Understanding Joe Biden’s Prostate Cancer Diagnosis: What a Gleason Score of 9 Means

Introduction: A Sobering Diagnosis for a Resilient Leader

On May 18, 2025, the nation received sobering news: Former President Joe Biden, at 82, was diagnosed with an aggressive form of prostate cancer, characterized by a Gleason score of 9 and metastasis to the bone. This announcement, shared by Biden’s office, has sparked widespread concern, support, and curiosity about what this diagnosis means. For a leader known for his compassion, his work on humanitarian efforts overseas, and his personal resilience through tragedy, this health challenge is yet another test of strength. At Boncopia, we stand with Biden, his wife Jill, and their family, wishing them courage and hope. Let’s dive into the details of this diagnosis, break down the medical terms, and explore what lies ahead, all while reflecting on Biden’s legacy of empathy.

What Is Prostate Cancer?

Prostate cancer is the second most common cancer among men in the U.S., affecting about 1 in 8 men, and the second leading cause of cancer death among men, behind lung cancer. According to the National Cancer Institute, an estimated 313,780 new cases will be diagnosed in 2025, accounting for 15.4% of all new cancer cases, with approximately 35,770 deaths. The prostate, a small gland in the male reproductive system located behind the bladder, can develop cancerous cells that, if undetected, may grow and spread. While early-stage prostate cancer often grows slowly and has a 98% five-year survival rate, advanced cases, like Biden’s, present significant challenges.

The Gleason Score: A Measure of Aggressiveness

The Gleason score is a critical tool used to assess how aggressive prostate cancer is. Pathologists examine biopsied prostate tissue under a microscope, grading the two most common types of cancer cells on a scale of 1 to 5 based on how abnormal they appear compared to healthy cells. These grades are added together to produce a score ranging from 6 to 10. A higher score indicates cancer cells that look more abnormal, are less differentiated, and are likely to grow and spread rapidly.

Biden’s Gleason score of 9 places his cancer in Grade Group 5, the highest risk category. This means the cancer cells are highly abnormal, poorly differentiated, and classified as high-grade, with a significant likelihood of rapid growth and metastasis. A score of 9 is nearly the most aggressive possible, signaling a serious prognosis, especially when paired with bone metastasis.

Metastasis to the Bone: What It Means

Metastasis occurs when cancer spreads beyond its original site to other parts of the body. In Biden’s case, the prostate cancer has spread to his bones, classifying it as stage IV or advanced prostate cancer. Bone metastasis, common in advanced prostate and breast cancers, can cause pain, fractures, and other complications. According to the Mayo Clinic, the five-year survival rate for prostate cancer that has metastasized drops to approximately 37%, compared to 98% for cancer confined to the prostate. This stark contrast underscores the severity of Biden’s diagnosis.

The cancer was detected after Biden experienced increasing urinary symptoms, leading to the discovery of a small prostate nodule during a routine physical exam. Further evaluation confirmed the aggressive cancer, highlighting the importance of regular screenings, as symptoms often appear only in advanced stages.

A Ray of Hope: Hormone-Sensitive Cancer

Despite the aggressive nature of Biden’s cancer, his office noted that it is “hormone-sensitive,” offering a viable treatment pathway. Hormone-sensitive prostate cancer relies on male hormones like testosterone to grow. Androgen deprivation therapy (ADT), or hormone therapy, can block these hormones, slowing cancer progression and managing symptoms, even in advanced stages. Experts suggest that if Biden responds well to treatment, he could live for years with a good quality of life. Other potential treatments include chemotherapy, radiation therapy, or emerging options like PSMA therapy, which uses radioactive molecules to target cancer cells.

Surgery, however, is typically not an option when cancer has spread beyond the prostate, as in Biden’s case. The focus shifts to managing the disease, reducing symptoms, and maintaining quality of life. Biden and his family are currently reviewing treatment options with his physicians, a process that will likely involve a multidisciplinary team of specialists.

Biden’s History with Cancer

This isn’t Biden’s first encounter with cancer. In 2023, while still president, he had a basal cell carcinoma, a type of skin cancer, removed from his chest. Before taking office, he also had several non-melanoma skin cancers removed. More personally, Biden’s son, Beau, died of glioblastoma, a form of brain cancer, in 2015 at age 46, a loss that profoundly shaped Biden’s life and work. As vice president, Biden led the Cancer Moonshot initiative under President Obama, and he reignited it as president, aiming to reduce cancer deaths and improve patients’ lives. His commitment to cancer research and prevention reflects his deep understanding of its impact, making his current diagnosis all the more poignant.

A Legacy of Compassion

Throughout his career, Joe Biden has been a champion for others, often prioritizing humanitarian efforts. From advocating for veterans exposed to burn pits (which he believes contributed to Beau’s cancer) to supporting international aid and refugee programs, Biden’s empathy has been a hallmark of his leadership. His work on the Cancer Moonshot, vowing to “end cancer as we know it,” demonstrates his commitment to alleviating suffering. Even in the face of personal health challenges, Biden’s resilience and focus on others inspire us all.

Public Reaction and Support

The announcement of Biden’s diagnosis prompted an outpouring of support from across the political spectrum. President Donald Trump, despite past criticisms, expressed sympathy on Truth Social, writing, “Melania and I are saddened to hear about Joe Biden’s recent medical diagnosis. We extend our warmest and best wishes to Jill and the family, and we wish Joe a fast and successful recovery.” Biden himself took to X on May 19, 2025, saying, “Cancer touches us all. 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.” This bipartisan and public support underscores the universal impact of cancer and the shared hope for Biden’s strength.

Why Early Detection Matters

Biden’s diagnosis serves as a stark reminder of the importance of early detection. The American Cancer Society noted a 5% year-over-year increase in advanced prostate cancer diagnoses, emphasizing the need for regular screenings. Prostate cancer often presents no symptoms in its early stages, making routine physicals and prostate-specific antigen (PSA) tests critical. Biden’s case, detected after urinary symptoms, highlights how advanced disease can progress silently. Encouraging men, especially those over 50 or with risk factors like family history or African ancestry, to prioritize screenings could save lives.

Looking Ahead

While a Gleason score of 9 and bone metastasis indicate a serious prognosis, advances in prostate cancer treatment offer hope. Biden’s hormone-sensitive cancer and access to top medical care position him to manage the disease effectively. As he navigates this challenge, his history of resilience—surviving a brain aneurysm in the 1980s and personal losses—suggests he will face this with the same determination that defined his career. We at Boncopia join millions in wishing him strength, peace, and quality time with his loved ones.

Conclusion: Standing with Biden

Joe Biden’s prostate cancer diagnosis is a reminder of life’s fragility and the strength found in community. His aggressive cancer, marked by a Gleason score of 9 and bone metastasis, is a formidable challenge, but his hormone-sensitive diagnosis and access to modern treatments provide hope. As we reflect on his legacy of compassion, from humanitarian efforts to the Cancer Moonshot, we’re inspired to support him and his family. Let’s honor Biden’s call to find strength in “the broken places” by raising awareness about prostate cancer and the power of early detection.

Thought Questions:

1. How can Biden’s diagnosis inspire conversations about prostate cancer screening in your community?

2. What role do humanitarian efforts, like those Biden championed, play in shaping a leader’s legacy?

3. How can we support loved ones facing aggressive cancer diagnoses while fostering hope?

Sources:

• ABC News, May 18, 2025

• Newsweek, May 18, 2025

• Hindustan Times, May 18, 2025

• NPR, May 18, 2025

• TIME, May 19, 2025

• The New York Times, May 18, 2025

• CNN, May 18, 2025

• NBC News, May 18, 2025

• BBC, May 18, 2025

• People, May 18, 2025

• The Washington Post, May 19, 2025

• NBC News, May 19, 2025

• CBS News, May 18, 2025

• Reuters, May 19, 2025

• CBS News, May 18, 2025

• ABC (Australia), May 18, 2025

• NPR, May 19, 2025

• Axios, May 18, 2025

• CNN, May 19, 2025

• USA Today, May 18, 2025

• AJMC, May 18, 2025

• Axios, May 18, 2025

• ABC News, May 18, 2025

• The Washington Post, May 18, 2025

• Fox News, May 18, 2025

• Posts on X, May 18, 2025