Patient's Guide: Prostate Cancer — Understanding the Disease, Treatment, and Early Screening Through Biden’s Case

Patient's Guide: Prostate Cancer — Understanding the Disease, Treatment, and Early Screening Through Biden’s Case

I. Biden’s Case and the Warning of Prostate Cancer

In May 2025, former U.S. President Joe Biden was diagnosed with aggressive prostate cancer accompanied by bone metastasis (Gleason score 9), drawing global attention. Prostate cancer is the second most common malignancy in men, with approximately 1 in 9 men worldwide at risk during their lifetime. Biden’s case highlights the insidious nature of prostate cancer, the high risk among elderly populations (age 82), and underscores the critical importance of early screening and standardized treatment.

II. Characteristics of Prostate Cancer

• Silent Progression and Bone Metastasis

Early-stage prostate cancer often has no symptoms. Symptoms like urinary difficulty, frequent urination, or blood in urine may be mistaken for benign prostatic hyperplasia.

Bone metastasis occurs in 60%-80% of advanced patients, causing bone pain, fractures (commonly in the spine or pelvis), and spinal cord compression.

• Risk Stratification and Gleason Score

Gleason Score: A microscopic grading system (1-10) based on cancer cell morphology. Biden’s score of 9 indicates highly aggressive, poorly differentiated cancer with rapid spread.

Staging and Prognosis: The 5-year survival rate for bone metastasis patients is below 50%, compared to over 95% for early-stage cases.

•  High-Risk Groups

Age >65, family history (risk increases 1-11-fold), and African ancestry (highest incidence).

Other factors: Long-term high-fat diets, abnormal sex hormone levels.

III. Treatment Strategies: Lessons from Biden’s Case

• Hormone Therapy: Biden’s cancer is hormone-sensitive. Androgen deprivation therapy (ADT), via drugs (e.g., GnRH analogs) or surgical castration, suppresses testosterone to slow tumor growth.

• Targeted Therapy & Chemotherapy: If hormone resistance develops, docetaxel chemotherapy or novel agents (e.g., PARP inhibitors, enzalutamide) are used.

• Radionuclide Therapy: Radium-223 (alpha emitter) selectively destroys bone metastases, reducing fractures and pain.

•  Multidisciplinary Approach (MDT): Combines radiation (pain relief), surgery (e.g., robot-assisted prostatectomy after metastasis regression), and supportive care (pain management, psychological support).

IV. Early Screening: Breaking the “No Symptoms” Trap

• Who Should Be Screened?

All men over 50 (annual screening), high-risk groups (family history, African descent) starting at 45.

• Screening Standards

PSA Test: Blood test for prostate-specific antigen.

Digital Rectal Exam (DRE): Detects prostate hardness or nodules (abnormal in 15%-40% of cases).

Imaging: Multiparametric MRI or transrectal ultrasound guides biopsy for suspicious lesions.

Definitive Diagnosis: Prostate biopsy remains the gold standard for confirming cancer.

V. Medical Resources & Experts in China

Major tertiary hospitals in China have achieved breakthroughs in innovative diagnostic technologies, including dual-modality molecular imaging probes based on prostate-specific membrane antigen (PSMA) and the widespread application of PSMA PET-CT technology, significantly improving lesion detection rates and radiation therapy planning coverage. The multidisciplinary team (MDT) approach—integrating experts from surgical oncology, internal medicine, pathology, radiology, nuclear medicine, and other disciplines—enables comprehensive and personalized treatment plans for patients. Below are renowned experts in prostate cancer in China:

• Ye Dingwei (Fudan University Shanghai Cancer Center)

Position: Vice President of Fudan University Affiliated Cancer Hospital, Chief Expert of the Multidisciplinary Collaborative Diagnosis and Treatment Center for Urogenital System Tumors.

Expertise: Early diagnosis of prostate cancer, MDT, precision therapy for bone metastasis and robot-assisted surgery.

• Li Yonghong (Sun Yat-sen University Cancer Center)

Position: Director of the Prostate Oncology Ward.

Expertise: Prostate cancer surgical interventions (robot-assisted and traditional open surgery), multidisciplinary comprehensive treatment, and holistic patient management.

• Sun Yinghao (Changhai Hospital, Naval Medical University)

Position: Academician of the Chinese Academy of Engineering; Chief Scientist of the National 973 Program.

Expertise: Diagnosis and comprehensive treatment of complex prostate cancer. Early diagnosis and therapy for prostate cancer. Anatomical radical prostatectomy. Advanced prostate cancer management and minimally invasive urologic surgery. Pioneering applications of da Vinci robotic surgery.

VI. Conclusion and Takeaways

Biden’s case is a stark reminder: prostate cancer is stealthy but manageable with early detection. Regular screening for men over 50 and high-risk groups is vital. For advanced patients, modern therapies (hormones, radium-223, robotics) can extend survival and preserve quality of life. China has reached the international advanced level in the field of prostate cancer treatment. If you have corresponding physical examination and medical needs, please contact us.