It was the news that stopped the scroll back in 2025. After decades in the public eye and a grueling final year in the White House, former President Joe Biden faced a new, deeply personal battle. He was diagnosed with an aggressive form of metastatic prostate cancer just months after leaving office. For a man who built a huge part of his legacy on the "Cancer Moonshot" initiative, the irony was thick, and frankly, a bit heartbreaking.
Honestly, when the reports first dropped in May 2025, people were blindsided. We’d spent years arguing about his gait or his verbal slips, but this was different. This was a Gleason 9 diagnosis—a number that sounds clinical until you realize it’s one of the most aggressive tiers on the scale.
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What Really Happened with the Diagnosis
The timeline is kinda wild when you look back at it. During his time in the Oval Office, his physician, Dr. Kevin O’Connor, consistently released memos calling him "fit for duty." There were mentions of sleep apnea, a stiff gait, and even some non-melanoma skin cancer removals. But nothing about the prostate.
Then came May 2025.
Biden’s post-presidency office confirmed that a routine physical—the kind of check-up we all tell our dads not to skip—turned up a small nodule. Further testing revealed the truth: it wasn't just cancer; it had already reached his bones. Specifically, it was metastatic prostate cancer.
If you're wondering how it moved that fast without being caught during his presidency, you aren't alone. Doctors have pointed out that symptoms often don't show up until the cancer is advanced. For Biden, it started with some nagging urinary symptoms that finally prompted the deeper look.
Breaking Down the Treatment Plan
By October 2025, things got serious. His spokesperson, Kelly Scully, confirmed he was starting a dual-track treatment: radiation and hormone therapy.
If you’ve ever known someone going through this, you know hormone therapy is no joke. It basically starves the cancer by dropping testosterone levels. Since prostate cancer cells usually "feed" on testosterone, cutting off the supply can slow things down significantly. But the side effects? They’re tough. We’re talking about muscle loss, bone density issues, and profound fatigue.
He also spent several weeks at Penn Medicine Radiation Oncology in Philadelphia. You might have seen the video his daughter, Ashley Biden, posted on Instagram. It was a short, raw clip of him ringing the bell to signal the end of that round of radiation. He looked tired, sure, but he was smiling.
The Specifics of a Gleason 9
In the medical world, they use something called a Gleason score to see how much the cancer cells look like healthy ones.
- Gleason 6: Low grade, slow-growing.
- Gleason 7: Intermediate.
- Gleason 8-10: High grade/Aggressive.
Biden’s score of 9 put him in "Grade Group 5." It means the cells were poorly differentiated and moving fast. Because it’s "hormone-sensitive," there’s a real path to management, even if a cure for Stage 4 isn't usually the word doctors use.
The Reality of Being 83 and Battling Cancer
There’s a lot of noise about his age—he turned 83 in November 2025—and how it affects treatment. Modern medicine is amazing, but an 83-year-old body handles radiation differently than a 60-year-old one.
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Experts like Dr. Randall Lee have noted that while Stage 4 isn't "curable" in the traditional sense, people live for years, even decades, with the right management. It’s about turning a terminal illness into a chronic one.
Biden hasn't exactly been hiding away, either. He’s still seen taking Amtrak trains back to Delaware and working on his presidential library. He’s basically living out the reality of the very research he funded through the Cancer Moonshot.
Practical Steps and Takeaways
If this news has you worried about yourself or someone you love, there are a few things that actually matter more than the headlines.
1. Don't ignore the plumbing.
Urinary changes—frequency, urgency, or trouble starting—are often written off as "just getting older." Sometimes it’s an enlarged prostate (BPH), but sometimes it’s the nodule that Biden’s team found. Get it checked.
2. The PSA test debate.
The Prostate-Specific Antigen (PSA) test is a simple blood draw. It’s not perfect, and it can lead to over-treatment of slow cancers, but for someone like Biden, it’s the first line of defense. Talk to a doctor about when to start screening; usually, it’s 50, but it’s 40 or 45 if you’re at higher risk (like Black men or those with family history).
3. Bone health is key.
Since advanced prostate cancer often moves to the bones, keeping them strong is a huge part of the fight. This means calcium, Vitamin D, and sometimes specific medications to prevent fractures.
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4. Second opinions are mandatory.
With an aggressive diagnosis, you want a multidisciplinary team. That means an oncologist, a urologist, and a radiation specialist all talking to each other.
Joe Biden’s diagnosis was a reminder that even the most powerful people are at the mercy of their biology. But the fact that he's "ringing the bell" and staying active suggests that an aggressive diagnosis doesn't mean the end of the story. It just means the start of a very different, very tough chapter.