>> Former President Joe Biden has seen an outpouring of support following an announcement that he has prostate cancer.

The 82 year-old shared his diagnosis on Sunday, calling it, quote, aggressive and adding that it's spread to his bones.

The American Cancer Society says about one in 8 men will receive the same diagnosis in their lifetime.

And doctors are reminding patients how to catch it early.

Joining us with more now is Dr Heath and Patel.

Your Olive Urologic oncologist at Northwestern Medicine, Dr Patel, thank you for joining us.

Yeah, thank you for having me.

So we mentioned one in 8 men will be diagnosed with this.

How will give us a sense how how common is prostate cancer, especially among former President Biden's age?

>> Yeah, prosecuted very common.

And if you live long enough, most men are going to get prostate cancer.

But it doesn't mean that it's going to be one that needs to be founders be aggressive.

But we do try to find aggressive cancers and those that have family histories, a significant histories early as we can.

>> The announcement from Biden's office said that his cancer is aggressive and that he is in 9 on the Gleason's scale.

Explain for us, please what that means and what it indicates.

>> Yeah, we quantify how aggressive a prosecutor is primarily by the greed.

Also called Gleason grade.

The modern great group system we use.

It usually goes from one through 5 to be more intuitive.

But the old-school numbers went to 6 to 10.

So yeah, Nick Leeson score 9 on the old group.

That's a 5 on the current system.

Some of the highest you can have.

And so those that are for 5 on the scale have a higher risk of spreading and usually to the lymph node or bones.

And unfortunately he's in the bones, which means is that a state for?

>> Does that grade also have any indication for what kind of treatments might or might not be pursued.

>> Yeah, many high-risk prostate cancer gree group 0.5 actually are still localized to the prostate.

They could be potentially cured with radiation or surgery, but we think of metastatic cancers, ones that we can control, but not, you know, not usually cure so treatment for men with metastatic prostate cancer, like, you know, what's been described, the President Biden have and use experimental therapy and so hormonal therapy also called androgen deprivation.

Therapy is treatments that can be an injection or a medication that can lower a man's testosterone levels to lower castrate levels.

And that helps strenger keep the prostate cancer from spreading.

And that can work actually very well for a long time.

But like I mentioned, it's not generally curable.

In most cases.

And there are other things you can do as well.

But that's the mainstay of treatment is hormone therapy.

>> And when you say for a long time for an 82 year-old with with cancer, with metastatic cancer, what's a long time?

>> I could still be years.

So a lot of men will that even have metastatic or advanced prostate cancers may be able to control with the new therapies, at least in the last 10 years.

Hormone therapy is not even better.

You know, we try not to use it because we want to hear men before they have metastases.

But when you have it, it can be years where as long as it's responding to the hormone therapy, it can stay under control are a lot of men actually die of other natural causes rather than the prostate cancer.

When it's Connor treated appropriately.

>> What does this mean then for the quality of life for someone with Obviously it can be treated.

But what's it going to be like for him?

>> Yeah, I think for someone who has a metastatic prostate cancer, the hormone therapy really does cause, you know, sometimes menopause like symptoms, hot flashes that he those are things that are pretty common but can be controlled and some men may not have bad of side effects as others.

But generally we think of it is potentially less side effects than something like chemotherapy or other therapies you might think of for metastatic cancers to have on foot.

There are rules for those therapies as well as just form of therapy in general will cause that can also make your bones a little more fragile.

So things like keeping calcium up and keeping bone health is very important.

And medical colleges help manage that.

>> kind of factors are taken into consideration when doctors are deciding on a treatment plan.

>> I think first, just isn't localize or not because of its localized to the prostate.

That's going to take down one path way of attending cure.

It's not localized to the prostate.

Then we have to think about, well, what's a man's life expectancy?

Are there other medical problems and might outweigh this problem there?

I think it's still a mainstay of treatment, but we can intensify treatment and it really depends on their general other health.

And so there are many men who are very healthy active that we can, you know, going done more intense on treatment and will extend their lives.

And hopefully the goal is that they die of something else before.

This is what causes that.

>> Biden's cancer stage 4 and we often hear cancer.

Early detection is And that's the key to catching it with that of help here because surely he was having regular health screenings.

>> Yeah, I think that current paradigm is men are in their 50's to 70's is probably the best time to diagnose or find prostate cancer.

ideally, we're trying to find it.

Localized doesn't mean it happens or younger men who have.

Metastatic prostate cancer that could be in 50's even in the 40's man with risk factors that are black or have family history or genetic risk factors.

They may want to start in their 40's.

A screen think is important and can prevent metastasis but not all the time.

Even men have been treated for local prosecutors may have a recurrence, but I would say that there are things you can do to help find it early on with PSA blood test, which is a simple blood test.

Primary care doctors may be doing can be done early on and can find these.

But even if you are getting screened, generally guidelines say to stop at 70, I think that's appropriate for most people.

But when you're, you know, very healthy or you're going to live a long time.

But may be something we can adjust.

You know, 75 80 is not unreasonable, depending on your life expectancy.

Lot of these cancers, unfortunately, take 10, 20 years before they're going to cause any trouble.

And so if you're diagnosed early, the country them but if you're not sure if you have a 10, 20 year life expectancy or doctors to give other medical problems, it may cause more harm than good to treat And so a lot of times we're not looking forward unless more aggressive.

>> What folks need to know about about you than you just touched on some of it about when to screen.

But also what questions to ask.

>> Yeah, I think men in their 50 you know, 50 to 70 would be the ideal time to ask, hey, can I do a PSA blood test?

That's the simplest thing to start with.

And if you have risk factors at age 40, getting a baseline values, not unreasonable.

That number is less than one.

That's a good factor.

Now it does involve just a blood test to start.

Most men are going to be nothing else.

It's going to be reassuring test a digital exam is something that most men, you know, may hesitate on, but it's not actually required for prostate cancer screening, even though can help.

And so that is optional.

But the blood test, I think, is a good idea to initiate the conversation.

And we have good tools as urologist that if someone needed to see we now days make more rational decisions because of these other tests we have like getting imaging, which was not a standard 10 years ago.

So last 10 years, a lot of treatment, not just.

At advanced prostate cancers, but just finding the right ones and finding them early is out there.

>> Ok, and you you addressed the one that I wanted to be sure.

We got to cause.

A lot of men are concerned about the digital exam that you mentioned that you you got to