Former President Joe Biden and his family announced on May 18 that he had been diagnosed with a "more aggressive form" of Stage 4 prostate cancer, which has metastasized to his bones.
The diagnosis is a serious one. But the statement noted that the nodule discovered by Biden's medical team "appears to be hormone-sensitive which allows for effective management."
Together with his physicians, the former president, 82, has begun discussing treatment options for the cancer, which, given its characteristics – it has a Gleason score of 9 – and metastasis, is likely to have been growing for years. One physician called it "very treatable, but not curable."
But despite those tough facts, oncologists say Biden may have a better prognosis than might have been expected even a few years ago.
Even in advanced cases, survival rates can be "measured in years now, not months," as Dr. Daniel W. Lin, a prostate cancer specialist at the University of Washington, told the New York Times.
Another clinician, Dr. Judd Moul at Duke University, told the Times that, even if the cancer has spread, today's targeted treatments mean patients could live for five, even 10 years after diagnosis.
"We have a lot more tools in our toolbox," said Dr. Moul. "Survival rates have almost tripled in the last decade."
Many of those personalized treatments have been developed over the past decade or so, thanks to federally funded research projects such as the Cancer Moonshot, the Precision Medicine Initiative and its NIH All of Us Research Project.
The Cancer Moonshot initiative in particular, of course, is particularly close to Biden. It was he, then serving as vice president, who was tasked by President Barack Obama to lead the effort in January 2016, in tribute to his son, Beau Biden, who had died of a brain tumor the year before.
"Several cutting-edge areas of research and care – including cancer immunotherapy, genomics, and combination therapies – could be revolutionary," said Biden at the time. "Innovations in data and technology offer the promise to speed research advances and improve care delivery."
"I don’t want to talk just about the next year," said Obama of the National Cancer Institute-funded Moonshot. "I want to focus on the next five years, 10 years, and beyond. I want to focus on our future."
By the end of 2016, Obama had signed the landmark 21st Century Cures Act into law, with – in addition to its key provisions related to interoperability and information blocking penalties – significant funding for the Cancer Moonshot and other precision medicine efforts.
Those efforts and others have continued through Biden's presidency, and the innovations and advancements have stacked up over the past decade.
As recently as 2024, the Moonshot has advanced oncology care by enjoining electronic health record developers – Epic, Oracle Health, Meditech, athenahealth and others – to incorporate FHIR-based standardization and adopt the CMS Enhancing Oncology Model.
Just this past summer, President Biden made $150 million in Moonshot funding available, via the Advanced Research Projects Agency for Health, or ARPA-H, to eight university research departments, earmarked for the developments of new precision cancer surgery techniques.
Another key effort has been the Precision Medicine Initiative, launched by the Obama administration 10 years ago to "enable a new era of medicine through research, technology, and policies that empower patients, researchers and providers to work together toward development of individualized care."
A key component of the PMI has been the National Institutes of Health's All of Us Research Program, which launched in 2015 with the ambitious goal of creating a nationwide cohort of 1 million participants "from every walk of life," all with the goal of building the "largest, richest biomedical dataset" yet compiled, to develop tailored treatments, not just for cancer care but for all diseases and chronic conditions. So far, more than 800,000 people, from all over the United States, have signed onto the program.
In 2016, as part of the PMI, then-VP Biden unveiled a precision medicine database at University of Chicago – the National Cancer Institute's Genomic Data Commons – which draws in data from many NCI programs to enable a wide array of research efforts.
Curing cancers is "the only bipartisan thing left in America," said Biden at the time.
"More than any other specialty, oncologists have to explore the unknown with their patients," he said. "No single oncologist or cancer researcher can find the answers on their own."
Mike Miliard is executive editor of Healthcare IT News
Email the writer: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication.
