I am a prostate cancer patient and a board-certified health care chaplain. I’ve served patients from every end of the spectrum. And I’m living with hormone-sensitive, high-grade (Gleason 9) prostate cancer, just like former President Biden.
Lots of political commentators have speculated about the timeline and severity of Biden’s recent diagnosis. If you don’t believe he only just found out, or if you’re wondering whether the short timeframe described in the White House’s public statement could really be accurate, I understand your skepticism. But I also understand this disease. And based on what I have lived and what I have seen in hundreds of patients, I want to explain why the official timeline is entirely plausible.
My cancer was found by mistake. A non-routine blood test was ordered in error, and that’s what flagged the concern. Just days before, I had undergone a prostate exam that came back completely normal. After my diagnosis, I consented to a follow-up evaluation by three different urologists to see if a more expert or aggressive technique would have caught it earlier. Only one thought he maybe felt something unusual. Maybe.
In other words, this is a cancer that hides well — even from the well-trained.
Prostate exams are unpleasant, for both the clinician and the patient. Providers who have with good relationships with their patients are often reluctant to cause discomfort. And frankly, the more important or high-profile the patient, the more likely it is that the exam will be cursory or overly cautious. I would bet money that an 82-year-old former president receives a less aggressive, less thorough, and less uncomfortable prostate exam than a 19-year-old enlistee at a military entrance processing station. That’s not negligence — that’s human nature.
As a healthcare chaplain, I have ministered to men in charity hospitals and in luxury retirement communities. I have had patients who saw their primary care doctor like clockwork and patients who met their first physician in hospice. Across all of those spectra — wealthy and working-class, thoroughly examined and tragically overlooked — I have known men who only discovered their prostate cancer only when rectal bleeding began. And by that point, any chance at curative treatment is gone.
So yes, it is entirely possible that Biden’s cancer was only recently discovered and is already considered advanced. That is how prostate cancer often works. It doesn’t cause pain early on. It doesn’t trigger alarms. And it often hides from detection unless something unusual leads a provider to dig deeper. The idea that a man could receive regular exams and still wind up with a late-stage discovery? It doesn’t surprise me at all. It happened to me.
I don’t know Biden personally, and my views on his politics are not even relevant. What I do know is this: He is a man with cancer, and I am deeply sorry he is going through this. I wish his family love and strength, and I hope they find the best path forward for him — one that makes sense for him and brings peace to those he loves. Full stop.
If you put anything resembling a “but” after that full stop — if you use this diagnosis to spin up a conspiracy theory, score political points or undermine the dignity of a man facing cancer — you’re not just attacking the president. You’re insulting the 3.5 million men in this country who are currently living with the second leading cause of cancer death among American men.
Jeff P. Crim, MDiv, BCC, is a prostate cancer patient and a board-certified chaplain serving a Catholic healthcare system in Georgia. A Lutheran pastor, he is the author of “Queering My Religion: Biblical Stories Of Queer Love In The 90’s.”
