Prostate cancer is the second leading cause of cancer-related deaths among men in the United States.
Former President Joe Biden has been diagnosed with an “aggressive” form of prostate cancer, according to a statement released by his office on Sunday. His cancer has been classified with a Gleason score of 9, indicating a high-grade tumor, and the disease has metastasized to the bone.
The diagnosis was made after a routine physical exam last Tuesday revealed a small nodule on his prostate. The finding prompted further evaluation, which confirmed the cancer diagnosis.
Biden has a history of cancer treatment. In February 2023, while serving as president, he had a cancerous lesion removed from his chest. Prior to his presidency, he had undergone Mohs surgery to remove multiple non-melanoma skin cancers.
As the world reacts to this news, many are wondering what his diagnosis means and what treatment options are available. Here’s what we know:
Understanding Prostate Cancer
Prostate cancer begins in the prostate — a small gland in men that produces seminal fluid. According to the National Institutes of Health (NIH), it is the most commonly diagnosed cancer in men and the second leading cause of cancer deaths among American men.
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Estimated new cases in 2025: ~313,780 (over 15% of all new cancer diagnoses)
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Estimated deaths: ~35,770 (5.8% of all cancer-related deaths)
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Five-year survival rate: ~98%
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Median age at diagnosis: 68
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Median age at death: 79
Although prostate cancer tends to grow slowly and may not always pose a serious threat, aggressive forms—especially those that have spread—require immediate and intensive treatment.
What Is a Gleason Score?
The Gleason score is used to grade the aggressiveness of prostate cancer based on how abnormal the cancer cells look under a microscope.
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The score ranges from 6 to 10, with higher numbers indicating more aggressive cancer.
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A Gleason score of 9 (like in Biden’s case) suggests that the cancer cells are highly abnormal and likely to grow and spread rapidly.
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This places the cancer in Grade Group 5, the highest risk category, associated with poorer prognosis and a higher chance of metastasis.
Treatment Options for Aggressive Prostate Cancer
While Biden’s specific treatment plan has not been disclosed, common therapies for advanced prostate cancer include:
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Hormone therapy (Androgen Deprivation Therapy – ADT): This reduces levels of male hormones (androgens), which fuel the growth of prostate cancer. It can slow disease progression and relieve symptoms, especially when the cancer has spread to the bones.
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Monitoring PSA levels: Regular blood tests to check prostate-specific antigen (PSA) can help track the effectiveness of treatment.
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Surgery: Typically not an option when the cancer has metastasized beyond the prostate.
Public Health Response
Following the announcement, the American Cancer Society (ACS) emphasized the importance of early detection:
“This news is a reminder about the tragic impact of prostate cancer in the U.S. Early detection is key, and we are concerned by the 5% year-over-year increase in advanced cases. We must do more to prevent late-stage diagnoses and reduce deaths,” said the ACS.