because of this, and the risk of over diagnosis, the PSA test on its own is not recommended as a screening test for prostate cancer. But men over 50 can usually ask their GP for a PSA blood test if they want. Your GP will explain the potential benefits and risks of having a PSA test.
Well you would think that someone with a Doctorate in Education would be educated about everything. Just when you thought he couldn’t be a bigger ass, oh wait no one has thought that.
I’m also wondering why this wasn’t caught through PSA testing. I’m not a VIP or anything, but my yearly physical has included a PSA test for the last 10 years. Did he not get the test regularly, or did it not show up in his test? If it’s the latter, that would be good to know simply because it shows the deficiency of the PSA test. I would also think there’s a possibility that this was a known condition and they were trying to keep it quiet.
In spite of our universal healthcare, routine PSA testing is not covered here in Ontario. The argument is the negatives of over treating benign prostate enlargement through false positives outweigh the positives.
I’m on testosterone replacement therapy due to a benign pituitary tumour, so I am tested annually at the insistence of my endocrinologist so it is covered for me.
I was under the impression that a PSA check was a routine part of annual bloodwork for men over 55 or so. He certainly got bloodwork at least annually.
And PSA testing has been suggested to be on an individusl basis for men ages 55-69.
There’s still controversy about these recommendations, with many urologists still inclined to PSA test and be relatively aggresive about prostatectomy. The problem with routine testing is that there’s only a small potential benefit in terms of overall survival, and a significant risk of false positives and overtreatment.
My father expeerienced back pain at an advanced age and was found to have prostate CA metastatic to bone. With non-surgical treatment he lived many years afterward and eventually died of something else.
Biden even when he first took office as President may not have been a good candidate for radical surgery and possibly didn’t want PSA screening for reasons mentioned previously.
I’m glad to hear from Qadgop that he’s doing well.
Oh, and DT Junior (plus all the right-wing sleazes spouting venom and conspiracy theories) are complete shits.
My best wishes to the former President - I really hope he makes a full recovery.
I am not quite cynical enough to wonder if this announcement was timed to drive stories of Jake Tapper and Alex Thompson’s new book Original Sin, about Biden’s cognitive decline while in office, from the headlines.
Routine PSA testing is not done here (mind you, annual physicals are not a thing here either. The NHS doesn’t encourage this sort of thing - there’s enough genuinely sick people without the worried well bothering them too).
The key phrase here is “with the blessing of the patient”. In general, no medical procedure will be performed without the patient’s informed consent. This is foundational to medical practice. A DNR is basically a formalized statement that in certain extreme situations consent is refused. Without a DNR, medical professionals are obligated to do everything possible to save a life, irrespective of how it may impact the patient’s future quality of life.
My statement that “doctors can and will do everything possible” has to be qualified with this understanding, and with the further qualification that obviously any medical intervention has to be judged in terms of risk versus potential benefits. Age will be a factor here, but it should only be a factor when assessing risk, including potential impairment of quality of life, where an elderly person might be better off just being left alone and given palliative care. It’s certainly an option a patient should have. I have no issue with this. My argument is that age should never, ever be a factor in terms of “too old to be worth it”.
Similar story with my mom, and God bless the Canadian health care system. With quite a lot of excellent and compassionate health care, including home care services and medical equipment at home, she lived a happy and productive life well into her 90s.
Yeah, it’s been widely speculated, but I’m pretty sure no one on the straight Dope message board is in a position to know for certain, one way or the other.
For any men (or spouses of men) in the thread just waking up to the ideas around prostate cancer, we’ve had threads and threads on various aspects of the topic.
This particular one started as one guy’s story about his journey and sort of morphed into the omnibus thread on “I’ve been diagnosed, what now?” and the whole rest of the follow-up.
Lotta good background there for anyone dealing with PC, whether as the guest of honor or as the SO.
PSA tests can commonly come back with false negatives even in the presence of advanced cancer. It’s not necessarily surprising that Biden’s condition was just discovered. We are currently in a political climate where almost any trivial thing can spawn a crazy conspiracy theory and I dearly wish that we didn’t contribute to it ourselves here on the Dope. The MAGA cult is already heavily into it.
My mom’s partner had a similar diagnosis as Biden. He’d had slow growing prostate cancer for years, with the general plan of just monitoring it. It was monitored. The first indication it had turned into a fast growing kind of prostate cancer was that he had unexplained pain, which turned out to be the cancer having metastasized to his bones.
Even when the doctors know it is there, even when the patient is complying with coming in for recommended checkups, it may still not be enough.
It isn’t routine, though. My primary care physician has never tested for it. Unless you specifically have a symptom like difficulty in urination, most physical exams will make do with the old standby “digital exam,” which isn’t precise to necessarily detect the “small nodule” found on Biden’s prostate.
Just when you thought he couldn’t be a bigger ass, oh wait no one has thought that.