Former President Joe Biden’s office announced Sunday that he has been diagnosed with an “aggressive” form of prostate cancer that has already spread to his bones. The condition, while serious, appears to be hormone-sensitive—meaning that it can still respond well to treatment.
According to Biden’s medical team, he has a Gleason score of 9, which places him in the high-risk category for prostate cancer. The Gleason score is used to grade the aggressiveness of prostate tumors by examining how abnormal the cancer cells look under a microscope. A score of 6 typically indicates a slower-growing cancer, while a score of 8 or higher points to a faster-growing, more dangerous form. A score of 9 is among the most concerning, indicating a cancer that is likely to grow and spread quickly.
Dr. Ben Davies, a professor of urology at the University of Pittsburgh School of Medicine, says Biden “has a very bad version of it, probably the worst version you can get.” Still, he adds that it’s not all doom and gloom. “He can easily live 10 years with this disease,” Davies said in an interview with NPR. “There are some very good treatment options.”
Treatment Options and Hope
There are currently three primary treatments on the table: hormonal therapy, chemotherapy, and radiation therapy.
Hormonal therapy, often the first step in treating advanced prostate cancer, involves reducing testosterone in the body—essentially starving the cancer of the hormones it needs to grow. “The cancer stops growing quite as fast and can almost melt away from the bones,” said Dr. Davies.
Chemotherapy is usually reserved for more advanced cases like Biden’s. While it can come with harsh side effects, it has proven effective in slowing progression and relieving pain. Radiation therapy is also a possibility and can extend survival, particularly when combined with hormonal treatment.
Despite Biden’s age—he turned 82 recently—his care team is optimistic that his overall physiology will allow for aggressive treatment. Dr. Davies emphasized that it’s less about the number on a birth certificate and more about how well the patient’s body can handle the therapies. “It’s not really an age-specific thing,” he said. “It’s more about how strong and resilient you are overall.”
Some medications may contribute to frailty or fatigue, which doctors will take into account when crafting a treatment plan. Biden’s health and mental fitness have long been under public scrutiny, especially since his decision not to seek reelection in 2024. That history has only heightened public interest in how this diagnosis might affect him moving forward.
A Widespread and Often Treatable Disease
Prostate cancer is the second most common cancer in men, behind only skin cancer. The American Cancer Society estimates that around 313,780 new cases will be diagnosed in the U.S. in 2025, with approximately 35,770 deaths.
The good news: prostate cancer is highly survivable when caught early. The five-year survival rate for all stages combined is 97%. However, once the disease has spread to distant parts of the body—like in Biden’s case—that number drops significantly to around 37%.
The American Cancer Society says this diagnosis should serve as a reminder of how serious prostate cancer can be, even though it often starts out silently. “Although it is a highly survivable disease when caught in early stages, it is the second leading cause of cancer death in men,” the group stated.
Adding to the concern is a recent trend: the number of prostate cancer diagnoses has been rising by 3% each year since 2014. Experts believe this may be due in part to cancers being discovered at later stages, when treatment becomes more complex.
Who’s at Risk?
Prostate cancer tends to occur in older men and is more prevalent among certain groups. It is most commonly found in Black men and Caribbean men of African ancestry, and risk increases significantly after age 50. About 60% of prostate cancers are found in men over age 65.
Family history is another important factor. Men with a father or brother who had prostate cancer—especially if diagnosed at a younger age—face a higher risk.
As for screening, guidelines vary. The American Cancer Society recommends:
- Age 50 for men at average risk
- Age 45 for men at high risk (including Black men and those with a close relative who had prostate cancer before age 65)
- Age 40 for those with more than one close relative affected at an early age
The U.S. Preventive Services Task Force suggests that men aged 55 to 69 consider prostate cancer screening after talking with their doctor about the risks and benefits.
Biden’s Response
In his first public remarks since the diagnosis, Biden thanked the public for their outpouring of support and shared a candid message: “Cancer touches us all,” he said. “Like so many of you, Jill and I have learned that we are strongest in the broken places.” He included a photo of himself with his wife and their cat, offering a moment of humanity amid the difficult news.
While this is undoubtedly a serious diagnosis, Biden’s case highlights the importance of regular screening, early detection, and continued medical innovation. With the right treatment and care, there’s reason to remain hopeful.
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