When former President Joe Biden’s office announced that he had been diagnosed with an “aggressive” form of prostate cancer, the phrase hit hard—especially with news that the cancer had already spread to his bones and carried a Gleason score of 9, the highest risk category.
But while the word aggressive can sound terrifying, cancer experts say that Biden’s condition, though serious, may still be manageable—thanks to one key detail: the cancer is hormone-sensitive, meaning it can likely respond well to specific treatments. So how dangerous is his diagnosis? And what does it mean in practical, scientific terms?
Here’s a clear, simple breakdown.
What Is Prostate Cancer—and How Common Is It? Joe Biden’s Diagnosis Explained
Prostate cancer is the second most common cancer among men in the U.S., after skin cancer. It forms in the prostate, a small gland that produces seminal fluid. It’s highly treatable when caught early, but once it spreads, it becomes more difficult to manage.
The numbers:
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Around 313,000 new cases of prostate cancer are expected in the U.S. in 2025
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About 1 in 8 men will be diagnosed in their lifetime
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If it’s caught early, the five-year survival rate is about 97%
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But if the cancer spreads—like Biden’s has—to distant parts of the body, that survival rate drops to 37%
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What is a Gleason score—and why does Biden’s matter?
The Gleason score is a way to grade how aggressive prostate cancer is by looking at how abnormal the cancer cells appear under a microscope. It ranges from 6 to 10. The higher the number, the more likely the cancer is to grow and spread quickly.
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Biden’s score: 9
This places him in Grade Group 5, the most aggressive category. It means the cancer cells look very different from normal prostate cells and are likely to grow and spread rapidly.
So yes, his cancer is in a high-risk group—but that’s only part of the picture.
What does “hormone-sensitive” cancer mean?
Hormone-sensitive (also called androgen-sensitive) prostate cancer responds to treatments that reduce testosterone, the hormone that fuels many prostate cancers. This gives doctors a clear path forward for treatment, even in more advanced cases.
According to Dr. Ben Davies, a urology professor at the University of Pittsburgh, hormone therapy can “almost melt away” cancer from the bones in some cases. This doesn’t mean it’s cured—but it can make the disease manageable and improve quality of life.
See also: Joe Biden’s Heartbreaking Reaction to His ‘Aggressive’ Cancer Diagnosis
What are Biden’s treatment options?
Biden’s medical team hasn’t released a full treatment plan, yet the most likely options include:
1. Hormone Therapy (Androgen Deprivation Therapy)
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Lowers testosterone levels to slow cancer growth
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Typically the first-line treatment in hormone-sensitive cases
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Can be given via injections or medication
2. Chemotherapy
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Used when the cancer has spread or stops responding to hormone therapy
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Helps shrink or slow down tumor growth, including in the bones
3. Radiation Therapy
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Not always used in advanced cases, but can help extend life in patients with newly diagnosed metastatic prostate cancer
Notably: Surgery is not an option for Biden
Because the cancer has already metastasized to the bones, removing the prostate won’t eliminate the disease. At this stage, treatment focuses on controlling the cancer—not removing it.
Does Biden’s age affect his outlook?
Biden is 82, but experts say age alone isn’t necessarily a deal-breaker. Physiology matters more than the number. As long as he can tolerate treatment, there are paths forward. However, some treatments can cause frailty, which is a concern in older patients.
“It’s not really an age-specific thing,” said Dr. Davies. “It’s how he can take the therapies that he’s getting.”
What’s the prognosis?
Despite the high Gleason score and bone metastasis, Dr. Davies says Biden could live 10 years or more with this diagnosis—especially if he responds well to treatment.
“It’s not all doom and gloom,” he said.
See also: Biden Blasts Trump Over Ukraine: “This Is Beneath America”
What does this mean for prostate cancer awareness?
Biden’s diagnosis has spotlighted a disease that affects millions. According to the American Cancer Society, about 35,000 men are expected to die of prostate cancer in 2025. While overall death rates have decreased, late-stage diagnoses are rising, with cases increasing 3% annually since 2014.
The ACS stressed that early detection is critical and expressed concern over the recent increase in advanced-stage cases like Biden’s.
Long before his own diagnosis, Biden was a prominent voice in the fight against cancer. After his son Beau died of brain cancer in 2015, Biden launched the Cancer Moonshot initiative to accelerate research and reduce cancer deaths by 50% over 25 years.
As president, he relaunched the program in 2022 with the goal of compressing a decade of progress into five years. Since leaving office, Biden has continued to champion science—despite a federal funding climate that has shifted under the Trump administration.
A recent Senate report found that the Trump White House slashed cancer research funding by 31% in the first three months of this year.
So—how serious is Biden’s diagnosis, really?
It’s serious. A Gleason score of 9 with bone metastasis is high risk. But it’s treatable, especially because the cancer is hormone-sensitive. Biden has access to the best doctors and therapies available, and experts say a multi-year survival is not only possible—it’s likely.
In his first public comments since the announcement, Biden struck a hopeful note:
“Cancer touches us all,” he wrote. “Like so many of you, Jill and I have learned that we are strongest in the broken places.”
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