Joe Biden Diagnosed with Aggressive Prostate Cancer: What Does a Gleason Score of 9 Mean?
Former U.S. President Joe Biden has been diagnosed with an aggressive form of prostate cancer, a condition that, according to his office, carries a Gleason score of 9 — indicating a high-risk, fast-growing cancer. The announcement came just weeks after a routine medical exam detected a suspicious nodule in his prostate, prompting further medical investigation.
In a more concerning development, doctors also confirmed that the cancer has metastasized to his bones, which typically signifies an advanced stage of the disease. Despite the seriousness of the diagnosis, experts note that certain treatments remain effective even in such late stages.
What Is Prostate Cancer?
Prostate cancer begins in the prostate — a small gland in men responsible for producing seminal fluid. It’s currently the most commonly diagnosed cancer among men in the U.S. and the second leading cause of cancer-related deaths in the male population.
According to data from the National Institutes of Health (NIH), around 313,000 new cases are expected in 2025, making up over 15% of all cancer diagnoses in men. Fortunately, when detected early, the five-year survival rate is roughly 98%.
That said, not all prostate cancers behave the same way. Some grow very slowly and may not require immediate treatment, while others can be aggressive and spread rapidly.
Understanding the Gleason Score
The Gleason score is a system used to evaluate the severity of prostate cancer based on the appearance of cancer cells under a microscope. Scores range from 6 to 10, with higher numbers indicating more abnormal, and thus more aggressive, cancer.
Biden’s score of 9 places his cancer in the Grade Group 5 category — the most severe classification. This suggests the cancer cells differ significantly from normal ones and are highly likely to grow and spread quickly.
Despite the aggressive nature of a Gleason 9 score, the prognosis can still be managed through appropriate treatment, especially if the cancer remains sensitive to hormone therapy.
Treatment Options and Outlook
While no specific treatment plan has been officially released, experts speculate that hormone therapy — specifically Androgen Deprivation Therapy (ADT) — may be among the first lines of defense. This treatment works by reducing testosterone levels, which fuel prostate cancer growth.
Because the disease has already spread to Biden’s bones, surgery is no longer considered a viable option. Instead, doctors are likely to focus on systemic treatments like hormone therapy, radiation, and potentially chemotherapy to manage the cancer’s progression.
Monitoring Prostate-Specific Antigen (PSA) levels will also play a key role in tracking the effectiveness of the treatment over time.
Past Health Concerns
This isn’t Biden’s first encounter with cancer. Back in February 2023, during his presidency, a cancerous lesion was removed from his chest. Prior to entering office, he also underwent Mohs surgery to remove several non-melanoma skin cancers — further highlighting a history of cancer-related health concerns.
A Broader Public Health Reminder
Following Biden’s diagnosis, the American Cancer Society issued a statement urging men to take prostate health seriously. “Early detection is essential,” the statement read, especially as cases of advanced-stage prostate cancer are on the rise.
Their reminder is clear: screenings save lives, and recognizing symptoms or undergoing regular checkups could mean the difference between early treatment and late-stage complications.
For those seeking more information or support, the American Cancer Society offers a 24/7 cancer helpline at 1-800-227-2345 and resources at cancer.org.
