Either the most monitored patient in America received substandard care, or the public was deliberately misled. Neither possibility inspires confidence.
"On Biden’s dx, I completely agree with your take. I obviously think it should be applied across the aisle, too. Candidate Trump liked about his height and weight, had a doctor lie about his health, and was completely not transparent about the medical ramifications of the attempted assassination. In his first term, he was rushed to the hospital and was completed opaque on it.
As part of a “good government” package, I think we should implement some medical exams required of certain important roles. And transparency about when mandated by law."
And I have to say that I absolutely agree. This is NOT a partisan whine, it's an attempt to call out dishonesty in order to preserve our ability to lead patients. A lack of transparency does not get us there.
I unfortunately see patients every day in this exact scenario. In fact, I recently saw a man in his 80s (still biking 40 miles per week) diagnosed with metastatic prostate cancer with no symptoms other than urinary retention. Gleason 9 means it commonly spreads quickly and is not found routinely through screening and by the time symptoms occur it is often metastatic. We have to be careful about these discussions online as they quickly become political fuel. Let’s focus on kindness and wish he and his family all the best instead of immediately jumping to conclusions.
I should also add that we do unfortunately see later staged prostate cancer (previously undiagnosed) in the ER but it's primarily in patients with limited access to care/refusal to seek care. Appreciate your perspective.
Love this context and follow up and appreciate you offering a 3rd option of possible that everyone practiced good medicine and it was just missed. I do wish him and his family the best and hope that they focus on comfort and quality of life.
This article reflects a fundamental misunderstanding of how prostate cancer behaves and how we care for aging patients. Aggressively screening any patient at 82 years old for prostate cancer is malpractice. Do your research please.
While obviously I agree that PSA is a terrible test and that screening leads to harmful and unnecessary biopsies (as I pointed out in the article), I'm not suggesting that there should have been more "aggressive screening" I'm simply suggesting that there must have been signs/symptoms prior to 2 days ago and that the most likely scenario is that he had symptoms, was diagnosed and dx was not shared. Does it seem likely that a patient who has access to medical care and is incredibly well cared for my top physicians could have a diagnosis such as this that were just missed? I'm happy to entertain that notion, it just seems incredibly unlikely compared to the alternative.
Received the following anonymous DM:
"On Biden’s dx, I completely agree with your take. I obviously think it should be applied across the aisle, too. Candidate Trump liked about his height and weight, had a doctor lie about his health, and was completely not transparent about the medical ramifications of the attempted assassination. In his first term, he was rushed to the hospital and was completed opaque on it.
As part of a “good government” package, I think we should implement some medical exams required of certain important roles. And transparency about when mandated by law."
And I have to say that I absolutely agree. This is NOT a partisan whine, it's an attempt to call out dishonesty in order to preserve our ability to lead patients. A lack of transparency does not get us there.
I like your clear presentation .
Great article! And disappointing/disturbing...
I unfortunately see patients every day in this exact scenario. In fact, I recently saw a man in his 80s (still biking 40 miles per week) diagnosed with metastatic prostate cancer with no symptoms other than urinary retention. Gleason 9 means it commonly spreads quickly and is not found routinely through screening and by the time symptoms occur it is often metastatic. We have to be careful about these discussions online as they quickly become political fuel. Let’s focus on kindness and wish he and his family all the best instead of immediately jumping to conclusions.
I should also add that we do unfortunately see later staged prostate cancer (previously undiagnosed) in the ER but it's primarily in patients with limited access to care/refusal to seek care. Appreciate your perspective.
Love this context and follow up and appreciate you offering a 3rd option of possible that everyone practiced good medicine and it was just missed. I do wish him and his family the best and hope that they focus on comfort and quality of life.
This article reflects a fundamental misunderstanding of how prostate cancer behaves and how we care for aging patients. Aggressively screening any patient at 82 years old for prostate cancer is malpractice. Do your research please.
While obviously I agree that PSA is a terrible test and that screening leads to harmful and unnecessary biopsies (as I pointed out in the article), I'm not suggesting that there should have been more "aggressive screening" I'm simply suggesting that there must have been signs/symptoms prior to 2 days ago and that the most likely scenario is that he had symptoms, was diagnosed and dx was not shared. Does it seem likely that a patient who has access to medical care and is incredibly well cared for my top physicians could have a diagnosis such as this that were just missed? I'm happy to entertain that notion, it just seems incredibly unlikely compared to the alternative.