8/11/2026
Lately, news has been spreading about Joe Biden's worsening cancer. What caught my attention was another article reporting Jill Biden's concern that Joe had experienced symptoms while he was still in the White House, but that his medical team followed the prevailing guidelines and did not perform PSA screening after his last known test in 2014.
Jill Biden said Joe was getting up as many as seven times a night to urinate while he was still in the White House, and that she raised the issue with medical staff. After he left office, the symptom persisted and eventually led to further evaluation. In May 2025, he was diagnosed with Gleason 9 (Grade Group 5) prostate cancer that had already spread to his bones.
The first thing that jumps out: his last known PSA was in 2014
11 years ago when he was 71. Why not performing one for his recent nocturia problem?
Because the U.S. Preventive Services Task Force recommends against routine PSA screening for men 70 and older because, at the population level, the potential harms of screening—including false positives, biopsies, overdiagnosis, and overtreatment—can outweigh the benefits.
So I would not say that his doctors were negligent. Nor do ordinary people have enough medical expertise to conclude from one case that the recommendation itself is wrong.
Still, this case raises some legitimate questions.
--Was the general screening guideline appropriate for every individual, particularly an otherwise healthy older man with access to unusually comprehensive medical care?
--More importantly, how were his urinary symptoms interpreted? Were they considered ordinary age-related symptoms, or did their severity and persistence warrant further evaluation?
--If routine screening is stopped in older men, shouldn't new and significant symptoms receive even greater attention?
--And could an unusually aggressive cancer, an age-based decision to discontinue routine PSA screening, and persistent urinary symptoms have combined to create a blind spot?
Screening an asymptomatic man is one thing. Persistent symptoms are another.
Getting up seven times a night to urinate is substantial nocturia. It can have many causes, including cancer.
The point is that persistent and significant changes in the body deserve attention, regardless of what the general screening guidelines say.
My health, I take responsibility for
There is a Chinese saying:
我的健康我做主
Wǒ de jiànkāng wǒ zuòzhǔ. "My health, I take responsibility for."
This does not mean we should ignore medical experts or decide for ourselves what tests and treatments we need. It means we should not passively outsource responsibility for our health to doctors, medical systems, or guidelines.
Keep in mind that guidelines are population-level recommendations, not personal guarantees.
If you develop significant symptoms, instead of thinking about the general guidelines, you should notice the changes in you and ask what it means for you.
This is personal responsibility. You are the person who experiences your body 24 hours a day.
You are the best observer of your own body, which makes you qualify as an essential member of your own healthcare team.
Don't blindly follow experts and don't blindly distrust them
The lesson I learn from this is: we should work with our doctors rather than simply follow them passively.
Ask questions. Understand the reasoning behind recommendations. Know your risk factors. Pay attention to changes in your body. Tell your doctor in details about unusual symptoms. Ask whether a general recommendation applies to your particular circumstances. And when something doesn't make sense, seek a second opinion.
Everything about you is unique: your health history, your risk factors and your body. So listen to the experts. Respect the guidelines. Meanwhile, never surrender your own judgment and responsibility.
No one knows your body better than you do. You may not be the expert on medicine, but you are the ultimate caretaker of your own health.
From a reader, “ 非常赞同！指南是人群层面的大方向，但每个人都是独一无二的.”