What to Know About Joe Biden’s Prostate Cancer Diagnosis

Former president Joe Biden has been diagnosed with an “aggressive form” of prostate cancer, his team shared in a statement on Sunday.

The 82-year-old’s cancer is stage 4 and has “metastasized to the bone,” the statement read, per The New York Times. “While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive which allows for effective management,” the statement said. “The president and his family are reviewing treatment options with his physicians.”

Biden later shared his own message on X alongside a photo of himself and his wife, Jill Biden. “Cancer touches us all,” he wrote. “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.”

The news of Biden’s diagnosis raises a lot of questions about prostate cancer, including how to stay on top of your own prostate health. Here’s what Biden has shared, plus what oncologists want you to know.

What has Biden shared about his cancer?

In addition to revealing that his cancer is stage 4 and has spread to the bone, Biden’s team revealed that the disease is “characterized by a Gleason score of 9.”

A Gleason score is a grading system for prostate cancer that’s used to determine how abnormal the cancer cells are and how quickly they are likely to spread and grow, according to the National Cancer Institute (NCI). The Gleason score usually ranges from six to 10, with lower scores being more likely to spread slowly. A nine is an aggressive form of cancer, points out S. Adam Ramin, MD, a urologist, urologic oncologist, and medical director of Urology Cancer Specialists in Los Angeles, CA.

How common is this?

About one in eight men will be diagnosed with prostate cancer in their lifetime, according to the American Cancer Society (ACS). An estimated 313,780 new cases of prostate cancer are expected to be diagnosed this year, and about 35,770 people will die from the disease, per the ACS.

Biden’s particular types of prostate cancer is “not common, although it’s become a little more common in the past few years,” Ramin says. Here’s why: In 2018, the U.S. Preventive Services Task Force (USPSTF) made a recommendation to change prostate cancer screening in the U.S. Previously, most men were screened regularly for prostate cancer by their primary care provider. But the new recommendation said that screening “offers a small potential benefit of reducing the chance of death from prostate cancer in some men” and recommends that men talk to their healthcare provider before undergoing screening.

“They cited the reason as over-diagnosis of prostate cancer and treatment,” Ramin says. A likely result was that fewer men got screened. “We as urologists noticed a spike in the number of patients who were then being diagnosed with more advanced prostate cancer.”

What led to his diagnosis?

Details are scarce, but Biden’s team shared that his healthcare team detected a “prostate nodule after experiencing increasing urinary symptoms” last week. He was diagnosed with prostate cancer on Friday.

Early prostate cancer symptoms can include problems urinating (including a slow or weak urinary stream or the need to urinate more often) and blood in the urine or semen, according to the ACS. More advanced symptoms include erectile dysfunction; pain in the hips, back, chest, or other areas; weakness or numbness in the legs or feet; loss of bladder or bowel control; weight loss; and feeling very tired.

“Prostate cancer screening involves both a blood test known as PSA, prostate specific antigen, and also a digital rectal exam. Around 85 to 90 percent of prostate cancers are detected or found because the PSA is abnormal,” says Douglas Dow, MD, a urological surgeon at Memorial Hermann Medical Group.

Why was it detected so late?

That’s not clear. However, it could be that the former president wasn’t getting screened for prostate cancer due to the updated recommendations, Ramin says. The USPSTF recommends that men over the age of 70 don’t get tested for prostate cancer. That’s due to concerns about overdiagnosis and overtreatment. (Often this cancer grows slowly enough that there is even a saying that men are likely die with prostate cancer and not of it.) Early prostate cancer also causes no symptoms, he points out.

“As prostate cancer spreads or advances, that’s when some of these symptoms may manifest themselves,” he says. “But at the early stages, where the cancer is curable and treatable, most men have no symptoms at all.” (If symptoms do arise, here’s a look at what they tend to be.)

“While prostate cancer is very common, this advanced presentation is less typical—especially in men who are receiving regular medical care,” says Tanya Dorff, M.D., oncologist and section chief of the Genitourinary Disease Program at City of Hope in Los Angeles, Calif. “However, in my experience, even with close monitoring, some aggressive prostate cancers can develop and spread quickly. This isn’t due to neglect or missed opportunities—it’s simply how fast and silent some forms of the disease can be.”

What treatment options are available for this?

Treatment options vary by person and case, but there is a general protocol for this type of prostate cancer, Ramin says. Typically, people with Biden’s form of prostate cancer will be given a medication called leuprolide, along with an oral anti-androgen medication. “Prostate cancer feeds off of testosterone,” Ramin says. “By administering hormone therapy, we reduce testosterone levels close to zero so the entire testosterone production in the body is halted.” That can help the cancer stop growing or slow the growth, he explains.

“There are other treatments for bone metastasis, but this is the most important,” Ramin says.

(Biden’s team said that the former president and his family are reviewing treatment options.)

What is the usual prognosis for this?

Stage 4 prostate cancer is not curable, Ramin says. “Unfortunately, there is a high chance of not being able to survive the cancer,” he says. The five-year survival rate for prostate cancer that has spread is 37 percent, according to the ACS.

Ramin says men should re-consider getting screened for prostate cancer, if it’s been a while or if they’ve never been screened. “Getting diagnosed with these aggressive, advanced cancers will not only reduce your life but also your quality of life,” he says. That’s why Ramin recommends that men continue to talk with their doctors to get screened for prostate cancer at appropriate intervals.