An outpouring of support has followed news that former President Joe Biden is battling an aggressive form of prostate cancer that has already spread to his bones.

The 82-year-old’s office confirmed the diagnosis on Sunday, prompting messages of goodwill from world leaders and political allies across the world.

Doctors say they are shocked the cancer wasn’t caught earlier—particularly as Biden had recently reported urinary problems, a known red flag.

A small nodule was discovered during a physical exam, and the cancer was later given a Gleason score of nine—a signal of a severe, fast-growing forms of the disease.

‘This is the one cancer in men that everyone in the medical community is trained to look out for,’ said Dr Marc Siegel, senior medical analyst at Fox News.

He added that while Biden doesn’t appear to have many risk factors, his age alone placed him at significantly higher risk.

Some commentators suggested the cancer may have been developing for some time, given its advanced state.

However, many of the symptoms of the disease that hits 55,000 British men and more than 300,000 in the US annually are frighteningly easy-to-dismiss, doctors warn. 

The office of the former president Joe Biden, 82, announced on Sunday that he has been diagnosed with an aggressive form of prostate cancer 

Causes of prostate cancer are largely unknown but the chances of developing the disease increase with age. Most cases develop in men aged 50 or over 

The prostate cancer signs that no man should ignore 

Because prostate cancer, like other cancers, are best treated in earlier stages, experts say all adult men should be aware of changes that could be a sign of the disease.

Due to the prostate’s location—the gland is situated below the bladder, and wraps around the urethra—it most commonly causes urinary symptoms. 

If a man notices these, its important to speak to a GP and discuss whether something called a PSA test might be warranted. 

PSA stands for prostate specific antigen, a hormone that’s produced by the prostate in higher amounts if there is a problem with the gland.

One of the most common signs something is wrong with the prostate is a change in urinary frequency.

While the amount people urinate can vary widely—anything between four and ten or so times can be seen as normal—it’s a noticeable increase that experts say men need to be aware of.

Sudden urges—needing to rush to the loo—may also be a sign of a problem.

This could be coupled with difficulty in starting to pee, known medically as hesitancy.

Straining or taking a long time to empty the bladder, a weaker than normal flow and the feeling that the bladder has not fully emptied are also symptoms.

Blood in the urine or semen should also be checked out by a doctor without delay.

These symptoms generally do not mean a man has prostate cancer – more often than not, it could simply be a sign of benign prostate problems that affect more than half of men.

However they should be investigated by a GP and, if a cause cannot be found, a referral to an experienced urologist should be made.

Signs of advanced cancer that may have spread include bone and back pain, a loss of appetite and unexpected weight loss, fatigue and pain in the testicles.

The former was first diagnosed after doctors performed a biopsy after he was experiencing urinary issues. However, while advanced prostate cancer can cause urinary symptoms, it doesn’t always.

In Biden’s case, because the cancer is so aggressive in nature, at stage five, and has already spread to his bones, his treatment options are limited. 

While there are medical based treatments such as chemotherapy and hormone therapy available, none of them are curative, doctors say. 

A statement from Biden’s office says his family is now reviewing his treatment options

More than 52,000 men are diagnosed with prostate cancer every year on average in the UK

Biden’s cancer is said to be hormone sensitive, meaning that uses hormones to grow inside the body. In the statement released on Sunday, Biden’s office said this allows for more effective treatment. 

What you should if if you’re worried 

The NHS states that any man over the age of 50 can request a PSA test from the GP regardless of symptoms. 

A PSA test alone can’t diagnose prostate cancer – sexual activity, vigorous exercise, certain medications, urinary infections and benign prostate enlargement, all of which are very common, can raise PSA.

However coupled with symptoms it may warrant an examination of the prostate and possibly further testing. 

For more information about prostate health visit Prostate Cancer UK.

If the cancer is caught early, and not causing symptoms, doctors may suggests an active surveillance approach. 

Some cases of prostate cancer can be cured in the early stages, with treatment including surgically removing the prostate, and radiotherapy.

If the cancer spread to other parts of the body and cannot be cured, treatment is focused on prolonging life and relieving symptoms.  

Advanced stages of prostate cancer, such as Biden’s, can significantly limit a person’s life expectancy and lead to symptoms that will affect daily life 

PSA test are also available from private doctors and there are home tests available from pharmacists, costing from as little as £30.

Dr Jamin Vinod Brahmbhatt, a urologist at Orlando Health Medical Group, determines 10-165 years of function when looking at cancer treatments to treat this aggressive disease. 

‘If there’s any inspiration in this, it is to go and get yourself checked out whether you have symptoms or not,’ Dr Brahmbhatt told the BBC.