TOP medics have said they are shocked that Joe Biden’s “aggressive” cancer was not picked up earlier and allowed to advance so far.

Physicians also revealed some of the potential treatment options ahead of the former president, 82, who is likely to suffer “bone pain”.

Biden’s office confirmed he had advanced-stage prostate cancer which has spread to his bones after a lump was discovered during an examination.

His case is rated with a Gleason score of 9 and Grade Group 5, which “represents a more aggressive form of the disease”.

Dr. Marc Siegel, a leading medical analyst at Fox News, informed the network, “This is the most aggressive form. It carries the highest risk of spreading, as we’ve seen in this case.”

“The diagnosis was made through a physical exam, specifically a prostate exam. Often, we detect a rise in prostate-specific antigen, PSA, and that’s when we start investigating further.”

Seigel explained that he tests all of his male patients over the age of 45 for the disease – and is surprised Biden was not diagnosed this way.

Seigel said: “He must have had the best possible care here. I’m a little taken aback that it’s this far advanced.

“It would be quite unexpected if they weren’t conducting careful screenings for this, as it’s well-known in the medical community that this is the one type of cancer in men that demands close attention.”

Doctors only performed a biopsy on Biden after noticing symptoms in his urine – which display when the cancer is relatively advanced.

The medic also explained that Biden’s doctors will likely treat him with hormone therapy, but may also try to use radiation against the lesion on the bone or remove the prostate altogether.

He said it is “not uncommon” to “do more than one therapy”.

Dr Howie Forman, a professor of radiology at Yale, was also shocked that Biden’s disease had not been picked up by routine blood tests.

He said: “It is inconceivable that this was not being followed before he left the Presidency.”

Forman said that the test for specific prostate antigens would have shown the cancer “for some time before this diagnosis” – so it could have been picked up earlier.

He noted Biden “must have had a PSA test numerous times before”, and concluded: “It’s just so odd to discover this with bone [metastasis] in a man of his stature and [with his] access to care.”

Similarly, on News Nation, urologist Dr David Shusterman said it is “unheard of” for cancer to develop with far without it being picked up.

He said: “It’s very unlikely that someone could get annual checkups and not notice,” – particularly true for Biden who had “state-of-the-art care”.

He continued: “It’s unusual to hear that someone has prostate cancer when they’re annually being followed up. The fact that we find it at a Gleason 9 is unheard of.”

Shusterman also suggested Biden “most likely had it for a long time”, and that there is “definitely evidence that he knew about this for a while”.

Some have even claimed a deliberate cover up is at play.

Dr Steven Quay wrote online: “It is highly likely he was carrying a diagnosis of prostate cancer throughout his White House tenure and the American people were uninformed.”

He explained prostate cancer is the “easiest […] to diagnose when it first starts and to watch it progress to bone metastases”.

“For even with the most aggressive form, it is a five to seven year journey without treatment before it becomes metastatic,” he said.

Pushing the point home, Quay said it would amount to “malpractice for this patient to show up and first be diagnosed with metastatic disease in May 2025”.

Donald Trump Jr joined also suggested the Bidens could have willfully held back the diagnosis.

He wrote: “How did Dr Jill Biden miss state five metastatic cancer or is this yet another cover-up?”

The former first lady is not a medical doctor.

His father, President Trump, was more restrained, sticking to a simple well-wishing message.

He took to Truth Social to say: “Melania and I are saddened to hear about Joe Biden‘s recent medical diagnosis.

“We extend our warmest and best wishes to Jill and the family, and we wish Joe a fast and successful recovery.”

Other tributes have poured in for the former president since the announcement, with Republicans and Democrats alike wishing Biden well.

Former President Barack Obama said he and Michelle were thinking of the entire Biden family.

He said: “Nobody has done more to find breakthrough treatments for cancer in all its forms than Joe, and I am certain he will fight this challenge with his trademark resolve and grace. We pray for a fast and full recovery.”

Biden’s Vice President Kamala Harris said: “Joe is a fighter — and I know he will face this challenge with the same strength, resilience, and optimism that have always defined his life and leadership.

“We are hopeful for a full and speedy recovery.”

Seigel explained that if the cancer is caught early while it’s still localized to the prostate gland, it’s curable “most of the time”.

He said: “The goal is to get it before it leaves the prostate […] When it’s left the prostate”, as Biden’s has, “it becomes much more difficult to cure”.