Prostate Nodules In Older Men: What Joe Biden’s Routine Exam Reveals About Age-Related Changes

A small nodule was found in the prostate of former US President Joe Biden during a routine physical exam recently. The finding “necessitated further evaluation”, a short official statement said, as reported by the Associated Press (AP) Tuesday. It is not known yet if the evaluation has since taken place, or what that examination revealed.

Biden is 82 years old. He had to abandon his reelection bid in 2024 following a disastrous debate performance last June, and his party's concerns over his advancing age-related problems.

What does the detection of nodules in the prostate generally entail? Does it require a further exam by a urologist to rule out prostate cancer? Does one need to press the panic button and fear the chances of cancer when a lesion or nodule is found on the prostates, or could it be something simpler like an inflammation or merely enlargement of the gland?

Prostate Nodules In Older Men 

ABP Live spoke to Dr Mathisekaran Thangarasu, Functional and Neuro Urology Consultant at Asian Institute of Nephrology and Urology, Chennai, to help understand the implications of such findings, albeit in a routine examination, as has been reported.

Dr Thangarasu said while the discovery has sparked public interest and some concern, medical experts advise that such findings are fairly common in older men and should be interpreted with clinical caution rather than alarm. "A prostate nodule is an area of tissue within the prostate that feels firmer or different from the surrounding gland. These nodules can appear for a variety of reasons. Although they may sometimes be linked to prostate cancer, they are often caused by benign conditions such as inflammation (prostatitis) or non-cancerous enlargement of the prostate — a condition known as BPH (Benign Prostatic Hyperplasia)." 

He also highlighted that at 82, Biden is in the age group where such changes in the prostate are frequently seen. 

So, what should a person who finds an examination showing a similar nodule in the prostates do next? 

"A typical next step after identifying a nodule includes further investigations like a PSA blood test, imaging (usually MRI), and possibly a biopsy, if doctors deem it necessary," Dr Thangarasu said. 

From a urologist’s point of view, he said, this kind of discovery is often part of routine screening and monitoring in older men. In fact, many prostate cancers — especially those detected in their early stages or in elderly patients — are slow-growing and may not require aggressive treatment. In such cases, active surveillance is preferred, with regular monitoring to ensure there are no changes over time.

Such cases only help highlight the importance of regular prostate exams, particularly for men over the age of 50. Early detection of any prostate abnormalities can lead to better management and outcomes, whether the issue is benign or malignant, said Dr Thangarasu.

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India's Prostate Cancer Burden

According to a report on the epidemiology, clinical extent at diagnosis, and treatment modalities for prostate cancer in India published in September 2024 in the Indian Journal of Urology, as of 2022, prostate cancer was the third most common cancer among Indian men, following lung and mouth cancers. It accounts for 6.1% of all male cancer cases nationwide, the report said. 

According to GLOBOCAN 2022 estimates, India reported nearly 38,000 new prostate cancer cases, with an age-standardised incidence rate (ASIR) of 5.6 per 100,000 — lower than global averages but indicative of a rising trend.

The rising burden of prostate cancer underscores the need for enhanced screening programs, public awareness campaigns, and improved access to diagnostic and treatment facilities, especially in rural and underserved regions. Early detection through regular screenings can significantly improve outcomes and reduce mortality associated with prostate cancer.

Kirti Pandey is a senior independent journalist.

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