Biden’s prostate cancer diagnosis underscores importance of screening, awareness

Former President Joseph R. Biden’s recent diagnosis of grade group 5 de novo metastatic hormone-sensitive prostate cancer has offered a sobering reminder that prostate cancer remains a growing concern for public health. In the US, incidence rates have been steadily rising since 2014, driven primarily by increases in advanced disease. The American Cancer Society (ACS) estimates that in 2025, more than 313,000 men will be diagnosed with prostate cancer and over 35,000 men will die from the disease.¹

The risk of prostate cancer is even greater for Black men, who are both more likely to get prostate cancer and 2 times as likely to die from the disease compared with White men.

These alarming data point to the continued need for thoughtful prostate cancer screening practices in the US. As the former president’s diagnosis starkly reminds us, prostate cancer can affect all men, regardless of status, geography, or race.

However, the guideline recommendations on when to begin and stop screening have been a balancing act—considering the risks of underscreening weighed against the potential risks of overdiagnosis.

The American Urological Association guideline² currently recommends initiating screening in men between the ages of 50 and 55 years. Some men who are higher risk for prostate cancer—such as those of African ancestry, those with a family history of prostate cancer, and those with genetic alterations that place them at higher risk—may initiate screening earlier.

The guidelines also recommend that screening be stopped in men aged 70 years and older, as the risks of screening will start to outweigh the benefits in these older men.

However, Adam B. Weiner, MD, a urologist at Cedars-Sinai Medical Center in Los Angeles, California, says that there are nuances to this recommendation that must be considered.

Adam B. Weiner, MD

“The true conversation comes between the primary care provider and the patient themselves,” he explained in an interview with Urology Times. “I know just from my own experience, the men that I see now in their 70s seem like they’re as healthy as the men I was seeing years ago who were in their early 60s. It’s a true phenomenon in the US. So, [although] most guidelines say 70, [that age] could be a little bit later in life too, [or] could even be earlier if there are more medical issues that come up.”

That said, Weiner notes that urologists tend to do a good job at identifying those who should undergo screening vs those in whom screening might pose more risks than benefits.

He explained, “In light of President Biden’s recent diagnosis, I think this is just a good reminder that we’re all trying to do what’s right when it comes to prostate cancer screening. We’re very saddened by the fact that his diagnosis was made in the metastatic stage. At the same time, I think we tend to do a good job at trying to screen the right people, biopsy the right people, and offer treatment to the right people.”

Treatment Advances

Despite the rising cases of prostate cancer across the country, the field has seen notable advancements that provide hope to those diagnosed with this disease. According to Weiner, the prognosis for these patients ranges from 5 to 10 years, depending on disease volume, which represents a notable advancement compared with past survival outcomes.

“The nice thing is that patients have options, and that’s what’s been really important and really gratifying to see as prostate cancer research has matured in the past 5 years,” Weiner said.

The backbone of treatment for patients in the metastatic setting is hormonal therapy, or androgen deprivation therapy (ADT). Even just recently, the FDA approved the combination of darolutamide (Nubeqa) plus ADT for the treatment of patients with metastatic hormone-sensitive disease,³ extending the use of the combination without the need for chemotherapy.

Other notable advancements in the hormone-sensitive and castration-resistant settings––including radioligand therapy, immunotherapies, and targeted radiotherapy—are providing additional opportunities for prolonged disease control with maintained quality of life.

The Path Forward

These advancements show that we’re on the right track, but ACS data confirm that there is still work to be done.

Michael S. Cookson, MD, MMHC, FACS

As prostate cancer continues to pose a threat to public health, awareness is essential to seeing meaningful improvements in mortality rates. According to Michael S. Cookson, MD, MMHC, FACS, a professor and the Donald D. Albers Endowed Chair in Urology at the University of Oklahoma Health Sciences Center in Oklahoma City, the unfortunate news of Biden’s diagnosis has put a spotlight on prostate cancer, offering an opportunity to inform the public on the risk of the disease and the benefits of screening.

“[Biden] has been a champion for trying to advocate for cancer [and] improve cancer outcomes and awareness. I hope we can build off of this moment and continue to raise awareness,” he said in an interview with Urology Times. “It still remains the No. 2 leading cause of cancer death in men, so we have a lot of work to do. Early detection is one of the best strategies, and it starts with screening in the right populations. I think we can turn this unfortunate event into a learning opportunity for us. I applaud anybody that can help bring [light] onto this so we can learn from it and improve the lives of others.”

REFERENCES

1. Siegel RL, Kratzer TB, Giaquinto AN, Sung H, Jemal A. Cancer statistics, 2025. CA Cancer J Clin. 2025;75(1):10-45. doi:10.3322/caac.21871

2. Wei JT, Barocas D, Carlsson S, et al. Early detection of prostate cancer: AUA/SUO guideline part I: prostate cancer screening. J Urol. 2023;210(1):45-53.

3. FDA approves darolutamide for metastatic castration-sensitive prostate cancer. US Food and Drug Administration. June 3, 2025. Accessed June 24, 2025. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-darolutamide-metastatic-castration-sensitive-prostate-cancer