Joe Biden's announcement that he has been diagnosed with prostate cancer has revived questions about what health issues the former US president was dealing with while he was in the White House.

In a statement on Sunday, Biden's office said the 82-year-old had received the diagnosis on Friday after seeing a doctor for urinary symptoms.

Some doctors have expressed surprise that the aggressive form of cancer, which has spread to his bones, was not detected earlier.

Others pointed out that cancers can grow fast without the patient displaying symptoms - and that men over 70 are not routinely screened.

President Donald Trump told reporters on Monday his predecessor should have been more transparent with the public, seeming to imply that the cancer diagnosis had been covered up - a suggestion rejected by a Biden aide.

"I think it is very sad actually. I am surprised that the public wasn't notified a long time ago," Trump said at an event at the White House.

"It could take years to get to this level of danger. So, look, it's a very, very sad situation. I feel very badly about it, and I think people should try and find out what happened."

A Biden aide said the former president's prior medical check for prostate cancer was more than a decade ago.

He had a Prostate Specific Antigen (PSA) test in 2014, the aide told reporters on Tuesday.

"Prior to Friday, President Biden had never been diagnosed with prostate cancer," the aide added.

The cancer diagnosis comes amid reports that the Democrat's aides sought to conceal other deteriorating health conditions from the public ahead of the 2024 election.

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Republicans argue that Biden, who ran for re-election as the oldest president in history at 81, was mentally and physically unfit for office. He dropped out of the race last summer after a disastrous debate performance against Trump.

According to Original Sin, a new book by journalists Jake Tapper and Alex Thompson, Biden was unable to recognise Hollywood actor and Democratic donor George Clooney or to recall the names of key aides in his final year in office.

The authors write: "Biden's physical deterioration - most apparent in his halting walk - had become so severe that there were internal discussions about putting the president in a wheelchair, but they couldn't do so until after the election."

The publicity generated by the book has forced senior Democrats to field questions on why they did not do more to respond to Americans' concerns about Biden's health as he campaigned for re-election.

"It was a mistake for Democrats to not listen to the voters earlier," Senator Chris Murphy said on Sunday.

After the news of Biden's diagnosis, Vice-President JD Vance wished him well, but asked whether Biden's doctors or staff members had sought to keep the public from knowing about the true state of his health.

"This is not child's play, and we can pray for good health, but also recognise that if you're not in good enough health to do the job, you shouldn't be doing the job," he added.

Dr Ezekiel Emanuel, an oncologist who worked as a Covid adviser to the Biden White House, was among those claiming that Biden probably had been ill with cancer for some time, without necessarily knowing it.

"He did not develop in the last 100, 200 days. He had it while he was president," he told MSNBC's Morning Joe show. "He probably had it at the start of his presidency in 2021. Yes, I don't think there's any disagreement about that."

US medical guidelines do not recommend routine blood screenings for men over 70 because prostate cancers can be very slow-growing, and the difficulty of testing and treatment may outweigh the risk from the cancer.

Biden had previously been diagnosed with benign enlargement of the prostate. In 2019, before he was elected, his campaign released the report from his medical screening, saying he had been treated with medication and surgery, "and has never had prostate cancer".

That's led to questions about whether Biden was tested at any point during his four-year presidency - and why the diagnosis came so late.

"I would assume the former president gets a very thorough physical every year," Dr Chris George of the Northwestern Health Network told Reuters. "It's sort of hard for me to believe that he's had a (blood test) within the past year that was normal."

However, Dr Robert Figlin, interim director of Cedars-Sinai Cancer, told the BBC that the aggressive way Biden's cancer had presented was not that unusual. And he warned critics against "assuming that somehow something was missed along the way".

Prostate cancer is the second most common cancer for men, according to the Cleveland Clinic.

According to the US Centers for Disease Control and Prevention (CDC), out of every 100 American men, 13 will be diagnosed with prostate cancer during their lifetime, and two or three men will die from it.

(BBC)

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