How was Joe Biden’s cancer not caught earlier? The news that the former president is battling an aggressive, stage-4 prostate cancer that has spread to the bone ignited a public debate about why a person with peerless access to medical care was diagnosed at such an advanced stage with a disease that is quite common in men his age.

“Last week, President Joe Biden was seen for a new finding of a prostate nodule after experiencing increasing urinary symptoms,” his personal office said in a statement. “On Friday he was diagnosed with prostate cancer, characterized by a Gleason score of 9 (Grade Group 5) with metastasis to the bone.”