President Joe Biden - Kamala Harris Administration

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#60,430
Persian Vol said:
For men over 70, PSA screening usually isn’t recommended based on USPSTF guidelines. It’s not a hard rule, but more of a general recommendation based on the risks and benefits. If anyone wants to know why, I’m happy to explain.

It’s very likely that President Biden didn’t get a PSA test—which is completely normal for someone his age. He probably started having symptoms from the cancer spreading to his bones, which led doctors to investigate and eventually discover the metastatic prostate cancer.

It doesn’t really make sense to think he knew he had prostate cancer and chose not to treat it, letting it spread. If he had ever had an elevated PSA, it would’ve been worked up and likely treated long before it got to this point.
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I’ll bite. Please explain why?

If his doctor considered him healthy and believed he had 10 years or more of life left, why would he not screen him?
 
#60,431
#60,431
StarRaider said:
Great questions... Sounds like it takes so long to metasize the USPSTF thinks it is not worth it?

Benefits of Early Detection and Treatment

The goal of screening for prostate cancer is to identify high-risk, localized prostate cancer that can be successfully treated, thereby preventing the morbidity and mortality associated with advanced or metastatic prostate cancer.

Adequate evidence from randomized clinical trials (RCTs) shows that PSA-based screening programs in men aged 55 to 69 years may prevent approximately 1.3 deaths from prostate cancer over approximately 13 years per 1000 men screened.3, 4 Screening programs may also prevent approximately 3 cases of metastatic prostate cancer per 1000 men screened.3 Current results from screening trials show no reductions in all-cause mortality from screening. There is inadequate evidence to assess whether the benefits for African American men and men with a family history of prostate cancer aged 55 to 69 years are different than the benefits for the average-risk population. There is also inadequate evidence to assess whether there are benefits to starting screening in these high-risk groups before age 55 years.

Adequate evidence from RCTs is consistent with no benefit of PSA-based screening for prostate cancer on prostate cancer mortality in men 70 years and older.

Harms of Early Detection and Treatment

The harms of screening for prostate cancer include harms from the PSA screening test and subsequent harms from diagnosis and treatment. Potential harms of screening include frequent false-positive results and psychological harms. One major trial in men screened every 2 to 4 years concluded that, over 10 years, more than 15% of men experienced at least 1 false-positive test result.5 Harms of diagnostic procedures include complications of prostate biopsy, such as pain, hematospermia (blood in semen or ejaculate), and infection. Approximately 1% of prostate biopsies result in complications requiring hospitalization. The false-positive and complication rates from biopsy are higher in older men.3 Adequate evidence suggests that the harms of screening and diagnostic procedures are at least small.

PSA-based screening for prostate cancer leads to the diagnosis of prostate cancer in some men whose cancer would never have become symptomatic during their lifetime. Treatment of these men results in harms and provides them with no benefit. This is known as overdiagnosis, and follow-up of large randomized trials suggests that 20% to 50% of men diagnosed with prostate cancer through screening may be overdiagnosed.3 Overdiagnosis rates would be expected to increase with age and to be highest in men 70 years and older because older men have high risk of death from competing causes.

Harms of prostate cancer treatment include erectile dysfunction, urinary incontinence, and bothersome bowel symptoms. About 1 in 5 men who undergo radical prostatectomy develop long-term urinary incontinence requiring use of pads, and 2 in 3 men will experience long-term erectile dysfunction. More than half of men who receive radiation therapy experience long-term sexual erectile dysfunction and up to 1 in 6 men experience long-term bothersome bowel symptoms, including bowel urgency and fecal incontinence.3 Adequate evidence suggests that the harms of overdiagnosis and treatment are at least moderate.

Adequate evidence shows that the harms of screening in men older than 70 years are at least moderate and greater than in younger men because of increased risk of false-positive results, harms from diagnostic biopsy, and harms from treatment.

USPSTF Assessment

PSA-based screening for prostate cancer has both potential benefits and harms. The USPSTF does not recommend screening for prostate cancer unless men express a preference for screening after being informed of and understanding the benefits and risks. The decision about whether to be screened for prostate cancer requires that each man incorporate his own values about the potential benefits and harms. The potential harms of screening, diagnostic procedures, and treatment occur soon after screening takes place. Although the potential benefits may occur any time after screening, they generally occur years after treatment, because progression from asymptomatic, screen-detected cancer to symptomatic, metastasized cancer or death (if it occurs at all) may take years or decades to occur.

The USPSTF concludes with moderate certainty that the net benefit of PSA-based screening for prostate cancer in men aged 55 to 69 years is small for some men. How each man weighs specific benefits and harms will determine whether the overall net benefit is small.

The USPSTF concludes with moderate certainty that the potential benefits of PSA-based screening for prostate cancer in men 70 years and older do not outweigh the expected harms.

Recommendation: Prostate Cancer: Screening | United States Preventive Services Taskforce

www.uspreventiveservicestaskforce.org www.uspreventiveservicestaskforce.org
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Which means the only reason his doctor considered wouldn’t have checked is if he assumed Biden has very little life left. That’s why the screening after 70 is optional.

If someone comes to me at 70, has an A1C > 14, previous MIs and/or strokes, etc there’s a chance I don’t screen them because they’re likely to die of heart disease in the near future.

If someone is 77 still working, relatively good healthy, and running for a public office he intends to hold for 8 years, I’m 100% checking his PSA
 
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#60,432
#60,432
Persian Vol said:
Prostate cancer tends to grow really slowly. Someone could develop it at 77 and not show any symptoms until they’re 90. That’s why you often hear the saying, “Most people die with prostate cancer, not from it.”

The thing is, treating prostate cancer isn’t always harmless. The biopsy and treatments like surgery or radiation can lead to side effects—especially urinary issues like incontinence. For men over 70, the thinking is that even if you do have prostate cancer, you’re more likely to die of something else before the cancer ever becomes a problem. So why put someone through all the tests and possible side effects if it’s not going to help them live longer with a greater quality of life. The risks often outweigh the benefits as you get older.
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There’s literally 0 risk to screening. A 77 year old presidential candidate is someone you should screen, if you believe he’s in good health and has 10 years or more ahead of him.
 
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#60,435
GroverCleveland said:
He still had enough gumption to have his girlfriend with him when he died.
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Lucy Mercer Rutherford.

It's widely believed that the marriage of Franklin and Eleanor was arranged, and maintained as a mutually beneficial political and financial partnership. Not unlike the Clintons. Also, it's often speculated that Eleanor was a lesbian.
 
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BowlBrother85 said:
It is ridiculous that anyone would make such a matter political, and do so with wild speculation. From the moment this was announced, it's clear that Republicans have shifted into conspiracy theorist and political opportunist mode and they are actively seeking to weaponize a cancer diagnosis. It is beyond pathetic.
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a) Biden spent half a century in politics - everything he does is a political matter; b) his whole presidency was a conspiracy - recognizing that at this point is not a theory but just an observation.

I feel bad for the guy on a human level for both his cancer and his dementia. When it comes my time, I would hate for the world to be talking about it. But for the last four years Biden has had the most powerful position in the world and it is worth debating whether that position was manipulated by people in his circle to the detriment of the country.
 
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VAVol85 said:
a) Biden spent half a century in politics - everything he does is a political matter; b) his whole presidency was a conspiracy - recognizing that at this point is not a theory but just an observation.

I feel bad for the guy on a human level for both his cancer and his dementia. When it comes my time, I would hate for the world to be talking about it. But for the last four years Biden has had the most powerful position in the world and it is worth debating whether that position was manipulated by people in his circle to the detriment of the country.
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It really isn’t debatable. It’s a fact.
 
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#60,441
#60,441
Vol8188 said:
There’s literally 0 risk to screening. A 77 year old presidential candidate is someone you should screen, if you believe he’s in good health and has 10 years or more ahead of him.
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obviously there is no risk to the blood test. It seems the risk is that people take actions based on the results that may not be warranted. But if you just view the results as a piece of information that needs to be validated, it is hard to see the downside.
 
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#60,442
volfanhill said:
Hypocrisy of the highest order. Was Biden health apologist and now wants credit for "exposing" it.
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I haven't read the book and don't plan to, but I'm wondering how much of his "exposing" is going to be actual exposing vs trying to blame a select few of Biden's circle and shift blame away from the Democrats and journalists as a whole.
 
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#60,443
#60,443
VAVol85 said:
a) Biden spent half a century in politics - everything he does is a political matter
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That is so narrow-minded and stupid. It is also strictly from the perspective of someone who did not know him. You probably think that you look smart for writing that too, don't you? Pathetic.

Not EVERYTHING that anyone does .... concerns only their job.
 
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#60,444
BowlBrother85 said:
It is ridiculous that anyone would make such a matter political, and do so with wild speculation. From the moment this was announced, it's clear that Republicans have shifted into conspiracy theorist and political opportunist mode and they are actively seeking to weaponize a cancer diagnosis. It is beyond pathetic.
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It's beyond clear that Dems are using the diagnosis as an attempt to squash discussion regarding the cover up of Biden's health while POTUS. Beyond pathetic
 
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#60,447
#60,447
Vol8188 said:
There’s literally 0 risk to screening. A 77 year old presidential candidate is someone you should screen, if you believe he’s in good health and has 10 years or more ahead of him.
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You’re right that checking a PSA doesn’t carry much risk on its own. The issue is what happens after an elevated result. It often leads to more tests—repeat labs, imaging, maybe even a biopsy—which can come with side effects and a heightened anxiety.

For many people over 70, especially those with other health issues, the chances of dying from prostate cancer are pretty low. Like I mentioned earlier, a lot of prostate cancers grow so slowly that they’d never cause problems in someone’s lifetime. So sometimes, not knowing is actually better—because once you start down the road of more testing, it’s hard to stop, even if it’s unlikely to help in the long run.
 
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