President Joe Biden’s recent diagnosis with an aggressive form of prostate cancer has raised serious medical and political questions—none more startling than the suggestion from a leading medical expert that the cancer may have been present and undetected for years.

While the official statement from the President’s team described the diagnosis as recent, one prominent oncologist has cast doubt on that timeline. According to the expert, the type and stage of cancer revealed in the President’s medical summary—characterized by a high Gleason score and signs of metastasis—strongly suggest that it has been developing quietly for an extended period.

Silent Symptoms, Serious Signs

“Prostate cancer of this nature doesn’t happen overnight,” the physician, who specializes in urologic oncology and asked to remain anonymous due to the sensitivity of commenting on a sitting president’s health, said. “A Gleason score of 9, with evidence of bone metastasis, usually indicates that the disease has been progressing for quite some time—often years. It raises valid questions about how and when this was detected, and whether there were earlier signs.”

Prostate cancer is one of the most common cancers among older men, but its progression can vary drastically. In many cases, it grows so slowly that patients die of other causes before the cancer becomes life-threatening. However, in more aggressive forms—like the one President Biden has—it can remain hidden while steadily worsening.

The diagnosis also noted that the cancer is hormone-sensitive, which, although serious, allows for more effective treatment options. Hormone therapy, radiation, or even chemotherapy could play a role in managing the disease. But the presence of metastases—particularly in the bones—signals a more advanced stage, with longer-term implications.

Timeline Questions

The question now looming among health professionals and political analysts alike is: Could this cancer have been caught earlier?

Experts say regular PSA (Prostate-Specific Antigen) testing is key to early detection. Typically, routine PSA screenings are recommended for men beginning around age 50, though some health organizations advise stopping the tests after age 70 due to the slow progression of most prostate cancers. Biden, at 81, would fall well outside of that standard screening window—unless he or his doctors had reason to monitor him more closely.

Dr. Lena Ortiz, a public health analyst and medical ethics advisor, explained: “When someone in the public eye, especially at this level of power, receives a diagnosis of this nature, the timeline becomes incredibly important. Not just for health reasons, but for transparency, trust, and the impact on national governance.”

She added, “If it’s found that this cancer had been developing over the course of several years and symptoms were ignored or downplayed, it could trigger an entirely different type of concern.”

A Complex Political Moment

The timing of Biden’s diagnosis—amid a contentious political season and shortly after books questioning his cognitive health surfaced—has added a layer of complexity to an already sensitive issue. Though the administration has emphasized that the President remains capable of performing his duties, some political observers say the news reinforces growing public concern over the President’s age and long-term viability.

Still, in a surprising gesture of unity, former President Donald Trump issued a public message of support following the announcement, offering best wishes for a “fast and successful recovery.” It marked a rare moment of civility in an otherwise combative political climate.

Despite the warm wishes, the diagnosis has prompted speculation about whether Biden will remain in the race for re-election or consider stepping aside. If treatment becomes more aggressive or taxing, it could impact his physical ability to campaign or fulfill the rigorous demands of office.

The Path Forward

As of now, Biden’s medical team has stated that he and his family are exploring treatment options, and further updates will be shared as appropriate. The nature of his cancer being hormone-sensitive is somewhat reassuring, as such cancers tend to respond well to intervention. Still, long-term outcomes remain uncertain—especially for a patient of his age.

Behind the scenes, the conversation is shifting. Medical professionals are urging the public to understand the implications of late-stage diagnosis, while political allies and critics alike wait to see how this new chapter in Biden’s presidency unfolds.

One thing is certain: this diagnosis did not arrive overnight. And as questions continue to swirl about when the signs began and whether they were addressed in time, the quiet shadow of uncertainty now looms over the highest office in the nation.