WASHINGTON — Stunned longtime aides to former President Joe Biden told The Post Monday that his stage 4 prostate cancer should have been caught long before it spread to his bones — and that they fear concern about public reaction delayed a possible diagnosis.
“I do believe that they felt like something was going on, and were worried about it and kind of hedged around it for a little bit,” said one White House staffer who worked in close proximity to Biden, 82.
Unlike the apparently concerted coverup of Biden’s declining mental fitness, the sources suspect willful ignorance of his condition out of fear of the effect that a prognosis would have on last year’s election — in which Biden repeatedly refused to bow out to allow Democrats an open contest for his successor.
The former president’s office said Sunday that he had been diagnosed two days earlier after reporting “increasing urinary symptoms.”
“I just don’t know how they just, kind of find this out on a Friday, and it’s this far advanced and serious,” the Biden White House aide said. “[If it’s] in the bones, there’s gotta be a discomfort … I think they just didn’t test.”
Another longtime aide to Biden questioned why his presidential physician, Dr. Kevin O’Connor, didn’t perform a Prostate-Specific Antigen (PSA) blood test, one of the most common ways to screen for prostate cancer.
The test was not mentioned on Biden’s February 2024 physical report, his last such exam while in office.
“I think the likely scenario, knowing Kevin O’Connor pretty well, is that they had a discussion on what a PSA test is, and they decided not to do one because it would likely be elevated and cause a story, since a lot of older men have high PSAs that are false positives,” this source said.
“A blood test has a paper trail. They probably just didn’t do the test. I think it would leak if he had a PSA test they tried to bury.”
“What’s ironic,” this person added, “is that if they didn’t give the president a PSA test because of the potential for optics of a possible false positive, that decision is ultimately going to lead to his death because they could have caught it earlier.”
Medical experts said Monday that Biden likely had prostate cancer for years before it metastasized.
“He did not develop it in the last 100, 200 days. He had it while he was president,” oncologist Dr. Zeke Emanuel, an appointee to Biden’s COVID-19 advisory board, told MSNBC’s “Morning Joe.”
“He probably had it at the start of his presidency in 2021. I don’t think there’s any disagreement on that.”
Biden faced significant concerns about his mental acuity while serving as president, as well as outward signs of physical aging, and was forced to abandon his campaign for re-election July 21 after a mutiny by fellow Democrats following a dismal June 27 debate against Donald Trump.
Although Biden justified staying in the race by saying he was best-positioned to defeat Trump, his critics say he paved the way for his adversary’s return to power.
The revelation of Biden’s cancer diagnosis came two days before the release of a highly promoted book, “Original Sin,” accusing his team of covering up his mental and physical decline.
The ex-White House aide was skeptical of the timing of Sunday’s announcement, noting that it got ahead of what could have been a narrative-setting account of the Democratic leader’s decline.
“You can’t dunk on a man with cancer. [“Original Sin” co-authors Jake] Tapper and [Alex] Thompson have to be more careful now. They were gearing up for a steamroll,” this person said.
“The American people have sympathy for an old man with cancer. It’s just like [special counsel Robert] Hur said [about Biden mishandling classified documents], ‘Can’t put him on the stand.’”
The second longtime aide scoffed at the theory, saying of Biden’s post-presidential team: “They’re not that cynical and smart.”
‘Doc isn’t discreet’
Both of The Post’s sources said they had trouble believing that O’Connor — known as “Doc” — had diagnosed Biden’s cancer while he was in office or that the loyal physician, who also worked with Biden during his vice presidency, would have known about any symptoms.
“Frankly, residence staff talk. It would have gotten out,” said the former White House staffer.
“I just know Doc could not have lived with himself if he knew this was happening and he didn’t do everything he could. Also, Doc isn’t discreet. Yes, he’s a doctor, but he’s always chatting.”
O’Connor was never allowed to brief the press on his annual assessments of Biden’s health. He gave a single interview to a news outlet, proclaiming the then-president’s health was ‘excellent” last July when a Post reporter spotted him on the White House driveway and filmed a Q&A.
The doctor, who is legally barred from discussing patients without their permission, could not be reached for comment Monday.
“They are two sides of the same coin,” the source said of Biden and O’Connor. “Between the two of them, someone would have slipped.”
Biden did say in July 2022 he had cancer — in the present tense — but the White House press office rushed to say he was referring to historical skin cancer. The clip has gotten significant attention since the Sunday announcement, though sources don’t believe that was in reference to the prostate cancer.
“[Biden] and O’Connor are incredibly close. He had unfettered access to the president. He’s more than a doctor — he’s a friend,” explained the former White House official. “And Doc cares deeply for the president. I’ve watched him stand at the side when Biden was giving speeches and he had tears in his eyes. He’s in total awe and admiration of the boss.
“Maybe [Biden] wasn’t transparent to his doctor on his symptoms… It’s just hard when you have that amount of privilege [and access] to healthcare, to believe that you then would never go in, explain your symptoms and get it checked. The symptoms sound like things that are textbook.”
Although Biden’s disclosure mentioned urinary symptoms — with frequent urination a hallmark of prostate issues — The Post’s sources said they were unaware of the then-president frequently using the bathroom while in office.
The White House alum said that only a core group of aides, including the director of Oval Office operations and deputy chief of staff Annie Tomasini, would have known if Biden had displayed prostate cancer symptoms while inside the West Wing.
The second source, who worked with Biden over more than a decade, said that Biden wasn’t shy about using the bathroom while a candidate for re-election — unlike Kamala Harris, his vice president and hand-picked successor as Democratic nominee.
“Biden would be like, ‘Where’s the john?’ He’s a normal person,’ the former campaign aide said. “Kamala didn’t like it if you used the word ‘bathroom’ with her, so we called it a ‘secondary hold’.”
Some former Biden aides told The Post they didn’t believe that the former president concealed his concerns to avoid additional bad press, with one acknowledging that while the octogenarian is “such a private person,” they have “no reason to think” symptoms were present before he left office.
“It is so sad,” they said. “Joe Biden has had so much tragedy in his life.”
A Biden spokeswoman did not immediately respond to a request for comment.
