Medical expert 'absolutely shocked' by timing of Biden's prostate cancer diagnosis

Former President Joe Biden's advanced prostate cancer diagnosis has left Fox News senior medical analyst Dr. Marc Siegel "absolutely shocked" by the timing.

"It has to get really pretty far advanced usually before you could have urinary symptoms leading to urinary retention," Siegel explained Monday on "Fox & Friends."

"Thank God they found it. [Biden is] a fighter. He's been through a tremendous amount in his life… with his son, with [his] wife, with [his] daughter. Two aneurysms, atrial fibrillation. He's been through a lot health-wise, but I am absolutely shocked that they didn't find this earlier."

The former president was diagnosed with prostate cancer with metastasis to the bone after experiencing "increasing urinary symptoms," his office confirmed on Sunday.

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Siegel said prostate cancer diagnoses typically occur before symptoms begin, meaning the former president likely had the condition for "months and months" and his stunningly late diagnosis is more than a personal health concern, but rather is a wake-up call concerning screening protocols.

"[It's] really, really surprising that it's this advanced at the time of diagnosis," he said. "Now, you can miss prostate cancer, but most of the time, regular screening picks it up." 

Siegel finds the diagnosis especially alarming for a recently-sitting president, who would likely receive advanced screenings while in office, including a routine PSA (prostate-specific antigen) test. 

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The PSA test would detect such cancers most of the time, but Biden's diagnosis came after a small nodule was discovered in his prostate gland.

"If he's diagnosed by somebody feeling a nodule, that's not – these days – the way we do it most of the time," Siegel shared.

Biden's office revealed the "aggressive" cancer is "hormone-sensitive," allowing for effective management. This anti-testosterone-type therapy, Siegel explained, can come in either oral or injectable form now, and Biden will likely receive that treatment.

"He should get personalized treatment, too. There's a lot of debate about whether you should do surgery, whether you should do radiation, [or] what you should [do] to that bone metastasy [sic]… the fact that there's only one [metastasy] is better than if there was more than that. That's good. He has to be monitored very, very closely," he added.

The cancer's Gleason score of nine – in Siegel's words – signals it's "quite aggressive" and "moving pretty fast," so doctors will need to begin with anti-hormone therapy in hopes of shrinking the nodule and perhaps employ more focused radiation on the bone lesion to decrease its size and reduce pain.

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Still, the prognosis is less than ideal.

"Over the last five years, the entire treatment for prostate cancer has changed, but still, his five-year survival rate might be under 50%, even with all of that," Siegel added.  

"But the key here is early response. Will he have early response? They're gonna see in the first six months how he does with his initial therapy. But I can't emphasize enough… personalized approach. I might say hormone therapy, [and] they [the doctors] might be saying hormone therapy, but with a former president, they might do a smattering of things. And two, early diagnosis is key."

"For everyone out there, every male out there over the age of 45, get your prostate checked, and I personally don't say a certain age is too old. I say keep going."