Doctor? No. Concerned Rabbi? Absolutely!

Earlier this week, someone at our evening minyan asked me whether I recommend getting the new COVID vaccine. The question sparked a few laughs, as these types of questions often do. My response was simple: I’m not a doctor. While I proudly hold an honorary doctorate from the Jewish Theological Seminary, my expertise lies in theology, not medicine. Just as I don’t offer guidance on business, law, or plumbing, I similarly leave medical advice to professionals.

But today, I am going to make an exception.

Regardless of political differences, all Americans were saddened last week to learn that former President Joe Biden has been diagnosed with aggressive metastatic prostate cancer. This news naturally raises concerns, not just about his health, but about the broader issue of how aggressive cancers can go undetected, even among those who receive routine medical care.

American presidents undergo extensive annual physical exams conducted by top physicians, with results made publicly available. Yet this cancer had already metastasized before detection. How does this happen? What can we learn from it?

The PSA (prostate-specific antigen) test is one of the most common tools for screening prostate cancer. It is an imperfect test, requiring careful evaluation and discussion between doctor and patient. Yet its ability to detect fast-growing, life-threatening cancers is well-documented by experts.

President Biden, however, had not undergone a PSA test since 2014. I would bet that many, if not most men reading this sermon receive PSA screenings during their annual physicals, beginning at age 50 or 55. So why was it not recommended for him?

One possible answer lies in medical guidelines. In 2012, the U.S. Preventive Services Task Force (USPSTF) gave PSA testing a “D” grade, advising against routine screenings for all men, regardless of age due to concerns about overdiagnosis and unnecessary biopsies. While some prostate cancers grow slowly and require little intervention, this blanket recommendation failed to account for aggressive cases, like the type President Biden now faces.

The Task Force revised its position in 2018, recommending that men under 70 discuss PSA testing with their doctors but still advising against screening for men over 70. This guidance, however, ignores the fact that many older men remain vigorous and have long life expectancies. Tragically, guidelines meant to prevent over-treatment may have contributed to late diagnoses for high-risk individuals.

And so, I am making an exception to my usual policy of not giving medical advice.

I urge every man reading this message to speak with your doctor about PSA screening, its strengths, its limitations, and whether it makes sense for you. What is right for one individual may not be right for another, but knowledge is power and possibly the key to saving lives.

While I am certainly not a physician, I am a rabbi who has sat beside too many hospital beds. I have seen the devastation that cancer, especially cancer detected too late, can cause. That is why we must take every step possible to prevent unnecessary suffering.

The Torah commands: “Take utmost care and watch yourself scrupulously” (Deuteronomy 4:9). Our sages understood this verse as a religious imperative—not just to care for the soul, but for the body as well. Our health is a sacred responsibility.

Talk to your doctor today.