Several top physicians and medical experts have expressed astonishment that former President Joe Biden’s prostate cancer was not found much sooner.

Biden has been diagnosed with an aggressive form of prostate cancer that has spread to his bones, according to a statement from his personal office on Sunday.

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

It added, “While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive, which allows for effective management.”

Biden and his family “are reviewing treatment options with his physicians,” according to CNN.

Not long after the news broke, leading experts began posing questions about the diagnosis. Donald Trump Jr. posted a screengrab of a statement from physician Dr. Steven Quay, who called prostate cancer “the easiest cancer to diagnose when it first starts and to watch it progress to bone metastases.”

Quay noted that routine blood tests recommended for men over 50 indicate how rapidly cancer can grow.

“It is inconceivable that this was not being followed before he left the Presidency,” wrote Dr. Howie Forman, a professor of radiology and biomedical imaging, public health management, and economics at Yale.