The news that any president — recently departed from office and who had been, up until a disastrous debate performance and the fallout, seeking another four years in the office — had been diagnosed with metastatic cancer is going to receive immediate and swift wall-to-wall coverage and attention from the media.

However, in addition to the coverage being given to the fact that former President Joe Biden has cancer, attention was also being paid — albeit not with the ardor the facts that we know about Biden’s specific case were being expounded — to the type of cancer he had and the general nature of its progression: prostate cancer which shows significant spread throughout his body.

On Sunday, the office of the former president announced that Biden had been diagnosed on Friday; according to The Associated Press, he had been complaining of urinary symptoms when doctors found a nodule on his prostate. Further tests revealed the cancer cells had spread to his bones.

“While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive which allows for effective management,” the former president’s office said. “The President and his family are reviewing treatment options with his physicians.”

It’s first worth noting that this is sanitized language. What can be gleaned from the release is that this is Stage 4 metastatic prostate cancer — specifically, Stage 4B, where the disease “has spread to distant parts of the body, such as the bones, other organs or distant lymph nodes,” according to cancer advocacy group City of Hope. For the uninitiated, there is no Stage 4C or Stage 5. This is, bluntly, as far as this disease goes on the clinical scale.

Prostate cancers are graded on what’s known as the Gleason Scale, which ranks them from 1-10 in ascending rate of seriousness. The Washington Post reported that Biden’s cancer had been given a Gleason Score of 9, the second-most aggressive kind possible.

“If I have a Gleason Score of 6, it is almost never metastatic. If I have a 7, 8, 9 or 10, it can be metastatic. As the number goes up, the likelihood of it being metastatic goes up,” said Otis Brawley, a medical oncologist at Johns Hopkins University.

However, here comes the thorny issue, the one the media doesn’t quite want to touch right now but which should raise some eyebrows: Even if prostate cancer is metastatic, it’s one of the slower-developing cancers even in aggressive form, and a Stage 4B diagnosis in a man who is receiving nearly constant medical treatment by the best doctors in the world for years on end — again, even if it is aggressive — ought to at least raise eyebrows.

Prostate cancer is also one of the easier cancers to diagnose, particularly given Biden’s age and the relative frequency of it. Blood tests that check your PSA, or prostate-specific antigen, levels ought to catch some abnormality. An MRI, an ultrasound or a biopsy would then yield further information about whether there was an issue.

Doctors on social media expressed some surprise that, even with an aggressive form of the disease, this was something that was just now caught due to random urinary symptoms:

Prostate cancer is the easiest cancer to diagnose when it first starts and to watch it progress to bone metastases. The PSA blood test shows the rate of cancer cell growth. For even with the most aggressive form, it is a 5-7 year journey without treatment before it becomes…

— Dr Steven Quay (@quay_dr) May 18, 2025

Best-selling author Dr. Steven Quay noted on X that “even with the most aggressive form, it is a 5-7 year journey without treatment before it becomes metastatic,” an assessment that X’s Grok AI seemed to confirm as a generally correct statement in a follow-up response.

The claim that prostate cancer is easily diagnosed early with PSA tests is generally accurate, as PSA screening often detects cancer before it metastasizes. However, aggressive cases can progress rapidly, and not all cancers show elevated PSA, so late diagnoses can occur. The 5-7…

— Grok (@grok) May 18, 2025

Dr. Drew Pinsky of “Loveline” fame also expressed some doubt over this when responding to a video featuring a Biden gaffe (or was it?) from one of his presidential speeches in which he claimed he had cancer.

“To be fair, beginning with the finding of a nodule and then discovering advanced disease does not pass the sniff test,” Pinsky said. “Someone not receiving adequate or routine healthcare this would make some sense but does not fit the level of medical supervision given to POTUS.”

To be fair, beginning with the finding of a nodule and then discovering advanced disease does not pass the sniff test. Someone not receiving adequate or routine healthcare this would make some sense but does not fit the level of medical supervision given to POTUS. https://t.co/ldujgqqWiM

— Dr. Drew (@drdrew) May 18, 2025

Urologist Dr. David Shusterman, appearing on liberal-leaning cable news outlet NewsNation, also shared a similar sentiment, saying a timeline of the progression of this kind of cancer would more than likely have encompassed the entirety of Biden’s presidency and first campaign, if not longer — meaning he either should have, or did, know about it. (The latter, again given the medical scrutiny afforded to candidates and presidents, is the far more likely scenario):

Urologist David Shusterman says Biden probably knew he had cancer 5-10 YEARS AGO, possibly before he even ran for President in 2020.

“Most likely, he had prostate cancer for a long time.”

Full on coverup. pic.twitter.com/4YEdaLzyaz

— Libs of TikTok (@libsoftiktok) May 19, 2025

It is also speculation — but not unwarranted speculation, not with the cover-up of the president’s physical and mental deterioration in office now being a matter of public record — to note the nature of that deterioration and the timing of the announcement.

Reports and books already released on the former president’s disastrous re-election campaign describe him as being unusually fatigued, mentally and physically, to the point where he was unable to get through either one of the two practice debates his team held before the June 27, 2024 debacle.

From Chris Whipple’s “Uncharted: How Trump Beat Biden, Harris, and the Odds in the Wildest Campaign in History,” regarding how former Biden chief of staff Ron Klain described those sessions:

“At his first meeting with Biden in Aspen Lodge, the president’s cabin, [Klain] was startled,” Whipple wrote.

“He’d never seen him so exhausted and out of it. Biden was unaware of what was happening in his own campaign. Halfway through the session, the president excused himself and went off to sit by the pool.”

“That evening Biden met again with Klain and his team, [Biden aides] Mike Donilon, Steve Richetti, and Bruce Reed. ‘We sat around the table,’ said Klain. ‘[Biden] had answers on cards, and he was just extremely exhausted. And I was struck by how out of touch with American politics he was. He was just very, very focused on his interactions with NATO leaders.’”

Also from that same book: “25 minutes into the second mock debate, the president was done for the day. ‘I’m just too tired to continue and I’m afraid of losing my voice here and I feel bad,’ he said. ‘I just need some sleep. I’ll be fine tomorrow.’ He went off to bed.”

Meanwhile, a new book from CNN’s Jake Tapper and Axios’ Alex Thompson alleges aides discussed having to use a wheelchair for his second term in office, with one aide telling them, “He just had to win, and then he could disappear for four years — he’d only have to show proof of life every once in a while.”

Among chemotherapy side effects from the website of the Cleveland Clinic:

• Fatigue. Fatigue is the most common chemotherapy side effect. The work your body is doing to fight cancer and recover from treatments can leave you feeling drained. Chemotherapy can also cause low blood counts (anemia), which leads to feeling tired.
• Trouble thinking and remembering. Chemo brain prevents you from thinking as clearly as you’re used to. Some people going through chemo experience issues with memory, especially short-term memory.
• Peripheral neuropathy. Chemotherapy-induced peripheral neuropathy (CIPN) may make parts of your body (usually your hands and feet) feel painful, numb or tingly (a “pins and needles” feeling). You may find it difficult to coordinate your muscles.

I think we can all agree two things: First, Biden was never mentally agile, and second, what we saw on stage last June was such a dramatic diminishment to what little agility he had that the shock to the American electorate was so great that — within weeks, despite herculean efforts on his part — he was no longer the standard-bearer of his own party, an unprecedented occurrence in the 236 years of the American presidential election process.

Second, the timing is again worth belaboring here, if just because it is so nakedly duplicitous that — were a grave disease and the attendant circumstances not involved — the story would be the cynicism and not the cancer, even at CNN.

Tapper and Thompson’s book on the president’s decline comes out on Tuesday and promises to be the biggest info-dump yet regarding just how serious the situation was, even if Tapper’s involvement — given that he was one of the biggest proponents of the “sharp as a tack” school of Biden-splaining during his term — is self-serving.

Meanwhile, on Friday, the first audio excerpt of Biden’s 2023 interview with special counsel Robert Hur was released, revealing that the transcripts didn’t do the diminishment of Biden’s capabilities justice and, by blocking any such release of the audio, the White House and congressional Democrats were complicit in covering up for the fact that this man was incapable of carrying out his duties in office:

It’s not second-shooter-on-the-grassy-knoll stuff to point out that, if there is ever a time to drop information regarding a cancer diagnosis for a former president to let it slip by with the minimal amount of serious media examination — particularly a diagnosis that might raise some significant questions about when and how the diagnosis was made, and how the cancer was missed if it were missed — it would be on a Sunday evening that’s equidistant between the date of the release of that audio clip and that of the book.

It’s the kind of timing that engenders reflexive sympathy and deters unwanted scrutiny at a much-needed moment — so much so that it would appear transparent to a minimally functioning journalistic ecosystem, which we as a culture do not (alas) currently possess.

Again, this isn’t something you want to talk about or hope that was kept from you.

As a matter of full disclosure, in fact, I have an anaphylactic reaction to conspiracy theories, more so than even the average American: Lee Harvey Oswald killed JFK, Sirhan Sirhan killed RFK, we landed on the moon, the temperature at which steel melts had nothing to do with the structural integrity of the World Trade Center buildings after the attacks, the lizard people only exist in “Fear and Loathing in Las Vegas,” and the Illuminati has not had influence on anything, anywhere, outside of maybe 18th-century Bavaria. End of discussion.

With Biden, however, what we are talking about are not conspiracy theories: They’re theories, period, full stop.

We not only know that he was critically diminished, even for an octogenarian, we also know that critical diminishment was actively hidden by a White House inner circle and Democratic Party that’s willing to talk about certain elements of his decline, but not all of it — nor furnish us with a complete medical history, which might not be believed anyhow given the subterfuge they’ve already copped to.

These people are now willing to admit the “what” without giving us too much about the “why.” It’s fair to say that, while our prayers are with President Biden and his family, this is a case where, yes, questions must be asked, and pointedly.

This is already a scandal that’s at least the equivalent of Watergate in scope and seriousness; an infirm and incapable president was propped up by a White House which threatened anyone in the press that dared to do their job and ask about the president’s ability to do his job. We now have an unfortunate new thread in this drama, and it needs to be examined.

Yes, such questioning may be painful, particularly for a former first family now dealing with a patriarch with Stage 4 cancer. However, that additional pain could have been precluded had we, the American people, been told the truth by that family and those who enabled them — and the consequences of that dissembling has affected each and every one of us. The Bidens and those close to them get our prayers, but they do not get a pass, not after what they’ve dragged us through just to save the political career of a senescent man now provably — very sadly, but very provably — on death’s door.

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