The announcement that former President Joe Biden has been diagnosed with Stage IV prostate cancer, disclosed on May 18, 2025, raises questions that extend well beyond medicine. These questions are not rooted in cruelty or partisanship, but in transparency, governance, and the public’s right to know whether a sitting president was fully capable of executing the duties of the office entrusted to him.
According to statements from Biden’s office, the cancer is aggressive, hormone-sensitive, and has metastasized to the bones, an advanced presentation by any medical standard. Such a diagnosis naturally invites a fundamental inquiry: When did this disease begin? And more pointedly, could it have been present during Biden’s presidency or vice presidency, undetected or undisclosed , despite the most comprehensive medical care available in the world?
As a physician trained in internal medicine with decades of clinical experience, I can say without hesitation that prostate cancer, particularly in men under continuous medical surveillance, is among the most detectable and manageable malignancies in modern medicine. While screening guidelines for the general population often recommend discontinuing routine PSA testing in the early seventies, those guidelines are driven largely by population-level cost-benefit analysis. They are not ironclad laws of medicine, nor are they typically applied rigidly to individuals with extraordinary national responsibilities, unlimited executive access to care, and ongoing, yet undiagnosed, yet obvious health concerns.
The President of the United States is not an average patient. Nor are senior elected officials equivalent to the general public. Their cognitive clarity, physical stamina, and continuity of function are matters of national consequence. In my own practice, I would not discontinue PSA surveillance in a patient of President Biden’s stature unless declining health from other irreversible causes rendered such monitoring irrelevant. That threshold was clearly never reached in Biden’s case, or perhaps it was!
Stage IV prostate cancer, particularly with bone metastases, does not emerge overnight. Medical literature consistently shows that aggressive prostate cancer often evolves silently over five to ten years before detection. A Gleason score of 9, among the highest possible, strongly suggests prolonged biological activity rather than a sudden onset. While very suspicious, no definitive public timeline has been provided by the Bidens; it is medically reasonable to infer that the disease may have predated Biden’s presidency, and possibly even his vice-presidency.
Yet the public has been offered no PSA history, no imaging records, and no explanation for apparent gaps in surveillance. This absence of data is not trivial. It clouds the timeline and invites speculation. This is not because the public is reckless, but because silence from those in power creates a vacuum that reason inevitably attempts to fill, which ultimately becomes not merely a medical issue, but a political one.
During Biden’s years in national office, Americans repeatedly observed cognitive lapses, physical frailty, and functional limitations that were dismissed or minimized by the White House and much of the legacy media. While prostate cancer does not commonly metastasize to the brain, both the disease itself and its treatments, particularly Androgen Deprivation Therapy (ADT), are known to contribute to cognitive impairment, muscle wasting, fatigue, and executive dysfunction. ADT, whether surgical or chemical, essentially suppresses testosterone, a hormone essential to neurological and muscular health.
It is not entirely inconceivable that Joe Biden had been diagnosed with Prostate cancer long ago and had been undergoing ADT treatment already. It may have been used precisely because it was less visible to the public than aggressive surgery or months of radiation therapy. Such therapy can be administered quietly. It does not require prolonged hospitalization. It does not announce itself to the public. And importantly, it can slow disease progression without necessarily curing it, consistent with a cancer that later advances despite years of management.
This is not an accusation. It is a question, one that deserves an answer. If the diagnosis were truly recent, if the disease had genuinely escaped detection until now, transparency would be the natural response. PSA trends, diagnostic rationale, and surveillance history would clarify matters quickly. Instead, the public received a dramatic announcement by Biden, followed by uncomfortable silence.
The obvious question, therefore, presses itself upon the public conscience: When did this disease begin? And equally important: what did the public not know while entrusting the highest executive authority in the nation to this man? These questions are not speculative. They are the natural consequence of opacity. At this point, a medical issue becomes a political one.
This pattern has a history, and it disproportionately, but not unexpectedly, involves the Democratic presidents and administrations.
In 1893, President Grover Cleveland secretly underwent surgery to remove a cancerous tumor from his jaw aboard a private yacht. The operation was concealed to prevent public panic during an economic crisis. The White House falsely described the procedure as routine dental work. The truth emerged only years later.
In 1919, President Woodrow Wilson suffered a catastrophic stroke that left him partially paralyzed and cognitively impaired. The American people were never informed of the extent of his incapacity. Instead, executive authority was quietly assumed by his wife, Edith Wilson, and a small circle of aides. For nearly two years, the nation was governed by proxy. This deception was so consequential that it later inspired the 25th Amendment, implicitly acknowledging that the public had been defrauded.
Franklin D. Roosevelt perfected the art of medical concealment. Though paralyzed by polio and unable to walk unaided, he orchestrated an elaborate public image of vigor and strength. Photographs were carefully staged; wheelchairs were hidden; journalists complied. The reality of his condition was subordinated to a political narrative.
John F. Kennedy, celebrated as the embodiment of youth and vitality, suffered from Addison’s disease, chronic pain, and severe physical instability. He relied on a complex regimen of steroids, painkillers, and stimulants. None of this was disclosed to the electorate. The image of health was manufactured; the truth was buried.
These cases differ in detail, but they share a common architecture: the belief that the Democratic Party, and its chosen leaders, are entitled to engineer or manage the truth rather than to disclose it.
As an immigrant to this country and a practicing physician who has spent decades caring for patients in my community, I did not come to these conclusions lightly. I came to this nation because I believed in its founding principles—chief among them the idea that legitimate government rests on the consent of an informed people. Over time, however, I have watched that principle erode under the weight of partisan loyalty and institutional silence.
History teaches us that republics are not overthrown all at once. They decay quietly, through rationalized deception and institutional arrogance. When truth becomes optional, accountability soon follows it into exile.
It is for this reason that I have invested years in writing a book titled Common Sense 2.0, a BBB (Big Beautiful Book). This is a book inspired by the original Common Sense, Thomas Paine’s insistence that truth, once spoken plainly, has a moral force of its own. The book examines not only contemporary controversies, but the deeper historical patterns of deception, consolidation of power, and moral exemption that have too often characterized the Democratic Party.
This Op-Ed is not an endpoint. It is an invitation. If Americans wish to better understand how repeated acts of concealment—medical, political, and historical—have shaped our current moment, Common Sense 2.0 will offer that examination. It is written for readers who believe that self-government requires honesty, that power must answer to truth, and that no political party is entitled to blind trust.
The book is scheduled for release soon. My hope is that it will encourage readers not merely to agree or disagree, but to think more deeply about the history we inherit, the narratives we are given, and the responsibilities we carry as citizens of a republic.
A free people cannot remain free by looking away. And common sense, once awakened, rarely consents to sleep again.
