Joe Biden announced over the weekend that he has been diagnosed with an "aggressive form" of prostate cancer, but a physician told MSNBC's "Morning Joe" the former president had almost certainly had the disease for a decade.
His personal office announced Sunday that Biden was examined after experiencing urinary symptoms and was diagnosed with a high-grade, aggressive cancer that had spread to his bones. Dr. Ezekiel Emanuel expressed strong confidence that the former president had been ill for years and quite likely had known long before he announced the diagnosis.
"Oh, he's had this for many years, maybe even a decade, growing there and spreading, that's right," said Emanuel, an oncologist and bioethicist. "It's a little surprising, I look back at the records, and there's no evidence that when he got his health status and the medical records were released, that he had a prostate-specific antigen.
"Now, it is true that a lot of people recommend not doing a prostate-specific antigen after [age] 70, but President Biden's been in public life a very long time. He was vice president and had a lot of exams under 70, so it's a little surprising that they didn't do it, and maybe President Biden decided he didn't want the test. Many men do decide they don't want a PSA."
Biden's office said his Gleason score was nine, which indicates the cancer looks very abnormal and more likely to grow and spread quickly. Emanuel said the fact that it had spread to the bone shows it had been present for many years.
"It's been around for a very long time in President Biden – years," Emanuel said. "We don't know [how many years], obviously, and it is a little surprising to many of us oncologists that he wasn't diagnosed earlier."
There's no indication Biden had a prostate exam, although both George W. Bush and Barack Obama had while they were president, but Emanuel was confident that, if he had, the test would have shown cancer was present.
"It is surprising that he did not get this test given the fact that the proclivity presidential physicians test more rather than less, and I think it is a little, it's a little strange," Emanuel said. "We do know from the population, like I said, 7 percent of people diagnosed with prostate cancer get it diagnosed at the metastatic moment, when it's already metastatic. So it's not unusual that people can say, 'No, I don't want the test,' or their doctor doesn't recommend it or they don't get the tests for one reason or another."
EXCLUSIVE: Breastfeeding mom of US citizen sues Kristi Noem after being grabbed by ICE
It's possible a test could have missed the cancer, the physician said, but he doubts that it would have been missed more than once.
"Given the fact that he has an annual exam, a test is unlikely to miss it given the fact that it's a Gleason nine, which means it's pretty wild-looking in the sense of underneath, it doesn't look like a normal prostate cell," Emanuel said. "It looks like a prostate cancer cell, which looks more, you know, atypical. It's not likely that his prostate-specific antigen, his PSA, which is the test we're talking about, would have been in the normal range.
"It would have been elevated above four, and that is, that does say you should do something about it. Now you might test it again a few months later and see if the number has gone up or gone down, that you've got an aberrant reading for one reason or another, but that doesn't seem likely in this situation."
"Either they didn't test for it or they didn't report it and we didn't get the information as a public," Emanuel added.
Watch the video below or at this link.