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.

Political leaders from across parties in the U.S. extended their sympathies to Democratic former President Joe Biden, 82, after his office announced Sunday that he was diagnosed with an “aggressive” form of prostate cancer.

President Trump said Monday that he was surprised that Joseph R. Biden Jr.’s cancer diagnosis was not made public a “long time ago,” seeming to suggest without evidence that the former president’s cancer was not newly discovered and had been covered up.