What we know about prostate cancer diagnosis

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What we know about prostate ******* diagnosis

Yang Tian and James Chater

BBC News

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Former US President Joe Biden has been diagnosed with an aggressive form of prostate ******* that has spread to his bones.

Biden received the news on Friday after he saw a doctor last week for ******** symptoms.

Here’s what you need to know about prostate ******* and its treatment options.

What is prostate *******?

Prostate ******* affects tissue of the prostate ******, the part of the male reproductive system that helps make ******. It is located between the ****** and the bladder.

According to the NHS, it usually develops slowly, so it can often grow unnoticed for years. That means some people can live for decades without needing treatment. But it also means symptoms often don’t appear until the ******* is already advanced.

Biden was diagnosed following ******** symptoms, one of the most common signs of prostate *******. That’s because it is often detected only when the prostate is big enough to have impacted the urethra, the tube that connects the bladder to the ******.

Those symptoms can include needing to ******** more frequently, as well as a slow or weak ******** stream.

Screening for prostate ******* is part of routine presidential health inspections, according to Dr Jeffrey Kuhlman, former White House doctor under President Barack Obama.

Prostate ******* is the second-leading cause of ******* death in American men, according to the American ******* Society, behind lung *******.

There will be more than 300,000 new cases in the US this year, according to projections by the American ******* Society. About one in 8 men will be diagnosed with prostate ******* during their lifetime.

While it is “not uncommon” for men in their 80s to be diagnosed with prostate *******, the grade and stage of Biden’s ******* are “more advanced than most men would encounter” at diagnosis, Dr Ryan Cleary, urologist at MedStar Health, told the BBC.

What is the Gleason score?

The former president’s prostate ******* is “characterised by a Gleason score of 9”, his office said in the statement announcing his diagnosis.

The Gleason score is the most common way of grading how likely the disease will advance and spread – also known as metastatic *******.

Specifically, it refers to how abnormal the ******* cells look in a sample under a microscope. The scale runs from six to 10, with a higher number indicating a more aggressive *******.

The scale starts at six because it is calculated by combining the two most common patterns of ******* cells found in a patient. The lowest score assigned to cancerous cells is three. That’s why the lowest Gleason score for a ******* diagnosis is six.

A Gleason score of nine, such as Biden’s, means it is a “high-grade *******”. ******* cells with a score of nine look very abnormal and are likely to grow quickly.

What are Biden’s treatment options?

In Biden’s case, the ******* is aggressive in nature and has already spread to his bones.

According to Dr Jamin Vinod Brahmbhatt, a urologist at Orlando Health Medical Group, this level of spread does limit the treatment options.

While there are medical based treatments such as chemotherapy, steroids and hormone therapy available, none of them are “curative”, he said.

“There are more medical options to stabilise the patient and control the *******, but it never gets rid of the ******* completely.”

Biden’s ******* is also said to be hormone sensitive, which means the ******* uses hormones to grow or develop.

These types of cancers can be managed by drugs that block or lower the amount of hormones in the body.

Dr Brahmbhatt said while this “opens up the toolkit” of treatment options for Biden, it was going to take “weeks or months” to see how he responds.

Dr Kuhlman said Biden could also have the option of entering “clinical trials for advanced disease” if he meets the inclusion criteria.

Biden and his family are said to be reviewing treatment options.

What is his prognosis?

In Sunday’s statement, Biden’s office said since the ******* appeared to be hormone-sensitive, that “allows for effective management”.

The full details of Biden’s case is not known. Dr Cleary said: “Generally about a third of patients will still be alive after five years of metastatic prostate *******.”

Advanced stages of prostate ******* can limit a person’s lifespan and lead to symptoms that make daily life harder.

Dr Kuhlman describes “10 to 15 years of function” when looking at aggressive ******* treatments and said it was important to consider treatments that maintain Biden’s quality of life in the next few years.

“If there’s any inspiration in this, it is to go and get yourself checked out whether you have symptoms or not,” Dr Brahmbhatt said.

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