Prostate cancer remains one of the most common cancers affecting men worldwide, yet it often flies under the radar until it becomes advanced. The recent diagnosis of former US President Joe Biden has brought renewed attention to this disease, offering an opportunity to discuss its prevalence, the importance of early detection, and what test results like the Gleason score really mean.
At 82, Joe Biden was diagnosed with an aggressive form of prostate cancer that had already spread to his bones. His diagnosis followed a period of worsening urinary symptoms, prompting medical evaluation. The cancer was classified as high-grade, with a Gleason score of 9 out of 10, indicating a rapidly growing and aggressive disease. While Biden’s cancer is hormone-sensitive—meaning it can be managed with certain therapies—his case underscores how prostate cancer can progress silently and become advanced before symptoms become noticeable.
Understanding the Gleason Score
The Gleason score is a crucial part of diagnosing and managing prostate cancer. It measures how abnormal the cancer cells look under a microscope and predicts how quickly the cancer might grow and spread. Here’s how it works:
- Pathologists examine prostate tissue samples and assign a grade from 1 (most like normal tissue) to 5 (most abnormal) to the two most prevalent patterns of cancer cells.
- These two grades are added together to give a Gleason score, ranging from 6 (least aggressive) to 10 (most aggressive).
Gleason score 6 – Low grade, slow-growing, less likely to spread
Gleason score 7 – Intermediate grade, moderate risk of spread
Gleason score 8-10 – High grade, aggressive, likely to spread
A score of 9, as seen in Biden’s case, signifies a highly aggressive cancer that requires prompt and intensive management.
Prostate Cancer: Often Asymptomatic Until Advanced
One of the most challenging aspects of prostate cancer is that it usually develops slowly and remains asymptomatic for years. Most men are diagnosed through routine screening or incidentally during unrelated medical exams. Early-stage prostate cancer typically does not cause symptoms because it often grows in parts of the prostate away from the urethra, so it doesn’t interfere with urination until it is more advanced.When symptoms do develop, they may include:
- Increased need to urinate, especially at night
- Difficulty starting or stopping urination
- Weak or interrupted urine flow
- Blood in urine or semen
- Unexplained back, hip, or pelvic pain
- Erectile dysfunction
Unfortunately, by the time these symptoms appear, the cancer may have already spread beyond the prostate.
Who Is at Higher Risk?
Certain groups are at higher risk for developing prostate cancer:
- Men over 50
- Black men (who have twice the risk compared to other ethnicities)
- Men with a family history of prostate or breast cancer
Encouraging Awareness and Action
Despite its prevalence, there is no national screening programme for prostate cancer in the UK, and many men mistakenly believe they’ll be routinely invited for testing. This makes personal awareness and proactive health checks even more important.
“We have a huge job to do helping men to understand their risk of Prostate Cancer, and we hope you will be part of that lifesaving mission.”
If you have any concerns, a family history of prostate cancer, or belong to a higher-risk group, I encourage you to get checked. Early detection can make all the difference. Don’t wait for symptoms—by then, the disease may already be advanced.
Take Control of Your Health
If you’re worried about your risk or have noticed urinary changes, please reach out to me for a discussion and assessment. Together, we can decide if further testing is appropriate and ensure you have the best possible chance for early detection and effective treatment.
