Some experts find it unusual that Joe Biden’s first prostate cancer diagnosis is already at an advanced stage, especially considering his access to top-tier medical care and regular screenings.
Former US President Joe Biden has been diagnosed with an aggressive form of prostate cancer that has metastasized to his bones. Doctors have shared insights into the disease, his prognosis, and potential treatment options.
Biden’s personal office confirmed the diagnosis on Sunday, May 18, following a recent medical evaluation that was prompted by worsening 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 office said in a statement.
Joe Biden is departing the White House and stopping to talk to the press on his way to an event in Miami, Florida, on January 30, 2024 | Source: Getty Images
They added that although the cancer is aggressive, it has been described as hormone-sensitive, which means it may respond well to certain treatments aimed at managing its progression.
Prostate cancer affects the tissue of the prostate gland, which is part of the male reproductive system and plays a role in semen production. The gland is located between the penis and the bladder.
Joe Biden arrives to deliver a statement from the Roosevelt Room of the White House in Washington, DC, on May 2, 2024 | Source: Getty Images
As noted by the National Health Service (NHS), this form of cancer typically progresses slowly, with many men living for years without experiencing symptoms or requiring treatment. However, in Biden’s case, the disease has been described as aggressive.
Dr. Jamin Vinod Brahmbhatt, a urologist with Orlando Health Medical Group, explained that when cancer spreads as extensively as Biden’s has, the range of available treatments becomes limited.
While medical approaches such as chemotherapy, hormone therapy, and steroid use are options, these are not designed to cure the disease but rather to help manage it and stabilize the patient’s condition.
Since Biden’s cancer is hormone-sensitive, it relies on hormones to grow and progress. According to Brahmbhatt, this allows for additional strategies, including medications that can reduce or block hormone levels in the body.
Joe Biden enters the State Dining room at the White House in Washington, DC, on May 31, 2024 | Source: Getty Images
These therapies expand the available treatment toolkit, though it could take several weeks or even months to gauge how well Biden responds.
Dr. Jeffrey Kuhlman, former White House doctor under President Barack Obama also noted that Biden may be eligible for clinical trials targeting advanced cases of prostate cancer, depending on whether he meets the required criteria.
His diagnosis includes metastasis, meaning the cancer has spread from its original site to other parts of the body—in his case, to the bones.
It is also classified with a Gleason score of nine, a high-grade classification indicating that the cancer cells appear significantly abnormal under a microscope and are likely to grow and spread rapidly.
Joe Biden waves at the conclusion of a campaign rally at Girard College in Philadelphia, Pennsylvania, on May 29, 2024 | Source: Getty Images
The Gleason scoring system ranges from six to 10, with lower scores suggesting slower-growing, less aggressive cancers that are less likely to metastasize.
In contrast, a score of nine signals a more aggressive form, which calls for treatment strategies tailored to its faster progression and greater likelihood of spreading.
Even so, numbers alone don’t capture the full picture of a prostate cancer diagnosis. The path forward begins with developing a treatment plan and having a clear understanding of what lies ahead.
The Gleason score and other test results are just one chapter in a broader story, one that continues to unfold as care decisions are made and treatment progresses.
Dr. Jill Biden and Former US President Joe Biden pose backstage on opening night of “Othello” on Broadway at The Barrymore Theatre in New York City, on March 23, 2025 | Source: Getty Images
Biden’s long-term prognosis remains unclear due to the limited details released about his condition. However, according to Dr. Ryan Cleary, a urologist at MedStar Health, “Generally, about a third of patients will still be alive after five years of metastatic prostate cancer.”
In advanced stages, prostate cancer can significantly reduce life expectancy and bring on symptoms that impact daily functioning. Kuhlman emphasized the importance of focusing on treatments that help preserve Biden’s quality of life in the years ahead.
Fox News senior medical analyst Dr. Marc Siegel also offered insight into Biden’s diagnosis based on publicly available information. He noted that Biden’s urinary symptoms are an indication that the cancer is in an advanced stage, since early-stage prostate cancer often develops without noticeable symptoms.
“This was found by physical examination by a prostate exam. A lot of times we find an elevation in prostate-specific antigen, PSA, and then we go after it… I mean, he must have had the best possible care here. I’m a little taken aback that it’s this far advanced,” Siegel noted.
Siegel explained that he routinely performs a prostate-specific antigen (PSA) test on all men over the age of 45. This blood test measures the level of PSA, and is commonly used as a screening tool to detect potential signs of prostate cancer.
While the PSA test isn’t always a definitive indicator of prostate cancer, Siegel noted that any rise in PSA levels typically warrants further investigation through an MRI. Based on the MRI results, doctors then determine whether a biopsy is necessary to confirm the presence of cancer.
More than 80% of men over the age of 80 are estimated to have some prostate cancer cells in their body. Hence, Siegel said, “It would be really surprising if they weren’t doing a very close screening on this because everybody knows in the medical community that this is the one cancer in men you really look out for.”
He added, “He doesn’t seem to have a lot of risk factors that I would think about other than age, but age is enough and he’s 82, so that’s a big risk factor.”
As for Biden’s treatment options, according to Siegel, doctors are likely to pursue hormone therapy. In addition to that, they may consider targeting the bone lesion with radiation or opting for surgical removal of the prostate. In some cases, a combination of these approaches is used to improve outcomes.
To manage advanced prostate cancer, two main types of medications are typically involved: one that blocks testosterone production, such as Lupron, and another that prevents testosterone from binding to receptors, like Casodex.
These treatments can lead to side effects, including fatigue and a general sense of low energy. “The other thing I’m concerned about is bone pain, because those metastases to the bone can be pretty painful,” he shared.
While advanced cases like Joe Biden’s are more challenging, Siegel emphasized that prostate cancer can often be cured if it is detected while still confined to the prostate gland. Once it spreads beyond that point, treatment becomes more complex and curative outcomes are less certain.
Just like Siegel, urologist Dr. David Shusterman has joined in on the conversation, saying, “It’s very unlikely that someone could get annual checkups and not notice a PSA elevation.”
The urologist suggested that Biden’s case resembles one involving someone who hasn’t received medical care in over a decade. “He was a former president. He had intensive state of the art care where we can see prostrate cancer, you know, 10 years in the past,” he noted.
Shusterman added, “It’s very unusual to hear that someone has prostate cancer when they’re annually being followed up and the fact that we just find it at a Gleason 9 is just pretty much unheard of in this day and age in medicine.”
The urologist also said that even within inner-city populations, such a case would likely be detected earlier. He believes Biden may have known about his prostate cancer while in office, or even during his campaign. “Aggressive prostrate cancer such as this grows over a long period of time,” he shared.
According to him, the progression from initial diagnosis to metastasis typically takes five to ten years. “To me it seems very surprising that the first diagnosis would be a metastasis diagnosis,” he admitted. Shusterman added that he would like Biden to release his PSA history to review how the levels have changed over time.
In light of Biden’s diagnosis, which has sparked discussion among medical professionals, it’s also worth noting the broader risks associated with prostate cancer. Statistically, about 1 in 8 men will be diagnosed with the disease during their lifetime, though the likelihood varies depending on several factors such as age and ethnicity.
Age plays a significant role as around 60 percent of prostate cancer cases are diagnosed in men aged 65 or older, while it remains uncommon in men under 40. The average age at diagnosis is approximately 67.
Race and ethnicity also affect risk levels. African American men, as well as Caribbean men of African ancestry, are more likely to develop prostate cancer compared to men of other racial backgrounds.
Brahmbhatt has underscored the value of early detection, noting that Biden’s diagnosis serves as a reminder of the importance of routine check-ups, even in the absence of symptoms.
As Biden and his family explore treatment options, the former president took to X on Monday, May 19, writing, “Cancer touches us all.”
He went on to share that he and his wife, former First Lady Jill Biden, “have learned that we are strongest in the broken places. Thank you for lifting us up with love and support.”
Amid the expert commentary and messages of support, Biden and his wife are leaning on each other, facing the road ahead together with strength and unity.
