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What Joe Biden's Diagnosis Can Help Us Understand About Prostate Cancer
Former President Joe Biden shared a prostate cancer diagnosis in 2025. Here is a calm, plain-language look at prostate cancer and screening, drawn from the National Cancer Institute.
A plain-language summary based on public reporting and trusted sources, linked below.
Please note: this page is educational only — it is not medical advice, and it does not speculate about anyone’s health beyond reliable public reporting. For questions about your own health, talk with your healthcare team.
What his office announced
Update, August 2026. In a BBC interview reported on August 8, 2026, Hunter Biden said his father's cancer had spread "into his bones and further" and was painful. Our companion page covers what progression and castration-resistant disease involve.
On May 18, 2025, Joe Biden's personal office released a statement. The Guardian quoted it in full.
"Last week, President Joe Biden was seen for a new finding of a prostate nodule after experiencing increasing urinary symptoms," it said. "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 added: "While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive which allows for effective management."
Biden, then 82, posted his own message the next day. "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."
That is the public record. This page does not speculate about his prognosis, his treatment choices, or anything not stated above. What it does is unpack the medical vocabulary in that announcement, because every phrase in it means something specific.
Reading the diagnosis, phrase by phrase
A prostate nodule. A firm lump felt on the gland during examination. It is a finding, not a diagnosis.
Gleason score of 9 (Grade Group 5). Pathologists grade prostate cancer by how far the cells have drifted from normal architecture. The National Cancer Institute (NCI) sets out the translation between the old Gleason score and the newer Grade Groups. Grade Group 1 is Gleason 6 or less. Grade Group 5 is Gleason 9 or 10. Grade Group 5 is the highest.
Metastasis to the bone. The cancer has spread beyond the prostate and established itself in bone.
Hormone-sensitive. The cancer still depends on male hormones to grow, so lowering those hormones should shrink it. The technical term is castration-sensitive. It matters because it opens the most effective treatments.
Why bone
Prostate cancer has a strong preference for the skeleton, particularly the spine, pelvis, and ribs. NCI notes that when prostate cancer does cause symptoms of spread, they include bone pain, pathological fractures, meaning breaks through weakened bone, and problems from bone marrow involvement.
This is why a bone scan or PET imaging is standard once high-grade prostate cancer is found, even in a man who feels well.
Get help now
Anyone with prostate cancer in the bones should know these. Go to an emergency department immediately for:
- Back or neck pain together with new weakness, numbness, or tingling in the legs
- Loss of control over the bladder or bowels, or numbness around the groin and inner thighs
- Complete inability to pass urine
The first two can mean the spinal cord is being compressed. Say the words out loud at triage: "I have prostate cancer in my bones and I am worried about spinal cord compression." Treatment within hours can preserve walking.
Contact your team the same day for:
- Sudden severe bone pain after a minor movement, which can mean a fracture
- Confusion, heavy thirst, constipation, and nausea together, which can mean high blood calcium
What hormone-sensitive treatment involves
Androgen deprivation therapy, usually shortened to ADT, lowers testosterone to very low levels. NCI lists several routes to this, including LH-RH agonist injections, antiandrogen tablets, and surgical removal of the testicles.
ADT alone is rarely the whole plan now for metastatic disease. Two additions have strong evidence.
NCI states that abiraterone acetate improves overall survival when added to ADT in men with advanced, castration-sensitive prostate cancer. It is generally well tolerated, though NCI notes it raises rates of serious high blood pressure and low potassium.
Chemotherapy is the other option. In a meta-analysis of three randomized trials covering 3,206 men, adding docetaxel to standard care gave a hazard ratio for death of 0.77. NCI describes that as an absolute improvement of 9% in four-year survival. The CHAARTED trial gave docetaxel every three weeks for six cycles alongside ADT.
What ADT costs
Lowering testosterone to near zero has consequences, and they deserve stating.
NCI lists loss of libido, impotence, hot flashes, and osteoporosis. It also notes that surgical castration has been associated with an elevated risk of coronary heart disease and heart attack. Fatigue, loss of muscle mass, and mood changes are common.
None of these are reasons to refuse treatment. They are reasons to ask what will be monitored, particularly bone density and cardiovascular risk.
Protecting bone and controlling pain
Several tools exist specifically for bone disease, and they are worth asking about by name.
Denosumab is an antibody that blocks osteoclasts, the cells that break down bone. Bisphosphonates work on the same problem by a different route.
For a painful spot, external-beam radiation is highly effective. NCI notes that a single 8 Gy treatment gave similar pain relief and quality of life as ten smaller treatments in the RTOG-9714 trial. One visit rather than ten matters when someone is unwell.
Radium-223 is different again. It is given by vein and taken up selectively by newly forming bone. NCI reports it improved overall survival in a randomized trial of 921 men with symptomatic castration-resistant disease that had spread to bone.
One trap with PSA
This point is easy to miss and causes real confusion.
PSA production is itself controlled by hormones. So ADT lowers the PSA reading whether or not the tumor is actually responding. NCI warns that clinicians "cannot rely solely on the serum PSA level to monitor a patient's response to hormonal therapy" and must also follow clinical criteria.
If someone you love is on hormone therapy, a falling PSA is encouraging but not the whole story. Scans and symptoms count too.
The numbers
SEER, NCI's cancer surveillance program, puts five-year relative survival for prostate cancer at 98.2% across all stages, counting men diagnosed between 2016 and 2022. That figure is driven by the 69% of cases found while still localized, where survival is 100.0%.
For distant-stage disease, five-year relative survival is 40.1%. About 9% of cases are diagnosed at that stage. NCI adds that the rate of tumor growth varies from very slow to moderately rapid, and that some patients have prolonged survival even after spread to bone.
Every number here is a group average from men diagnosed years ago, under older treatment standards. None of them predicts what will happen to one person.
Sources
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Put the story in context
Prevention, possible warning signs, screening, and diagnosis
This story relates to Prostate cancer. The information below is general: it does not reveal anything else about a public person’s health, and not every point applies to every cancer. Personal advice depends on age, symptoms, family history, exposures, and medical history.
Prevention and risk reduction
Not every cancer can be prevented. Avoiding tobacco, protecting skin from ultraviolet radiation, limiting alcohol, staying active, and receiving recommended HPV or hepatitis B vaccination can lower the risk of certain cancers. A risk factor is not a prediction or a cause in one individual.
Symptoms and possible early signs
Possible signs vary and are often caused by conditions other than cancer. Changes worth discussing include a new lump, unexplained bleeding or weight loss, a persistent cough, lasting bowel or bladder changes, a changing skin spot, or symptoms that persist or worsen. Some early cancers cause no symptoms.
Screening and early detection
Screening looks for certain cancers before symptoms begin. Recommended tests exist only for some cancers and depend on age and risk. Screening can have benefits and harms; it is not the same as evaluating a new symptom, and there is no single routine scan or blood test that reliably screens for every cancer.
How cancer is diagnosed
Diagnosis may involve a history and exam, imaging, laboratory tests, and often a biopsy. Pathology can identify the cancer type and may test biomarkers that guide treatment. Symptoms, screening results, tumor markers, or online stories alone cannot confirm cancer.
Learn about this story’s cancer topic
A public story may encourage questions, but it should not be used to estimate your risk or choose testing. Contact a healthcare professional about a persistent or concerning change. Seek urgent care for severe or rapidly worsening symptoms.