“The President and his family are reviewing treatment options with his physicians.”

What is prostate cancer and how does it develop?

The prostate is a small yet essential part of the male reproductive system.

The walnut-sized accessory gland surrounds the urethra underneath the bladder and produces a fluid which, combined with sperm cells from the testicles, makes semen.

Prostate cancer can occur when cells in the prostate become cancerous and grow abnormally, causing them to spread and form a malignant tumour.

While any person born with a prostate has a risk of developing prostate cancer, lifestyle and genetic factors can increase one’s risk of the disease.

Age is the biggest determining factor. The risk increases as you get older, with the majority of cases diagnosed in men over 50.

Family history is also important. Those who have a first-degree relative (such as a father or brother) with a history of prostate cancer are twice as likely to develop it, while those with two affected first-degree relatives have five times the risk.

Other risk factors include race (black men have a significantly higher incidence and mortality rate than other ethnic groups) and genetics (those carrying the BRCA1 and/or BRCA2 genes inherit a higher chance of developing prostate cancer).

Doctors use the Gleason scoring system to grade cancer cells taken during a biopsy from six to 10, the Cancer Society says.

The higher the score, the more likely the cancer cells are to spread through the body. Biden’s score of nine is considered high-grade and aggressive.

How do I check for prostate cancer?

With ambiguous symptoms, checking for prostate cancer usually involves a blood test, called a prostate-specific antigen (PSA) test, and a digital rectal examination (DRE).

PSA is a protein produced by the prostate, with a PSA test measuring the amount in your blood. While the PSA level in blood tends to be higher in men with prostate cancer, a high PSA level does not always mean it’s there.

Your doctor may physically examine your prostate through a DRE to check for any hard lumps that could be cancerous.

Prostate cancer can only be definitively confirmed through a prostate biopsy, which helps determine the type and grade of cancer and the best course of treatment.

How do you treat it?

Treatment depends on the stage the prostate cancer is in, along with other health markers and indicators, and is determined by health professionals, with a GP and urologist creating a personalised, needs-based approach.

Whether the cancer is localised (confined to the prostate gland), locally advanced (moved outside the prostate gland) or metastatic (moved to distant parts of the body) will dictate what treatment doctors recommend.

According to the Cancer Society, active surveillance may be offered if the cancer has a very low risk of spreading, with the cancer monitored by one’s medical team through routine check-ups.

Doctors may also use surgery to remove the whole prostate or cryotherapy to freeze and kill cancer cells in one part of it, although the latter procedure will still destroy most of the prostate and is only available in Tauranga.

Other treatment options include radiation treatment (using radiation beams to destroy or slow the growth of cancer cells), hormone therapy (known as endocrine therapy), and chemotherapy (typically reserved for more advanced cancer).