Former President Joe Biden has been diagnosed with an aggressive form of prostate cancer that has spread to his bones.
That’s according to a statement released by his office earlier Sunday.
Dr. Keith Kowalczyk, a urologist with Georgetown School of Medicine and MedStar Health, joined WTOP’s Sarah Jacobs to figure out the details of the diagnosis.
The interview has been lightly edited for clarity.
Sarah Jacobs: This diagnosis sounds so daunting, aggressive cancer spread to the bones, but then they say it’s hormone sensitive. Can you tell us what that means?
Dr. Keith Kowalczyk: There’s a lot to unpack here. And this is what prostate cancer patients have to go through every day. Essentially the aggressive form, what they’re looking at is the Gleason score and that’s a grade. And grade of cancers are, how aggressive is it? How fast can it spread? So his is the highest grade, Gleason Group 4 plus 5, equals 9. That’s pretty much as aggressive as you can get in terms of how the cancer looks. So, we often find these cancers metastatic at presentation, which unfortunately it looks like is the case with President Biden.
So it is very aggressive. It doesn’t get more aggressive than this, but there’s still a lot of variables here. Some people have a little bit of metastatic disease. Some people have a lot. And initial treatments, with hormonal therapies, chemotherapies, especially recently, with a lot of advances, can be very, very successful. So a lot depends on on how he is initially treated. So right now, it should be hormonally sensitive, which means sensitive to initial treatments.
Sarah Jacobs: And what do President Biden and his family have to consider as they’re weighing their treatment options.
Dr. Keith Kowalczyk: They have to consider a lot. They have to consider quality of life for sure, because these treatments are not without side effects. However, untreated stage 4 prostate cancer is also associated with a lot of poor side effects. So I do believe they will proceed with treatment. And so that’s the main thing they have to consider. This is not a curable disease. I think we need to make that clear. But it is something that may be controlled. Best case scenario, you know, 30% he can survive, maybe over 50% he can survive up to five years. If it’s very, very extensive, and it might be a poor prognosis. So I just, we just don’t have enough information on the extent of disease. So metastasis can be just one spot. It can be many spots.
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