Joe Biden’s recent diagnosis of “aggressive” prostate cancer has sparked concerns about how much progress the disease has progressed.
The former president’s prostate cancer is characterized by a Gleason score of 9 (grade group 5) with “metastasis to the bone.”
A score of 9 indicates “high quality” prostate cancer with very abnormal cells.
Biden’s prostate cancer is called “aggressive” – what you know about the prognosis of the disease
“This represents a more aggressive disease, but cancer appears to be hormone sensitive and allows for effective management,” the statement said. “The president and his family are reviewing treatment options with his doctor.”
The fact that Biden’s cancer is classified as “hormonal sensitivity” means it may be responsive to hormone therapy and therefore may be more treatable.
Joe Biden’s recent diagnosis of “aggressive” prostate cancer has sparked concerns about how much progress the disease has progressed. (AP Photo/Evan Vucci)
According to the National Cancer Institute, hormone-sensitive prostate cancer requires androgens (male hormones) to grow. Once these androgens are reduced or blocked, the cancer will not grow.
Dr. Marc Siegel, a senior medical analyst and professor of clinical medicine at NYU Langone Health and Fox News, said the hormone sensitivity designation does not necessarily mean that Biden is already taking hormone therapy.
Gleason score for prostate cancer: What you need to know about Biden’s diagnosis
“You can tell under a microscope whether this is the type of cancer that responds to hormone therapy, but no matter how it looks, you won’t know until you try it,” he told Fox News Digital.
“And sometimes it seems to work, but ultimately it resists treatment.”
The former president’s prostate cancer is characterized by a Gleason score of 9 (grade group 5) with “metastasis to the bone.” (AP/Evan Vucci)
According to Dr. Bilal Siddiqui, a medical oncologist and prostate cancer researcher at the University of Texas MD Anderson Cancer Center, MD, has long been known to eat the male hormone testosterone.
“The overwhelming majority of prostate cancer (99% plus) are hormone sensitive and initially depend on testosterone,” he told Fox News Digital.
“I think that’s a very reasonable assumption. [of hormone sensitivity]however, we will definitely know when hormone therapy begins. ”
“The vast majority of prostate cancers are hormone sensitive and initially depend on testosterone.”
The skeleton of the treatment of metastatic prostate cancer is “androgen ablation therapy,” which is directed at lowering the body’s testosterone levels.
“Usually, when you start androgen ablation therapy, your testosterone levels will drop and your PSA levels will drop along with it. This is conclusive evidence for you that cancer is hormone sensitive,” Siddiqui said.
The skeleton of the treatment of metastatic prostate cancer is “androgen ablation therapy,” which is directed at lowering the body’s testosterone levels. (istock)
Historically, oncologists say that androgen (hormonal) detachment therapy has been surgically performed through the removal of the testes, but the typical methods today include pills or injections.
“It eliminates about 80-85% of the testosterone produced in the body,” he said.
In many cases, doctors may add other drugs to block testosterone from secondary sources in the body, such as the adrenal glands that are sitting on top of the kidneys.
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Dr. Alexa Mises Marxuk, a family physician in North Carolina, said that prostate cancer has repeatedly reduced or slowed progression after blocking testosterone as eligible for hormone sensitivity.
“This means that it grows or shrinks in relation to how well androgens or testosterone is circulating in the body,” she told Fox News Digital.
“Usually, when you start androgen deprivation therapy, your testosterone levels will drop and your PSA levels will drop along with it. This is conclusive evidence for you that cancer is hormone sensitive,” the oncologist said. (istock)
“If you suppress testosterone, if the cancer is not contracting and continues to grow or spread, cancer is unrelated to the amount of hormones circulating in the body.”
There are various ways to monitor disease progression, but doctors noted that it is most commonly done by combining PSA blood tests and imaging studies.
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Ultimately, metastatic prostate cancer progresses and becomes hormone resistant. This means that, according to Siddiqui, they no longer respond to hormone therapy.
“It can vary depending on how long it takes to get to that point,” the oncologist said. “It was usually a few years ago that we evolved from hormone sensitivity to hormone resistance.”
The “ultimate test” to see if cancer has become hormone resistant is lowering testosterone levels and observing where it goes, he noted.
“It was usually a few years ago that we evolved from hormone sensitivity to hormone resistance.”
Signs of illness can also worsen.
“That could mean an increase in PSA (prostate-specific antigen) tests, new pain or symptoms, or new tumors appearing on scans,” Siddiqui told Fox News Digital.
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The US Preventive Services Task Force says men ages 55 to 69 should have the option to receive regular prostate-specific antigen (PSA)-based screening to monitor prostate cancer.
“Before deciding whether to take the screening, men should have an opportunity to discuss the potential benefits and harms of screening with their clinicians and incorporate values and preferences into their decisions,” the USPSTF said.
Siegel questioned this guidance for skipping screenings for older men.
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“I don’t agree with the guidelines not to test people over 70, especially in so many treatments that provide prostate cancer,” he said.
In addition to hormonal therapy, some men may be candidates for robotic prostate surgery, chemotherapy and radiation, Siegel added.
