Dr Howie Forman, a professor of radiology and biomedical imaging at Yale, who has worked in the US senate as a health policy fellow, said: “It is inconceivable that this was not being followed before he left the presidency.”
Former president posts new image with wife Jill as he says they have ‘learnt that we are strongest in the broken places’
Michael Searles 19 May 2025
Doctors have raised concerns that Joe Biden’s late cancer diagnosis should have been spotted sooner, suggesting the delay could be part of a wider “cover-up” of the former president’s health.
On Sunday, Mr Biden’s office announced that he has an “aggressive” form of incurable prostate cancer that has metastasised to the bone. The 82-year-old sought medical attention after experiencing urinary symptoms, his spokesman said.
But doctors have challenged this claim, questioning how the cancer could have been missed.
Prof Karol Sikora, a former director of the World Health Organisation Cancer programme and founding Dean of the University of Buckingham Medical School, said Mr Biden’s late diagnosis was “very unusual”.
He said it could have been “a cover-up by his doctors” that had been hidden for months or years, but was more likely to be “a rapid growing cancer”.
Prof Sikora said: “He would have had health screens every month, and he doesn’t have to wait six weeks to see his GP. He’s not likely to be asking the NHS for advice.”
This view has also been shared by Donald Trump Jr. Mistaking Mr Biden’s diagnosis as stage five, rather than stage four, the current president’s son wrote on X: “How did Dr Jill Biden miss stage five metastatic cancer or is this yet another cover-up???”
Mrs Biden is a doctor of education rather than a medical doctor, but a number of prominent US health professionals have asked why Mr Biden’s prostate cancer, which can be detected early using routine blood tests recommended for all men over 50, was not spotted earlier.
On Monday morning, Mr Biden released a message on social media, which read: “Cancer touches us all. Like so many of you, Jill and I have learnt that we are strongest in the broken places. Thank you for lifting us up with love and support.”
On Monday, JD Vance, the US vice-president, raised concerns about why the American public were kept in the dark about Mr Biden’s health woes.
“I don’t think he was able to do a good job for the American people, and that’s not politics... that’s because I don’t think he was in good enough health,” said Mr Vance. “In some ways, I blame him less than I blame the people around him.
“Why didn’t the American people have more accurate information about what he was actually dealing with? This is serious stuff. This is the guy who carries the nuclear football for the world’s largest nuclear arsenal. This is not child’s play.
“We can pray for good health, but also recognise that you’re not in good enough health to do the job, you shouldn’t be doing the job.”
Mr Biden, the oldest serving president in American history, was given a clear bill of health and deemed “fit to serve” by his doctor last February amid growing concerns over his age and claims of declining health. Dr Kevin O’Connor said there were “no new concerns” with the then president’s health.
His office announced in a statement: “On Friday, he was diagnosed with prostate cancer, characterised by a Gleason score of 9 [Grade Group 5] with metastasis to the bone.”
Donald Trump is not concerned about the standard of White House physicians following Mr Biden’s diagnosis, his press secretary said.
Asked if the US president was worried about his quality of care, Karoline Leavitt told a press briefing: “Not as far as President Trump is concerned.”
“The White House position we have here is phenomenal, and the team of physicians that take care of the president, particularly at Walter Reed Medical Centre, are great.”
Ms Leavitt said she believed Mr Trump is screened for prostate cancer as part of his medical examinations.
The King has written privately to Mr Biden in the wake of his cancer diagnosis, Buckingham Palace said. The monarch, who is still undergoing treatment for an undisclosed cancer, is thought to have expressed his support and sent his best wishes.
Prostate cancers are graded for aggressiveness using the Gleason score. A score of nine suggests Mr Biden’s cancer is among the most aggressive.
Metastasised cancer, when the disease spreads to other parts of the body, is much harder to treat than localised cancer because it can be hard for drugs to reach all the tumours and completely root out the disease.
“While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive which allows for effective management,” Mr Biden’s office added. “The president and his family are reviewing treatment options with his physicians.”
Dr Howie Forman, a professor of radiology and biomedical imaging at Yale, who has worked in the US senate as a health policy fellow, said: “It is inconceivable that this was not being followed before he left the presidency.”
The prostate-specific antigen (PSA) test would have shown he had elevated levels of cancer cells “for some time before this diagnosis”, he wrote on X. “And he must have had a PSA test numerous times before. This is odd.”
It is unclear whether the former president was screened for prostate cancer during his presidency, which means his aggressive form of the disease may have developed undetected. Health bodies have warned that PSA testing is often unreliable.
Like Dr Forman, other health experts have questioned how the cancer went undetected in a man of his stature and access to medical care.
Dr David Shusterman, a urologist, told News Nation on Sunday: “It’s unusual to hear that someone has prostate cancer when they’re annually being followed up. The fact that we find it at a Gleason 9 is unheard of.” He added that Mr Biden would have had “state-of-the-art care”.
Dr Stephen Quay, a physician and cancer expert, went further, saying it would be “malpractice” to not test for prostate cancer in a serving US president.
“It is highly likely he was carrying a diagnosis of prostate cancer throughout his White House tenure and the American people were uninformed,” he added.
Prostate cancers are generally slower growing than other forms of cancer and can take up to eight years to spread to other parts of the body, but some aggressive forms can spread quickly. It is unclear whether or not Mr Biden will receive surgery. Some patients get chemotherapy or radiation on top of hormone therapy.
Outcomes have improved in recent decades and patients can expect to live with metastatic prostate cancer for four or five years, said Dr Matthew Smith of Massachusetts General Brigham Cancer Center.
“It is treatable, but not curable,” said Sophie Smith, a senior specialist nurse at Prostate Cancer UK. But treatments are “very effective” even if it has spread, she said, adding that men with advanced forms of prostate cancer can “easily live for five to 10 years”.
“It is very possible Joe Biden could die of something totally different,” said Ms Smith.
In February 2023, Mr Biden had a lesion removed from his chest that was a basal cell carcinoma, a common form of skin cancer. In November 2021, he had a benign but potentially precancerous lesion removed from his colon.
In the wake of his new diagnosis, a resurfaced video from 2022 is being widely shared of Mr Biden accidentally saying he had cancer, which sparked speculation surrounding his health at the time.
Delivering a speech on environmental pollution in Massachusetts, he said in the present tense: “That’s why I – and so damn many other people I grew up with – have cancer”.
Mr Biden’s diagnosis came just days after Original Sin, a new book based on the accounts of White House insiders, claimed that aides had shielded the public from the extent of his decline while he was serving as president.
On Sunday night, Naomi Biden, Mr Biden’s granddaughter, criticised Brian Stelter, a CNN media analyst, who said it was “extraordinary” that the announcement about her grandfather’s cancer diagnosis came just as the book was released.
Mr Stelter spoke at length about Original Sin, by his CNN colleague Jake Tapper. An X user asked if Mr Stelter “had no shame” when appearing to market the book on air. Ms Biden responded: “Apparently not.”
Mr Biden would have most likely had prostate cancer while he was president, Dr Zeke Emanuel said.
Speaking on MSNBC, Dr Emanuel, who was appointed to the Covid-19 Advisory Board by Mr Biden, said the condition would not have developed in the “last 100 days”.
“He had it while he was president,” he added.
“He probably had it at the start of his presidency in 2021. Yes, I don’t think there’s any disagreement about that.”