Dr. David Shusterman, a certified urological surgeon who also mentors future doctors in the field of urology, appeared on NewsNation and indicated that former President Joe Biden may have been living with cancer for “five to ten years” based on the characteristics of his diagnosis.
The announcement from Biden’s office on Sunday revealed that he has been diagnosed with an “aggressive” form of prostate cancer. His Gleason Score of nine suggests a higher likelihood of the cancer spreading and becoming more severe.
“I have to say that in my expertise as a urologist, prostate cancer like this doesn’t come on just overnight. This happens over a long period of time. And typically you would see a PSA elevation, you would do a biopsy, and then you would do a treatment for the prostate cancer,” Dr. Shusterman told NewsNation.
“Then after the prostate cancer is treated, it can actually get worse and spread to different parts of the body. And so it’s very unlikely that someone could get annual checkups and not notice a PSA elevation over the past.”
Shusterman reflected on his time treating patients in VA hospitals, noting that the diagnosis aligns with individuals who “hasn’t had medical attention in 10 years, presents to an emergency room with bone pain, and then they find that it’s metastatic prostate cancer.”
The doctor further explained, “But in the modern age of medicine, especially the fact that he was a former president, he had intensive state-of-the-art care where we can see prostate cancer 10 years in the past. So this is, I mean, it’s very unusual to hear that someone has prostate cancer where they’re annually being followed up.”
He pointed out that discovering a cancer case with a Gleason Score of 9 in today’s medical landscape is “just pretty much unheard of in this day and age of medicine,” emphasizing that such a diagnosis would be rare even in communities with limited access to healthcare. “Even in a medically neglected population, it would be surprising to have a surprise diagnosis with a Gleason score of 9,” he said.
When asked if he believed Biden may have been managing cancer during his presidency, the doctor was posed the question: “You believe that he knew that he had prostate cancer and even potentially as he was running in 2020 before he assumed office?”
Shusterman replied by stating that this was the “most likely” scenario. “Well, most likely he had prostate cancer for a long time and aggressive prostate cancers such as this at age 80 grows over a long period of time. I mean usually it takes from the first diagnosis of prostate cancer to the to spread would take five to ten years even in the most aggressive form.”
In a follow-up, he was asked whether either the disease itself or its treatment may have impacted Biden’s cognitive performance. “Yes, absolutely,” the urology expert replied without question.
“Because what happens is when prostate cancer becomes, like say you get treated for prostate cancer and then the prostate cancer recurs, what you would do is you would start someone on a testosterone blocking hormone such as Lupron. Because Lupron acts to lower your testosterone, it gives you symptoms of depression, lower energy, fatigue,” he said.
“So there’s a lot of things that go with being on Lupron treatment. So, Lupron is a class of medicine that just chemically castrates someone so that the prostate cancer doesn’t spread. And so, Lupron was likely used on Joe Biden,” Shusterman speculated.
According to a source familiar with the situation, Biden and his family are consulting with physicians and exploring “multiple treatment options,” which may include hormone therapy.
The source noted that Biden is currently recuperating at his Wilmington, Delaware residence. At this point, it remains unknown where he plans to undergo treatment.
“Gleason nine is by definition, aggressive, but you don’t know how bad it is unless you know what the PET scan looks like,” said Dr. Alan Tan, genitourinary section lead at Vanderbilt University Medical Center.
Medical experts emphasized that while the diagnosis is serious, it doesn’t automatically mean a fatal outcome. With effective treatment, Biden could live with the disease for several years in a manageable condition. Most men diagnosed with prostate cancer do not die from it, Tan noted.
According to the American Cancer Society, about 1 in 8 men will receive a prostate cancer diagnosis during their lifetime. It primarily affects older men and ranks as the second-leading cause of cancer death among American males, following lung cancer.
