Former president Joe Biden and his staff have been accused of concealing his cancer diagnosis and other health problems while he was in office.
Mr Biden at the weekend announced his diagnosis of an aggressive form of prostate cancer, which has metastasised to the bone.
His diagnosis was characterised by a Gleason score of 9, with the score measuring on a scale of 1 to 10 how the cancerous cells look compared to normal cells.
“Cancer touches us all. Like so many of you, Jill and I have learned that we are strongest in the broken places. Thank you for lifting us up with love and support,” Mr Biden, 82, said in a post on X.
Amid an outpouring of support from friend and foe – including Mr Biden's successor President Donald Trump – some have accused him and his team of a cover-up.
“What I want to know is how did Dr Jill Biden miss stage five metastatic cancer, or is this yet another cover-up?” Donald Trump Jr said in a post on X. The former first lady holds a doctorate in education.
The Wall Street Journal's editorial board accused Democrats of covering up Mr Biden's infirmity and denying the American people a better presidential candidate. Mr Biden stepped back from the presidential race in July, instead backing his vice president, Kamala Harris.
“He did not develop it in the last, 100, 200 days. He had it while he was President. He probably had it at the start of his presidency, in 2021,” oncologist Zeke Emanuel, who served as an adviser on Covid-19 to the Biden administration, told MSNBC. “I don't think there's any disagreement about that.”
Men are typically screened for prostate cancer annually starting at about the age of 55, with a test measuring the blood for a prostate-specific antigen. From then, they are usually screened every two to three years.
Most men will get prostate cancer if they live long enough, according to the Mayo Clinic. Some prostate cancers are more aggressive while others can be slow growing.
Every sitting president is required to have an annual physical and the results are released to the public. Mr Biden's medical team did not previously indicate that he had prostate cancer.
But Matthew Smith of Massachusetts General Brigham Cancer Centre told the Associated Press that the sudden discovery of aggressive prostate cancer is "a very common scenario".
Guidelines recommend against prostate cancer screening for men 70 and older so Mr Biden may not have been getting regular blood tests to detect the antigen. He added that while the test can help flag some cancers in some men, it does not do a great job of identifying aggressive prostate cancer.
Even before the cancer announcement, Mr Biden was believed to be showing symptoms of dementia, or at least suffering the effects of advanced age.
During the first presidential debate against Mr Trump, Mr Biden appeared frail and lost his train of thought. At other events, he confused the leaders of countries, calling Egyptian leader Abdel Fattah El Sisi the president of Mexico.
While Mr Biden was under investigation over claims he retained sensitive government documents after his time as vice president under Barack Obama, the special counsel in the case concluded that charges were not needed due to both a lack of evidence and the former president's “significantly limited” memory.
“Mr Biden would likely present himself to a jury, as he did during our interview of him, as a sympathetic, well-meaning, elderly man with a poor memory,” the report said.
The former president also often stumbled or fell, slipping down the stairs of Air Force One in 2021 and collapsing after handing out diplomas at an Air Force graduation two years later.
In the coming book Original Sin: President Biden’s Decline, Its Cover-Up and His Disastrous Choice to Run Again, journalists Jake Tapper and Alex Thompson recount how Mr Biden failed to recognise actor George Clooney at a campaign event in June last year. Weeks later, Clooney called on Mr Biden to step down from the presidential race.
“It wasn’t a straight line of decline; he had good days and bad. But until the last day of his presidency, Biden and those in his innermost circle refused to admit the reality that his energy, cognitive skills and communication capacity had faltered significantly. Even worse, through various means, they tried to hide it,” the authors write.
