Donald Trump is right: Joe Biden’s cancer diagnosis should be investigated
Joe Biden’s cancer diagnosis, revealed just four months after he left the White House, is provoking deeply awkward questions.
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Donald Trump is right. Joe Biden’s cancer diagnosis, revealed to the world a mere four months after he left office, does demand a serious investigation.
I’ll begin with an obvious proviso: the former US president’s diagnosis is tragic news, and everyone should hope for his treatment to proceed as successfully as possible. Nothing written below invalidates that.
But the plea we’ve heard from some Democrats in the US, that Mr Biden’s condition should quieten the already raging discussions about his health, defies sense.
“I think those conversations are going to happen, but they should be more muted and set aside for now,” said the former top political adviser to Barack Obama, David Axelrod, for example.
Come on. It is entirely possible to have sympathy for Mr Biden, and to hold concerns about the way both he and those around him handled his ill health throughout his presidency. We’re adults here, we can consider more than one thing at a time.
And how very much there is to consider. Mr Trump can get us rolling.
“I think people should try and find out what happened,” he said today.
“I don’t know if it had anything to do with the hospital. Walter Reed (where presidents receive medical treatment) is really good. They’re some of the best doctors I’ve ever seen. I don’t even know if they were involved.
“But a doctor was involved, in each case. Maybe it was the same doctor. And somebody is not telling the facts. It’s a big – that’s a big problem.”
I started the article by saying Mr Trump is right. It’s more that he’s partially right. He’s right about the most basic question here, and is getting a little too speculative about the rest.
“Somebody is not telling the facts,” is an assumption for which we do not have evidence.
“People should try to find out what happened,” however, is obviously true. We need more information before we can judge whether this was caused by negligence, or incompetence, or flawed medical guidelines.
The concept of a cover-up, with which Mr Trump flirted, is being floated more openly by others. The idea here is that Mr Biden was diagnosed well before now, but for presumably political reasons, it went undisclosed.
That remains far-fetched until any proof to support it emerges.
Certain facts are already available.
We know, from the public summary released after his most recent annual physical at Walter Reed, in February of last year, that Mr Biden consulted almost a dozen specialists, from fields including orthopaedics, neurology, cardiology, dermatology and radiology.
We also know he underwent a range of tests; you can read about them yourself here. But those tests did not include a prostate-specific antigen (PSA) test, which is what eventually yielded the cancer diagnosis, having been prompted, at an as yet unspecified date, by the discovery of a nodule in his prostate.
By then the cancer had developed into an advanced, aggressive form. And as Mr Trump pointed out today, that development typically “takes a long time”. Potentially years.
“I’m surprised that the public wasn’t notified a long time ago, because to get to Stage 9, that’s a long time,” he said.
There’s no such thing as Stage 9 cancer. Mr Trump was presumably mixing that up with Mr Biden’s Gleason score of nine, a measure which can range from six to ten, and measures the severity of prostate cancer specifically. (You can read about the Gleason score, and how it’s calculated, here.)
But the question Mr Trump skirted around, which is how Mr Biden’s cancer remained undetected for so long, is an entirely valid one.
“Everyone is asking me that same question,” said Dr Kirsten Greene, a specialist in prostate cancer and chair of the urology department at the University of Virginia.
“I have two speculations. One is that prostate cancer screening guidelines in the US recommend stopping prostate cancer screening after age 75,” she told UVA Today, the university’s news site.
“It’s uncommon to continue to check a PSA every year beyond the age of 75 if your PSA has been fine prior to that.”
That could plausibly fit with the timeline of Mr Biden’s diagnosis. The former president is 82, and prostate cancer can take as many as seven years to develop to this extent.
“The other possibility could be that his prostate cancer is so aggressive or de-differentiated that it actually stopped making PSA. It’s an unusual situation.”
Dr Greene also noted it was possible that Mr Biden’s previous biopsies had simply “happened to miss” the cancer.
The most likely explanation, then, is that Mr Biden didn’t receive the PSA test during his presidency because America’s guidelines don’t recommend it at that age. But keep in mind, this is one of the most powerful, well-cared for people in the world, with the best medical specialists available to him at any time.
Mr Trump did do the test during his annual physical three months ago, and returned a normal result. He, too, is above the age threshold where it’s recommended.
Whatever the reason for Mr Biden’s cancer being missed, it should be found – at the very least, as a matter of public interest for the treatment of future, ahem, geriatric presidents.
Biden health scandal keeps growing
None of the above should distract too much (despite Mr Axelrod’s suggestion) from all the other issues swirling around Mr Biden’s health.
This cancer news has emerged in the exact same week as a damning book, written by CNN anchor Jake Tapper and Axios journalist Alex Thompson, which details Mr Biden’s “decline” while in office and a “cover-up” orchestrated by those around him.
Mr Biden’s granddaughter, Naomi, has dismissed the book as “a bunch of unoriginal, uninspired lies written by irresponsible self-promoting journalists out to make a quick buck”, which would read as eerily Trumpy if she had only added a few words in all-caps.
Wait, let me fix it.
“A bunch of Unoriginal, Uninspired LIES written by irresponsible self-promoting ‘journalists’ out to make a QUICK BUCK.”
That’s better.
But look. Tapper and Thompson are respected, veteran journalists. They’re not right-wing hacks. The book contains extensive reporting. And yes, many of their sources were given anonymity in return for speaking – I can’t recall Ms Biden, or any Democrats, having a problem with that when tell-all books about Mr Trump were being published.
So, through sheer weight of evidence, we know Mr Biden’s inner circle was capable of obscuring the truth about his health.
Mr Trump’s Vice President, J.D. Vance, made a fair point while speaking to reporters today.
“We really do need to be honest about whether the former president was capable of doing the job,” Mr Vance said.
“You can separate the desire for him to have the right health outcome with the recognition that whether it was doctors, or whether there were staffers around the former president, I don’t think he was able to do a good job for the American people.
“That’s not politics. That’s not because I disagreed with him on policy. That’s because I don’t think he was in good enough health.”
Mr Vance said that, “in some ways”, he blamed Mr Biden himself less than those around him.
“Why didn’t the American people have a better sense of his health picture? Why didn’t the American people have more accurate information about what he was actually dealing with? This is serious stuff,” he said.
“We can pray for good health, but also recognise that if you’re not in good enough health to do the job, you shouldn’t be doing the job.”
Twitter: @SamClench
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