STEVE INSKEEP, HOST:
Dr. Ben Davies has been reading the statement of the former president. He's a professor of urology at the University of Pittsburgh School of Medicine and is here with some analysis. Good morning.
BEN DAVIES: Good morning.
INSKEEP: The one thing that I know about prostate cancer as a layman is that most men - nearly all men - are said to survive it. It's not supposed to be that bad. But in this case, we hear of something called a Gleason score of 9 and metastasis to the bone, which sounds very bad. So what do these things mean in layman's terms?
DAVIES: Yeah, Steve. I wish I could disabuse you of some of those notions. Prostate cancer kills over 40,000 people a year in America. Of course, many men do not die from it. Actually, the majority do not die from it. In the president's case, he has a very bad version of it - probably the worst version you can get - and it has gone to his bones. Obviously, I don't know the extent of the disease, but there are some good options for him. And that could include hormonal injections, which should kind of calm it down and take away some of the testosterone levels in his body so the disease stops growing quite as fast and can kind of almost melt away from the bones. He also can get chemotherapy, which - there's a great study that happened just a few years ago, which could extend his life if he qualifies for it. And radiation therapy, too, is definitely in play, which also has been proven to extend life in patients with newly diagnosed metastatic prostate cancer.
So he's got quite a lot of things he could do. I think frailty is an issue for him 'cause some of the medicines can increase some of the frailty aspects of life. But it's not all doom and gloom, to be honest. He can easily live 10 years with this disease. In fact, I think it's about - the median half-life of having - the median life is about five to seven years from newly diagnosed metastatic prostate cancer, but he could easily go over that.
INSKEEP: You mentioned frailty being an issue here. Are your options limited somewhat when you're 82?
DAVIES: No, I don't think so. There's lots of different 82s. I've met marathoners, you know, who are 82 years old, so it's not really an age-specific thing. It's more the, you know, physiology and how he can take the therapies that he's getting.
INSKEEP: Are you surprised at all that we would learn about this quite suddenly from a single screening, and that it's an advanced case that we presume, from what we know, was not noticed or caught earlier?
DAVIES: Oh, boy. It's a little bit of an intellectual question, I think, Steve. You know, it's a humble business, being a physician. And, you know, even if you screen regularly, many patients, you know, we can't find the disease before it's already in your bones. You can't screen away, you know, prostate cancer. It's going to happen to every physician. So I wasn't that surprised, to be honest with you.
INSKEEP: So if someone asks questions - and of course, questions were already being asked about the president's health while he was president. If someone raised the question of whether there should have been something said or noticed about this while he was president, you would not say there automatically should have been?
DAVIES: No, I think that would be ridiculous. No.
INSKEEP: So what resources would you recommend for people who are in the former president's position who are asking questions about their own health?
DAVIES: Sure. I think, you know, if you're an 80-year-old man and you're wondering whether or not you have prostate cancer, obviously, you should see your primary care physician and go over, you know, what it means to be screened. We do not, as a profession, screen men in their 80s for prostate cancer for a variety of reasons, most of which you've mentioned, because most prostate cancers found in that age are indolent. So if you screened a population of patients for prostate cancer in their 80s, you would be getting all kinds of diseases you didn't need to know about and adding unwarranted worry to those patients. So I would talk to your primary care physician about what it means to be screened, the pluses and the minuses. And I would actually recommend not to screen most 80-year-old men.
INSKEEP: Really? So what is the age where you should be getting screened?
DAVIES: There's actually a few definitions. But between 50 and 70 are the current recommendations from most organizations.
INSKEEP: And you said something at the beginning - you said 40,000 people die of prostate cancer. And yet the common wisdom that came to me was that it's easily treatable, that you can do something about this, and most people are fine. Why is it that 40,000 people are still dying if there are so many treatments available?
DAVIES: Oh, well, the - you're asking me a tricky question. But I mean, obviously, people get cancer all the time and pass away from it. So it's not uncommon with prostate cancer to pass away with it. I think I'd like to emphasize a few things, Steve, if you'll let me.
INSKEEP: Yeah.
DAVIES: We've had - made major gains in prostate cancer care in the metastatic space over the past 10 years and really extended life. So there's no reason to think that the president can't really have an extended life with metastatic prostate cancer. Ten years is not unheard of with disease in your bones. We will only make headway into prostate cancer care with careful and robust funding of our science institutions, which I'm really hoping will continue. And that will pave the way for future people who get the disease the president has.
INSKEEP: This is something that the president himself advocated for. Dr. Ben Davies, professor of urology at the University of Pittsburgh School of Medicine, thanks for your insights. Really appreciate it.
DAVIES: My pleasure. Thank you for having me on. Transcript provided by NPR, Copyright NPR.
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