JUANA SUMMERS, HOST:
President Biden's diagnosis with metastatic prostate cancer highlights some of the progress made in treatments of the disease, as well as some of its challenges. NPR's consumer health correspondent Yuki Noguchi joins us to discuss what it all means. Hi, there.
YUKI NOGUCHI, BYLINE: Hi.
SUMMERS: Yuki, many of us have often heard that prostate cancer is common. What are the risks of getting it and then surviving?
NOGUCHI: You know, it's the most common form of cancer in men. Only lung cancer is more lethal. But there are huge recent developments in drugs and detection, so survival is rapidly increasing. Oncologist William Dahut is chief scientific officer of the American Cancer Society. But before that, he researched prostate cancer for two decades.
WILLIAM DAHUT: Prostate cancer mortality has fallen by about 50% since the early '90s, which is a spectacular number.
NOGUCHI: I mean, it's a lot, and he says much of that is because of earlier detection, as well as new treatments that have made, you know, even faster-growing, aggressive disease, like former President Biden's, easier to fight.
SUMMERS: Now, what we've seen in terms of the statement about Biden's diagnosis mentions that his cancer appears hormone-sensitive, and that's good for prognosis. Can you explain why?
NOGUCHI: Yeah. Earlier, I mentioned big advances in cancer treatments, and one of the big ones is the breakthrough in understanding the significant roles hormones play in feeding cancer. Hormones fuel gynecologic cancers like breast or ovarian cancer, too. And it turns out cancer growth can also be interrupted by starving it of testosterone or estrogen. Now, this ability, in general, to be able to target cancer is very, very key to understanding why cancer is more survivable today. You know, being able to identify and kill only the cancer cells and not the healthy ones reduces those nasty side effects that can make, you know, it very hard for patients. Here's Dr. Dahut again.
DAHUT: Men who have a very long response to multiple hormonal therapies are the ones who, you know, have the - sort of the best overall quality of life and tend to live the longest with metastatic prostate cancer.
SUMMERS: Now, Yuki, we've been told that this was caught after it had metastasized to his bones. And presumably presidents, they get more medical attention than the rest of us. So how might this have gone undetected until it had spread?
NOGUCHI: Yeah. That's a good question. You know, one of the things that's true, generally, about the population is that only about a third of men are screened for prostate cancer, you know, which starts out with a blood test and then an MRI, if you need it, and a biopsy. You know, access to care for those things can be an issue for the overall public, especially in minority communities. Obviously, that is not the case for, you know, former President Joe Biden.
His cancer is also unusual in that it is aggressive and fast-growing, which, you know, typically, prostate cancer is not. You know, but one - another reason why it might not have been caught is that, you know, the guideline gurus in, you know, the U.S. Preventative Services Task Force (ph), you know, no longer recommends routine screening for men over the age of 70. And that's because most tumors are slow-growing...
SUMMERS: Right.
NOGUCHI: ...So there aren't a lot of benefits to treatment at a certain age. So doctors often recommend watchful waiting. But obviously, in this case...
SUMMERS: OK.
NOGUCHI: ...With the president, that's not going to work.
SUMMERS: NPR's Yuki Noguchi. Thank you.
NOGUCHI: Thank you.
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