Former United States President Joe Biden has been diagnosed with aggressive prostate cancer, which has spread to his bones, his office said in a statement on Sunday. The diagnosis came after the 82-year-old reported urinary symptoms, and doctors a nodule on his prostate. According to the statement, he was diagnosed with prostate cancer on Friday, with the cancer cells having spread to the bone.
“While this represents a more aggressive form of the disease, the appears to be hormone-sensitive, which allows for effective management,” his office said.
Notably, prostate cancers are graded for aggressiveness using a Gleason score that ranges from 6 to 10, with 8, 9, and 10 prostate cancers behaving more . Biden’s office stated that his score was 9, suggesting that his cancer is among the most aggressive.
Let’s understand the connection between prostate cancer and its spread to the bones.
Prostate cancer starts in the prostate gland, which is part of the male reproductive system. “It usually grows slowly, but in some cases, it can spread to other parts of the body, mainly the bones,” said Dr Siddhesh Tryambake, consultant medical oncologist, TGH Onco Life Cancer Center, Talegaon.
Dr Sachin Almel, section head, medical oncology, P. D. Hinduja Hospital and Medical Research Centre, Mahim, added that prostate cancer spreading or metastasizing to the bone is an indicator of the advanced stage of the disease known as metastatic prostate cancer.
“Bone is the most common site for prostate cancer metastasis, affecting areas like the spine, hips, and pelvis. This spread is particularly concerning because it can lead to , fractures, spinal cord compression, and decreased mobility, significantly impacting quality of life,” explained Dr Almel.
Unlike typical bone weakening seen in osteoporosis, Dr Almel stressed that prostate cancer often triggers abnormal bone formation, leading to dense but brittle bones that are prone to breaking. Bone pains are notably worse at night, asserted Dr Almel.
In people over 80, prostate cancer spreading to the bones is fatal, as it can cause severe pain, fractures, weakness, and limited mobility, said Dr Tryambake.
Early detection
Dr Almel emphasised that monitoring PSA (Prostate-specific antigen) levels and imaging tests can help catch metastasis sooner.
Symptom awareness
Persistent pain, especially in the back or hips, unexplained fractures, and neurological symptoms should not be ignored. The Gleason score is used to grade the aggressiveness of prostate cancer based on biopsy findings. The scores range from 6 to 10, with scores of 8 to 10 indicating highly aggressive cancer. “In addition to the Gleason score, PSA levels, and the stage of the disease are important factors in determining the course of treatment. A patient with a Gleason score of 9, as reported in the case of U.S. President , would typically require active treatment due to the aggressive nature of the disease,” said Dr Samir Khanna, director, urology, CK Birla Hospital, .
Treatment options
Therapies include hormone therapy, radiation, chemotherapy, bone-targeting agents (like bisphosphonates or denosumab), and sometimes surgery, said Dr Almel.
While a complete cure may not always be possible in advanced stages, treatment can help improve quality of life and manage symptoms such as urinary incontinence, haematuria (blood in urine), and involuntary loss of urine after urination, frequent urination, or inability to urinate, said Dr Tryambake. “Bone pain, , fatigue, or sudden fractures should be reported immediately to a doctor. Seek immediate treatment after the symptoms appear,” added Dr Tryambake.
Bone health management
Calcium, vitamin D supplementation, and moderate physical activity can help maintain bone strength.
Palliative care
Addressing pain and improving quality of life is crucial for advanced-stage patients.
Early intervention can slow disease progression and enhance quality of life, underscoring the importance of regular check-ups and prompt attention to symptoms.
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