Joe Biden’s prostate cancer triggers global debate; Indian doctors advocate timely screening

Hyderabad: Former US President Joe Biden’s stage 4 prostate cancer diagnosis at the age of 82 has reignited conversations around men’s health globally.

In India, where awareness about prostate cancer remains low, Dr. Sirandas Arun, Consultant Urologist at the Asian Institute of Nephrology and Urology (AINU), is using the moment to advocate for timely screening, particularly among elderly men.

Silent Progression of a Common Cancer

“Prostate cancer is often silent. By the time symptoms appear, the disease may have already spread, just like in President Biden’s case,” said Dr. Arun. Biden’s condition, reportedly discovered after he experienced urinary symptoms and back pain, had already metastasized to his bones.

This is not uncommon, according to Dr. Arun. In India, many elderly men tend to ignore early warning signs or opt for over-the-counter medication without consulting a specialist. “This is more common in rural areas, where elderly men often live apart from their families and lack access to proper urological care,” he said.

Symptoms Often Missed

The typical symptoms of prostate cancer—frequent urination (especially at night), weak or interrupted urine flow, blood in urine or semen, and a sense of incomplete bladder emptying—are frequently overlooked. “Yet in over 90% of cases, the disease is asymptomatic in the early stages,” noted Dr. Arun.

PSA Test: A Simple First Step

Dr. Arun strongly recommends annual screening through the Prostate-Specific Antigen (PSA) blood test, which costs between ₹800 and ₹1,000 and yields results in six to eight hours.

“This basic test can be lifesaving,” he said. “If the PSA levels are high, we follow up with imaging like an MRI or a prostate biopsy.”

Though U.S. guidelines generally advise against routine PSA screening in men over 70 due to risks of overdiagnosis, Dr. Arun calls for a more individualized approach suited to India’s unique healthcare landscape. “Given our demographic and healthcare access challenges, we recommend men start PSA screening annually from age 50, or 45 if there’s a family history.”

Treatment and Prognosis

Treatment options vary by stage. “In early cases, surgery to remove the prostate may offer a complete cure. For more advanced stages, like in Biden’s case, hormone therapy is used to control the disease and slow its progression,” Dr. Arun explained.

“Prostate cancer is typically slow-growing, which gives us a window to act—if detected early,” he added. “Elderly men must not ignore urinary symptoms. Awareness, early testing, and timely treatment are the keys to a long and healthy life.”

Indian Context

In India, the incidence of prostate cancer varies across regions, with an estimated average of 9 per 100,000 men. Urban areas like Delhi report higher rates—up to 12.4 per 100,000—while regions like Mizoram in the Northeast have significantly lower rates, around 3 per 100,000.

“At our institution, among all prostate cancers diagnosed, we often see 60 to 70% early-stage cancers and 30 to 40% advanced cases,” said Dr. Arun.

The message from medical professionals is clear: early detection through accessible and affordable screening could significantly improve outcomes for India’s aging male population.