Biden's sudden diagnosis of aggressive prostate cancer is unfortunately
all too common
[May 20, 2025]
By CARLA K. JOHNSON
Former President Joe Biden’s office said Sunday that he has been
diagnosed with aggressive prostate cancer and is reviewing treatment
options with his doctors.
Biden, 82, was having increasing urinary symptoms and was seen last week
by doctors who found a prostate nodule. On Friday, he was diagnosed with
prostate cancer and the cancer cells have spread to the bone, his office
said in a statement.
“It's a very common scenario," said Dr. Matthew Smith of Massachusetts
General Brigham Cancer Center. Men can “feel completely well and a
diagnosis of metastatic prostate cancer could come as quite a surprise.”
Guidelines recommend against prostate cancer screening for men 70 and
older so Biden may not have been getting regular PSA blood tests, Smith
said. What's more, while the PSA test can help flag some cancers in some
men, it does not do a great job of identifying aggressive prostate
cancer, Smith said.
When caught early, prostate cancer is highly survivable, but it is also
the second-leading cause of cancer death in men. About one in eight men
will be diagnosed over their lifetime with prostate cancer, according to
the American Cancer Society.
Here are some things to know about prostate cancer that has spread.
What is the prostate gland?
The prostate is part of the reproductive system in men. It makes fluid
for semen. It’s located below the bladder and it wraps around the
urethra, the tube that carries urine and semen out through the penis.
How serious is Biden's cancer?
Biden's cancer has spread to the bone, his office said. That makes it
more serious than localized or early-stage prostate cancer.
Outcomes have improved in recent decades and patients can expect to live
with metastatic prostate cancer for four or five years, Smith said.
“It’s very treatable, but not curable,” he said.
What are the treatment options?
Prostate cancer can be treated with drugs that lower levels of hormones
in the body or stop them from getting into prostate cancer cells. The
drugs can slow down the growth of cancer cells.
“Most men in this situation would be treated with drugs and would not be
advised to have either surgery or radiation therapy," Smith said.
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President Joe Biden walks after speaking during an interfaith prayer
service for the victims of the deadly New Years truck attack, in New
Orleans, Jan. 6, 2025. (AP Photo/Gerald Herbert, File)
 What is a Gleason score?
Prostate cancers are graded for aggressiveness using what’s known as
a Gleason score. The scores range from 6 to 10, with 8, 9 and 10
prostate cancers behaving more aggressively. Biden’s office said his
score was 9, suggesting his cancer is among the most aggressive.
Should older men get screened?
Screening with PSA blood tests can lead to unnecessary treatment
with side effects that affect quality of life. Guidelines recommend
against PSA screening for men 70 and older.
The PSA test looks for high levels of a protein that may mean cancer
but can also be caused by less serious prostate problems or even
vigorous exercise.
For men aged 55 to 69 the U.S. Preventive Services Task Force says
screening “offers a small potential benefit of reducing the chance
of death from prostate cancer in some men.” The task force adds that
“many men will experience potential harms of screening, including
false-positive results that require additional testing and possible
prostate biopsy; overdiagnosis and overtreatment; and treatment
complications, such as incontinence and erectile dysfunction.”
Is late-stage diagnosis more common in older men?
Yes. Of all men diagnosed with prostate cancer between 2017 and 2021
whose cancer staging was recorded, men 75 and older were more likely
to be diagnosed with late-stage disease compared to those younger
than 75.
One in five men 75 and older with prostate cancer were diagnosed
with cancer that had metastasized, compared to just 6.3% of men
under 75, according to an AP analysis of federal data from the U.S.
Cancer Statistics Working Group.
Between 2017 and 2021, 90,551 men were diagnosed with late-stage
prostate cancer, representing around 8.8% of prostate cancer
diagnoses. More than 40% of them were 75 or older. ___
AP data journalist Kasturi Pananjady contributed to this report.
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