Dr. Ezekiel Emanuel, an oncologist who served on Joe Biden’s COVID-19 advisory board, expressed shock over revelations that the former president has aggressive prostate cancer, saying he was “surprised” the diagnosis was only released Sunday as the advanced cancer had almost certainly developed by the start of the former president’s term in office.

The country was stunned over the weekend when Biden revealed he had been diagnosed with prostate cancer that had metastasized to the bone. The announcement immediately spurred accusations, including from President Donald Trump’s eldest son, that Biden had known for years about the diagnosis and covered it up to run for reelection last year.

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On Monday, Emanuel appeared on MSNBC’s Morning Joe to express his own “surprise” that the diagnosis was missed before now, raising concerns that Biden’s doctors may have uncovered the diagnosis but hid the information from the public.

“He’s had this for many years, maybe even a decade, growing there and spreading,” the doctor said. “And it is a little surprising to many of us oncologists that he wasn’t diagnosed earlier.”

Emanuel also said he was confused why Biden would not have been tested for prostate-specific antigens, a screening exam for prostate cancer commonly used by other presidents, during his time in the White House. Trump, along with former Presidents George W. Bush and Barack Obama, have taken the PSA test, Emmanuel told host Joe Scarborough.

“President Obama had this test,” Emanuel said. “President Bush had this test. It is a little surprising that the doctor didn’t take it. And if he took it and didn’t report it and it was elevated, that is another case of doctors not being straightforward with us. And if that is true, that would be very troubling.”

Emanuel said he had examined Biden’s health records and found no evidence that he had a PSA test.

“Now, it is true that a lot of people recommend not doing a prostate-specific antigen after 70, but President Biden’s been in public life a very long time,” the doctor said. “He was vice president and had a lot of exams under 70, so it’s a little surprising that they didn’t do it.”

The Gleason score measures how advanced prostate cancer is on a historical scale of 6-10, with 10 being the worst. Emmanuel said that because Biden’s Gleason score was a nine, it was highly unlikely any test would miss the aggressive cancer.

“Either they didn’t test for it or they did test for it, they didn’t report it, and we didn’t get the information as a public,” the doctor told Scarborough.

Emanuel’s concerns echo those of other doctors as well. And a stream of top political figures, primarily Republicans, have leveled accusations that Biden’s team deliberately covered up the cancer diagnosis from the public, even as the former president mounted a reelection campaign in 2024.

The medical report comes as Biden’s team has been inundated with accusations in recent days that it deceived and misled the public as to the extent of the former president’s cognitive decline. The worries have been fueled by a book set to come out later this month by CNN’s Jake Tapper and Axios’s Alex Thompson, which details Biden’s dementia-like symptoms over the past few years, as revealed by close associates and Democratic colleagues.

“The book makes it very, very clear there are people who knew and said nothing,” former Obama adviser and CNN commentator Van Jones said Sunday. “And that is a crime against this republic. I think the Democrats are going to pay for a long time for being a part of what is now being revealed to be a massive cover-up.”

BIDEN DIAGNOSED WITH AGGRESSIVE FORM OF PROSTATE CANCER: WHAT TO KNOW

Some of the most staunch Biden loyalists have stuck to their guns, saying they still believe the former president was fit to spend another four years in the Oval Office.

“I talked to him on the telephone very often,” Rep. James Clyburn (D-SC) said during a CNN interview on Sunday. “And I never saw anything that I thought was outside of the ordinary. I watch my dad reach the age of 80. I saw him slow down, he couldn’t do the same things he did at 50 or 60. But it didn’t bother his mental capacity at all. And then my father died from prostate cancer. So I never saw anything I thought was unusual.”