Former President JESPH BIDEN has a spokesperson described as A “little nodule” in his prostate. How much a patient should be worried by such a conclusion depends on the circumstances, urologists said.
In some cases, the nodules are caused by inflammation, which can make prostate firm or cause calcifications in the prostate that resemble nodules. These are mild.
They can also result from a common condition in older men, a nodular benign prostatic hypertrophy, in which non -threatening nodules are formed in the prostate, the enlarging. These also have no risk.
But in the worst cases, they can be cancers.
When a urologist feels a nodule in a man’s prostate, he is not always clear what to do with it, said Dr. Scott Egggener, urologist at the University of Chicago.
“There are absolutely moments when it is vague and ambiguous and you do not know what it is,” he said, adding that growth can look like “a large bulky rock which is almost certainly cancer”.
But, said Dr. Eggener, he wonders why a doctor manually examined Mr. Biden’s prostate in the first place. Maybe he had a new symptom, such as a urinary problem, or pain, or a high level of specific antigen of prostate, or PSA, a blood protein whose level increases with prostate cancer.
If the exam was only part of the routine screening, it would be contrary to guidelineSisaded by professional organizations that argue against prostate screening for men The age of Mr. BidenUnless they are unusually healthy.
Indeed, prostate cancers tend to grow slowly, if at all, and are very common in the age of Mr. Biden, said Dr. Eggener.
“At least 50% of men have cancer in their prostate,” said Dr. Egggener. “The overwhelming majority is best not to know it.” They can die with slow growth cancer, not. They may not have symptoms and that may not threaten their lives.
Screening from the age of a man of Mr. Biden is “very controversial,” said Dr. Judd Moul, urologist at Duke University.
It was projected, however, then “I suppose that in this stage, it is water under the bridge,” said Dr. Moul. “Someone did a digital rectal exam and found something he considered abnormal.”
Now the question will be how to assess the conclusion.
A usual method would be to do a PSA test. Alternatively, it could have a new urine test looking for genetic signals of cancer.
Doctors could examine Mr. Biden’s prostate with MRI or ultrasound.
“In the end, if they think this nodule is prostate cancer, the last step would be a biopsy,” said Dr. Moul.
And then, if it is a cancer, Mr. Biden would be confronted with the difficult decision to have him treated or not, which may require surgery or radiotherapy.
“Sometimes when we face older gentlemen with prostate nodules and other health problems, it may be appropriate to monitor it,” said Dr. Moul.
Dr. Moul said that before following the additional tests, he would first have a long conversation with a patient like Mr. Biden of what it could lead. If a patient discovers that he has prostate cancer, he must decide to undergo treatment, which can be difficult, or live knowing that he has cancer and that he chooses not to treat him.
“I would try to make a shared decision with him before going to any other test,” said Dr. Moul.
Mr. Biden’s spokesman said that he had spent a Philadelphia hospital on Friday and that he was undergoing an additional evaluation.