Joe Biden diagnosed with 'aggressive' prostate cancer: The early signs you should look out for

Former US President Joe Biden has been diagnosed with prostate cancer. As per a statement from his office shared on Sunday, the cancerous growth has spread to his bones. Biden, 82, was diagnosed on Friday after he saw a doctor last week for urinary symptoms.
The cancer is a more aggressive form of the disease, characterised by a Gleason score of 9 out of 10. According to Cancer Research UK, this means his illness is classified as "high-grade" and that the cancer cells could spread quickly.

The news comes almost a year after the former president was forced to withdraw from the 2024 US presidential election over concerns about his health and age. He is the oldest person to hold the office in US history.


Currently, Biden and his family are said to be reviewing treatment options. The former president's office added that the cancer is hormone-sensitive, meaning it can likely be managed.


Here’s a detailed look at the disease and the early signs one shouldn’t ignore.


What is prostate cancer?

Prostate cancer is a disease where cancerous cells develop in the prostate gland, a small walnut-sized gland part of the male reproductive system. It is a type of cancer that can grow uncontrollably, potentially spreading to other parts of the body.

Prostate cancer occurs when abnormal cells in the prostate gland grow out of control. The cancer cells can spread to surrounding tissues and organs, or to other parts of the body.



What does ‘a Gleason score of 9 out of 10’ mean?

The Gleason score is a grading system that pathologists use to assess the aggressiveness of prostate cancer. The system classifies prostate cancer based on the appearance of cancer cells under a microscope.

The Gleason score ranges from 6 to 10, with higher scores indicating more aggressive cancer. A Gleason score of 9 out of 10 indicates a high-grade, poorly differentiated prostate cancer. It suggests the cancer cells are poorly differentiated, highly abnormal, and likely to grow and spread aggressively. Gleason scores are used to assess the aggressiveness of prostate cancer.

A Gleason score of 9 suggests the cancer is likely to grow and spread quickly. The Gleason score, along with other factors like the stage of the cancer, helps doctors decide on the best treatment plan.


Early signs of prostate cancer:

Prostate cancer often develops without noticeable symptoms, especially in its early stages. Hence, early prostate cancer often has no symptoms. However, some men may experience urinary issues like frequent urination, especially at night, difficulty starting or stopping urination, or a weak urine flow. Blood in the urine or semen is also a possible sign. In rare cases, erectile dysfunction can be an early sign.


Here’s a detailed explanation:

Urinary issues:

Frequent urination: The need to urinate more often, especially during the night, is a common symptom.

Difficulty starting urination: Trouble getting the flow of urine started can be a sign.

Weak urine flow: A slow or interrupted urine stream can also occur.

Former US President was diagnosed with the disease after he saw a doctor for urinary symptoms.

Blood in urine or semen: Blood in the urine (hematuria) or semen is another possible early sign.

Erectile dysfunction: Difficulty achieving or maintaining an erection can be a symptom, although it's also common for other reasons.

Other possible signs: Some men might also experience pain or burning during urination or ejaculation.


Diagnosis:

Prostate cancer is often diagnosed at an early stage, typically stages I or II, where the cancer is localized within the prostate gland. In these early stages, the cancer has not spread beyond the prostate. However, it can also be diagnosed at later stages, such as III or IV, where the cancer has spread beyond the prostate.


Elaboration:

Stages I and II: These stages are considered "localized" or "early-stage" prostate cancer. The cancer is confined to the prostate gland and has not spread to nearby tissues or other parts of the body.

Stage III: In this stage, the cancer has spread beyond the prostate, but may still be confined to nearby tissues or organs, such as the seminal vesicles.

Stage IV: This stage indicates that the cancer has spread beyond the prostate and has reached distant sites, like lymph nodes or other organs.

Early detection through screening tests (e.g., PSA blood test) and regular check-ups can help diagnose prostate cancer at an early stage, increasing the chances of successful treatment.

A Gleason score of 9 indicates Stage IIIC prostate cancer. This stage signifies that the cancer has or has not spread outside the prostate, and has not spread to lymph nodes, but the Gleason score is 9 or 10, and the PSA level can be any, according to the National Cancer Institute. A Gleason score of 9 is part of Grade Group 5, which is the highest risk category for prostate cancer.


Treatment:

Prostate cancer treatments vary depending on the cancer's stage, aggressiveness, and the patient's overall health. Common options include surgery, radiation therapy, hormone therapy, and chemotherapy, with active surveillance also a possibility for low-risk cancers.


A more detailed look at the treatment options:

Active surveillance: For low-risk prostate cancer, active surveillance involves monitoring the cancer's progress with regular checkups, PSA tests, and imaging scans instead of immediate treatment. This approach allows for delaying treatment if the cancer is slow-growing and may minimize potential side effects.

Surgery:

Radical prostatectomy: Removing the entire prostate gland, some lymph nodes, and surrounding tissue is a common surgical option for localized prostate cancer.

Lymph node removal: Surgery may also involve removing lymph nodes to check for cancer spread.

Radiation therapy:

External beam radiation therapy: Uses high-energy beams to target and destroy cancer cells in the prostate.

Internal radiation therapy (Brachytherapy): Involves placing radioactive seeds directly into the prostate gland.

Hormone therapy:

Hormone therapy: aims to reduce the levels of testosterone, which can stimulate prostate cancer growth.

Orchiectomy: Surgical removal of the testicles, which are the main source of testosterone.

LHRH Agonists/Antagonists: Medications that lower testosterone levels by reducing the amount produced by the testicles.

Anti-androgens: Medications that block the effects of testosterone on cancer cells.

Chemotherapy: Uses drugs to kill cancer cells. It is often used for advanced or metastatic prostate cancer that has spread to other parts of the body.

Other treatment options include: Cryotherapy (freezing the prostate tissue to destroy cancer cells), High-Intensity Focused Ultrasound (HIFU) (using focused ultrasound waves to heat and destroy cancer cells), targeted therapy (using drugs that target specific molecules or pathways involved in cancer growth), and immunotherapy (stimulating the body's immune system to fight cancer).

Joe Biden's Parkinson's diagnosis:

Although there have been speculations whether or not the former US President has also been diagnosed with Parkinson’s disease, as of May 2025, there is no official confirmation on that.
The speculations gained momentum after the New York Times reported that visitor logs showed a doctor specializing in the illness visited the White House at least eight times from August 2023 through March 2024. Concerns that Biden might be suffering from an undisclosed illness started getting more attention since he stumbled, appearing frail and losing his train of thought at times, at his June debate last year, against Donald Trump.
However, when Dr. Kevin O'Connor, Biden’s personal physician, was asked by the New York Post last year about former US Prez’s health, he had affirmed that Biden was in ‘excellent health’. Dr. O'Connor's medical evaluations, including detailed neurological exams conducted during Biden's annual physicals, had found no evidence of neurological disorders such as Parkinson's disease. Moreover, Dr. O'Connor also stated publicly that Biden had not been diagnosed with Parkinson's and was not receiving treatment for it.



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