University of Colorado Cancer Center member Al Barqawi, MD, talks about the latest developments in the disease.
Former President Joe Biden, who as vice president under Barack Obama launched a “Cancer Moonshot” program to speed innovation in preventing and treating the disease, has been diagnosed with an aggressive form of prostate cancer.
Biden’s personal representative said on May 18 that Biden had been seen by a physician “for a new finding of a prostate nodule after experiencing increasing urinary symptoms. On May 16 he was diagnosed with prostate cancer, characterized by a Gleason score of 9 with metastasis to the bone.”
A Gleason score, explains University of Colorado Cancer Center member Al Barqawi, MD, is a grading system for prostate cancer that combines scores for the two most cancerous areas of the prostate, ranking each from a 1 to 5 scale based on how abnormal they look. A combined Gleason score of 6 or higher is considered cancerous.
According to the American Cancer Society, there will be approximately 313,780 new cases of prostate cancer in the U.S. in 2025, and about 35,770 deaths from the disease.
We spoke with Barqawi, professor in the CU Department of Surgery, to learn more about what Biden’s case tells us about how prostate cancer is diagnosed and treated.
Q&A:
How likely is it to be diagnosed with an aggressive form of prostate cancer that has spread to the bones?
It is unusual. In nine out of 10 people diagnosed with prostate cancer, we either diagnose a low-risk disease or a high-risk disease, but we catch it early. Because of the PSA (prostate-specific antigen) tests and the exams we do regularly on these patients, approximately 7% of people present with an aggressive and metastatic disease, not organ confined, which is an advanced stage.
How do you learn if cancer has spread to the bones?
With a PET (positron emission tomography) scan, which is a test where someone ingests a radioactive tracer that shows areas where cancer has spread. Over the past two years, we have started to use a very sensitive prostate-specific membrane PET scan, or PSMA scan, that specifically looks for prostate cancer in the whole body, including the bones. It lights up like a candle on the scan, and it very accurately depicts metastatic disease.
What does hormone-sensitive prostate cancer mean in terms of treatment?
Hormonal treatment, in effect, means castration. It means we’re going to cut the testosterone production from the body. We used to do that by orchiectomy, or removal of the testicles, which produce about 90 percent of the testosterone in the male body. More recently, we have developed hormonal blockade injections that mimic testosterone and shut down testosterone production biochemically, so you don’t have to do the surgery.
Now, this is not a cure. This is not a treatment that is expected to cure hormone-sensitive prostate cancer. Most prostate cancers, if not all of them, will convert to a hormone-resistant status eventually — some within six months, some within five years. After that, no treatment will work. There are studies on different chemotherapies, radioactive therapies, and immunotherapies, but none of them have shown more than a 10% to 20% response rate.
Is surgery an option once it has metastasized to the bones?
No. You cannot remove it from the bone, so it’s not going to have a lot of effect removing the prostate at this stage.
Is there a way to treat the metastasis, outside of the hormonal blockade therapy?
Some people use radiation, with very mixed results.
Can age change anything in terms of treatment?
Yes, because once you get into the realm of advanced, metastatic disease, we’re talking about aggressive treatment. These aggressive treatments have a lot of side effects that not everybody can tolerate. The younger you are, the better your immune system is, and the better you will respond to more aggressive treatment. Age is an important factor when we are deciding what treatment to use.
What are the current guidelines for prostate cancer screening?
For people at normal risk, the American Cancer Society recommends a PSA test, which is a blood test, once a year beginning at age 50. Those at higher risk, including African American men and men who have close family members who have been diagnosed with prostate cancer, should talk with their primary care doctors about potentially getting screened even earlier.
What exactly is the PSA test measuring? What is prostate-specific antigen?
Prostate-specific antigen is a protein produced specifically by the prostate, but it’s not specifically tied to cancer. It is specific to the prostate, but it can go up for three reasons: enlarged prostate; prostate inflammation, or prostatitis; and prostate cancer. The challenge we have is that the number doesn’t always tell you which of the three is driving the PSA up. I have a lot of patients who have low PSA, and they do have cancer. I have a lot of patients who have high PSA, and I repeatedly do biopsies, and they have no cancer. They just have enlarged prostates or prostatitis.
→ Explaining PSA numbers.
If someone has a high PSA, is the next step a biopsy to determine if they actually have cancer?
Not necessarily. We usually do an MRI and discuss the history of PSA. If someone has had a PSA of 5 or 10, which is considered a bit high, for the past 20 years, and it hasn’t changed, this is not cancer. I’m not going to rush to do a biopsy on this guy. I would probably do an MRI first.
On the other hand, the patient who went from 1 to 3 within six months, without symptoms to explain it, I would definitely recommend a biopsy. It’s a very individual decision-making process, not just a number that we look at and decide what to do.
Is there anything new in the treatment for prostate cancer?
There is always something new. We at the university have started doing focal laser ablation, which uses laser energy to destroy tumor cells. We use the NanoKnife, which destroys cancer cells with electrical pulses. I did the first laser treatment here for prostate cancer with MRI guidance. We’re just starting to use the TULSA (transurethral ultrasound ablation) procedure, which uses ultrasound, delivered through the urethra, to destroy prostate tissue. I just got trained on that one, and hopefully we can have the machine here very soon to start treating patients.
All these treatments are for confined early-stage prostate cancer, and the idea is to prevent complications of treatment like radical surgery and radiation, which can be devastating.
Trump Complains Biden Let Thunderstorms Into the U.S.
The president made an embarrassing flub aboard Air Force One while en route to a summit where he will discuss mounting global instability with other NATO leaders.
President Donald Trump got a little tongue-tied speaking with reporters on Air Force One, appearing to suggest his predecessor had left the United States vulnerable to attacks by forces of nature.
Asked by one journalist about the threat of Iranian retaliation on U.S. soil following strikes against three nuclear sites in the Islamic Republic over the weekend, the president was quick to pin the blame on Joe Biden.
“Biden let a lot of supercells into the United States. He was an incompetent president. He had no idea what he was doing,” Trump said in audio of the exchange obtained by Fox News.
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“It was gross incompetence,” he went on. “Among everything else, he let a lot of supercells in, many from Iran. But hopefully we’ll take care of them. What Biden did to this country should never be forgotten.”
There has been mounting concern in recent days over the prospect of Iran activating “sleeper cells” of terrorist agents embedded in the U.S. to carry out attacks against American citizens and infrastructure.
The term “supercell,” meanwhile, refers to a type of thunderstorm that rotates on an axis as the result of powerful updrafts.
Trump’s comments came as he flew to the Netherlands for a NATO summit at The Hague, where he is expected to discuss mounting global instability with other alliance leaders.
Another journalist aboard the aircraft pointed out that at a time of increasing conflict, many member states have expressed concern over the president’s historically tepid view of Article Five, pertaining to NATO’s provisions for mutual defense.
Asked whether he stood by those provisions, Trump responded, “Depends on your definition.”
“There’s numerous definitions of Article Five, you know that, right? But I’m committed to being their friends,” he said. “I’m gonna give you an exact definition when I get there. I just don’t wanna do it on the back of an airplane.”
Biden Stumbled So That Trump Could Soar: Happy One-Year Anniversary to the Debate That Saved America
Exactly one year ago today, President Joe Biden wandered onto a CNN debate stage in Atlanta. Democrats were oozing confidence ahead of the showdown against Donald Trump. They had managed to persuade most mainstream journalists that all the video clips of Biden bumbling around like a demented geezer were dangerously misleading “cheap fakes.” Former Hillary Clinton strategist Zac Petkanas argued Biden had “already won” so long as he wasn’t “wheeled out on stage in a hospital bed.” Biden’s campaign team posted a photo of the president “feeling pretty jacked up” and holding a can of “Dark Brandon” water.
What happened next would spark a chain reaction that would ultimately usher in a new era of American greatness and change the course of Western civilization for the better. Donald Trump would cruise to victory and secure another four years (at least) in the White House. Within a year, many of Iran’s senior military leaders would be dead, its nuclear program in ruins, and its own doddering tyrant cowering in an underground bunker.
Biden wasn’t wheeled out on stage in a hospital bed that fateful night, but he might as well have been. His answers were rambling and incoherent. His mouth agape. His gaze glossy and unmoored, as though he’d been jolted awake from his afternoon nap and ordered to perform open-heart surgery with a pair of child’s scissors.
“Making sure that we’re able to make every single solitary person eligible for what I’ve been able to do with the—with the COVID,” Biden said in response to an early question about tax policy. “Excuse me. With dealing with everything we have to do with—look, if [long pause] we finally beat Medicare.”
In response to a softball question about abortion, Biden gave a rambling answer about how illegal immigrants, and men more generally, weren’t the only ones out there raping women.
“Look, there’s so many young women who have been—including a young woman [Laken Riley] who just was murdered,” Biden said. “The idea that she was murdered by an immigrant coming in, and they talk about that, but here’s the deal. There’s a lot of young women who are being raped by their in-laws, by their spouses, brothers and sisters.”
When it was finally over, Dr. Jill Biden praised her husband like one might applaud a toddler who got all of his poo-poo inside the potty. “Joe, you did such a great job,” she gushed. “You answered every question, you knew all the facts.”
The rest is history.
Biden’s disastrous performance, arguably the worst in the history of politics, made it impossible for Democrats to keep lying about his fitness to serve another four years. Journalists sprang into action. They finally had a reason to report on Biden’s decline now that it seemed likely to cost Democrats the election. Biden refused to drop out at first. His advisers warned Democrats that the only viable alternative, Vice President Kamala Harris, was an incompetent bimbo. Alas, she eventually became the nominee and proved her critics right.
Joe Biden will be remembered as a terrible president who accomplished nothing. However, his insistence on running for reelection—a decision fueled by his wife’s insatiable ambition—was undoubtedly a crucial turning point in American history. In his own bumbling way, Biden helped save the United States from ruinous decline, and delivered a crippling blow to the Islamist regime in Iran. The only things he had to sacrifice were his dignity, the respect of his party, and his so-called legacy.
Any patriotic American would accept that trade.
Happy anniversary!
Trump Ignores Funeral Service for Victims of MAGA Madman
President Donald Trump skipped the funeral of slain Minnesota lawmaker Melissa Hortman and her husband, Mark.
Among the hundreds in attendance at the service were former President Joe Biden and former Vice President Kamala Harris, who paid their respects to the couple slain in what authorities say was a plot targeting Democrats.
A eulogy at the Catholic service was given by Minnesota Gov. Tim Walz, whose eyes were red from crying.
“Maybe this is a moment when each of us can examine the way we work together, the way we talk about each other, the way we fight for the things we care about,” Walz said. “A moment when each of us can recommit to engaging in politics and life the way Mark and Melissa did: fiercely, enthusiastically, heartily, but without ever losing sight of our common humanity.”
The president, however, was not there. Trump didn’t issue a statement about the funeral, either. And The White House did not immediately return a request for comment on his absence.
The man suspected of killing the Hortmans is Vance Boelter, 57, who was arrested two days after the June 14 attacks, in which state Sen. John Hoffman and his wife, Yvette, were also shot and injured.
Boelter’s car contained a list of potential targets, including his victims, Walz, Rep. Ilhan Omar, and Sen. Tina Smith—as well as abortion providers and advocates. A friend of Boelter’s described him as a “strong” supporter of Trump’s.
Although Trump did not mention the funeral service on social media, he did post several times on Saturday, touting low gas prices and his “big, beautiful” bill.
According to Fox News, Trump spent the morning golfing with Republican senators Eric Schmitt, Lindsey Graham, and Rand Paul and CIA director John Ratcliffe.
“WHY ARE THE DEMOCRATS ALWAYS ROOTING AGAINST AMERICA???,” Trump wrote in one post, hours before Hortman and her husband were laid to rest.
In the immediate wake of the shootings, Trump chose not to call Walz and offer support.
“I could call him and say, ‘Hi, how you doing?’” Trump said. “The guy doesn’t have a clue. He’s a mess. So, you know, I could be nice and call him, but why waste time?”
Melissa Hortman, 55, was the top Democrat in Minnesota’s House of Representatives. She had previously served as the speaker. The two were shot dead at their home in Brooklyn Park, Minnesota.
The couple is survived by their two adult children: daughter Sophie, 28, and son Colin, 30, who wept as Saturday’s service began, according to The New York Times.
During his eulogy, Walz did not linger on the manner of the couple’s death, instead focusing on their lives. He mentioned their love for gardening, playing billiards, and making sourdough, according to the Times.
The day before the funeral, Melissa and Mark Hortman—and their beloved dog, Gilbert—lay in state at the Minnesota State Capitol, as thousands of people, including Biden, paid them tribute.
Again, Trump was nowhere to be seen.
Biden pays tribute as lawmaker Melissa Hortman, husband Mark, and dog lie in state at Minnesota Capitol
The public took the opportunity on Friday to bid farewell to slain Democratic Minnesota House Speaker Emerita Melissa Hortman, her husband Mark and their dog, Gilbert — all of whom are lying in state in the Capitol Rotunda.
Melissa Hortman is the first woman to ever lie in state at the Minnesota Capitol, and only one of nearly 20 people to ever have the honor.
Gov. Tim Walz was among the first mourners to visit the rotunda on Friday. Later Friday afternoon, former President Joe Biden arrived at the State Capitol rotunda to pay tribute.
In a statement, Sen. Amy Klobuchar said, “A tearful morning at the State Capitol where Sen. Smith and I met with the Hortman family. Through their grief, Sophie and Colin were strong and determined to make sure everyone carries on their parents’ legacy of public service and goodness. Seeing the caskets in the rotunda was heartbreaking but remembering all they did for the world is what we must do.”
People began arriving before 10 a.m., standing on the Capitol steps to make sure they were in place for their chance to pay tribute to the lawmaker many say perfected the art of compromise — working with colleagues on both sides of the aisle to do what she thought was best for all Minnesotans.
“It’s an honor to be here,” said Julie Johnson, of Rochester. “Melissa was just such a giving, selfless servant for everybody. And I’m especially touched by the loss of Gilbert. To me, that underscores how senseless this was.”
Some came with flowers. Others wore their hearts on their sleeves, devastated by the loss of the people’s lawmaker who worked for decades to make the lives of all Minnesotans better.
“She was a personal hero, she was a great gift to the state of Minnesota and, I think actually, to the rest of the country,” said Jean Strauchon, of Minneapolis.
Talk of the impact Hortman had on the state was at the forefront of every conversation in the line that stretched for blocks.
“She got a lot of things done, she championed a lot of things that are important to a lot of people,” Ken Toenjes, of Anoka, said. “She was very good at compromising, and she was a wonderful person.”
A private funeral for the Hortmans will be held Saturday at 10:30 a.m. WCCO will livestream the service beginning at 10 a.m.
On behalf of the Hortmans’ children, Walz extended an invitation to former Vice President Kamala Harris. She will attend Saturday’s services but will not be speaking.
Melissa Hortman served in the Minnesota House for 11 terms, representing District 34B. She also spent several years in the role of House Speaker.
Since her killing, many have been praising the former Minnesota House speaker’s leadership. On Thursday, U.S. House Majority Whip Tom Emmer, R-Delano, honored her on the House floor as a bridge builder.
“As speaker of the Minnesota House, she led with integrity and fostered bipartisan collaboration, even during the most challenging times in our state,” Emmer said.
Former President Biden visits Sen. Hoffman
The former President also paid a visit to Sen. John Hoffman.
Hoffman and his wife Yvette were also attacked by Boelter the same night.
Yvette Hoffman shared in a statement: “John’s condition continues to improve. He is alert, he’s been up walking around and is able to eat. He’s also giving the State Troopers guarding him some grief.”
Suspected killer makes court appearance amid Capitol event
Vance Boelter, 57, is accused of killing the Hortmans and their dog inside their Brooklyn Park home in the early morning hours of June 14. He was arrested near his Sibley County home some 36 hours after the shootings. Officials say it was the largest manhunt in Minnesota history.
About 90 minutes before the Hortmans were killed, Boelter is accused of going to the Champlin home of Democratic state Sen. John Hoffman and shooting him nine times. His wife, Yvette, was shot eight times. The Hoffmans are still recovering.
Boelter is charged by the U.S. Attorney’s Office with two counts of murder, two counts of stalking and two weapons charges. Boelter may face the death penalty if convicted. He is also expected to face a state trial, and could face life without parole.
He attended his second federal hearing on Friday morning, where his defense team asked for and was granted a continuance, moving his detention and preliminary hearing to July 3.
The defense alleges Boelter is enduring poor treatment in the Sherburne County Jail in Elk River, Minnesota, where he has to sleep on a mat on the floor with lights on around the clock. He told the court he hasn’t slept for nearly two weeks.
Boelter appeared in court wearing a green garment instead of an orange outfit, meaning he’s on suicide watch. But Boelter told the judge on Friday, “I’ve never been suicidal. I’m not suicidal now.”
“This violence does not at all align with our beliefs as a family”
Boelter’s wife, Jenny Boelter, released a statement on Thursday through her legal team, saying her family is “horrified” by her husband’s alleged actions.
“We are absolutely shocked, heartbroken and completely blindsided,” said Jenny Boelter. “This violence does not at all align with our beliefs as a family. It is a betrayal of everything we hold true as tenets of our Christian faith.”
Biden pans “efforts to erase history” — and takes veiled shot at Trump — in Juneteenth event at Texas church
Washington — Former President Joe Biden criticized “ongoing efforts to erase history” during a Juneteenth Celebration Service at a historic African Methodist Episcopal Church in Galveston, Texas — and appeared to take a shot at his successor, President Trump.
He took part in the service at the Reedy Chapel AME Church, one of the locations where an order announcing the end of slavery in Texas was read on June 19, 1865, two years after President Abraham Lincoln issued the Emancipation Proclamation, according to the church. Biden called Galveston “the city where freedom rang out 160 years ago.”
In 2021, Biden signed into law a measure that made June 19, or Juneteenth, a federal holiday commemorating the end of slavery in the U.S. Called the Juneteenth National Independence Day Act, the bill passed the House with overwhelming support and was approved by unanimous voice vote in the Senate. Juneteenth became the nation’s first new federal holiday since Martin Luther King Jr. Day was established in 1983.
Biden spoke about his early history in politics and recounted his role in making Juneteenth a federal holiday, saying, “the events of Juneteenth are of monumental importance to America’s story.”
“Still today, some say to me and you that this doesn’t deserve to be a federal holiday. They don’t want to remember…the moral stain of slavery,” he said.
Biden also chided what he referred to as “ongoing efforts to erase history from our textbooks and our classrooms.”
In at least two moments, Biden seemed to reference Mr. Trump, though not by name. When speaking about attempts to erase history, he referenced “this guy” before giving himself the sign of the cross — drawing laughter from the audience.
At another point, Biden pointed to efforts during his administration to rename military bases named after Confederate military officers, a process mandated by Congress.
“What are we doing now? Reinstating those names,” Biden said, referring to the Trump administration’s push to restore the military bases’ old names. The bases are now dedicated after non-Confederate military veterans who share the same last name as the installations’ original Confederate namesakes.
“Darkness can hide much but can erase nothing,” the former president said.
Several speakers recognized Biden during Thursday’s service, including Galveston Mayor Craig Brown, who presented Biden with a plaque noting his role in making Juneteenth a national holiday.
“I still consider our special guest, President Joe Biden, as my president,” Brown said to applause.
Mr. Trump — who has recognized Juneteenth in prior years — said earlier Thursday the U.S. has “too many non-working holidays.”
Former White House physician to appear before House committee investigating Biden’s mental fitness
Dr. Kevin O’Connor was the target of a subpoena from House Oversight Committee Chair James Comer, R-Ky.
Dr. Kevin O’Connor, the former White House physician who treated then-President Joe Biden, will appear for a deposition before the House Oversight Committee on July 9, a source familiar with the committee’s schedule confirmed to NBC News.
O’Connor agreed to appear after being subpoenaed by the committee’s chairman, Rep. James Comer, R-Ky., who is spearheading an investigation into Biden’s alleged cognitive decline while in office. Comer is specifically focused on Biden’s use of an autopen for official government business.
In addition to O’Connor, the Oversight Committee has scheduled transcribed interviews with former Biden White House aides Neera Tanden, Anthony Bernal, Ashley Williams and Annie Tomasini. Those aides all scheduled interviews without being subpoenaed.
O’Connor could be a key witness in the committee’s attempt to prove allegations that Biden’s diminished capacity led to key decisions being made by people other than the president. The committee has yet to offer any specific evidence to back up that argument.
As for the use of the autopen, the Department of Justice’s office of legal counsel issued a memo in 2005 that concluded that the practice was legal. A federal appeals court ruled as recently as 2024 that “the absence of a writing does not equate to proof that a commutation did not occur,” when it relates to the use of a presidential autopen.
Biden himself has been insistent that he was the one making the decisions while in office and his former aides have consistently rejected any claim that anyone other than the president was in charge.
“Any accusation that President Biden was not making decisions is false. President Biden made the decisions about the pardons and the executive orders he issued, and the legislation he signed into law,” a former official, who was not authorized to speak on Biden’s behalf, told NBC News.
The Republican-led Senate Judiciary Committee has also signaled interest in investigating Biden’s mental acuity. The panel held its first public hearing on the topic last week, but the witness list did not include anyone with first-hand knowledge of Biden’s mental fitness or decision-making while in office.
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