Joe Biden’s Prostate Cancer Diagnosis: Understanding the Gleason Score 9, Stage, Global Trends, and Treatment Options

On May 2025, news broke that U.S. President Joe Biden has been diagnosed with advanced prostate cancer, specifically an aggressive type characterized by a Gleason score of 9. This diagnosis has sparked global concern and interest in prostate cancer awareness, diagnosis, treatment, and outcomes—especially given the high-profile nature of the case.

In this post, we break down the medical facts about prostate cancer, what a Gleason score of 9 signifies, global statistics, and the range of treatment options available—from traditional therapies to the latest in precision oncology.

What Is Prostate Cancer?

Prostate cancer develops in the prostate gland, a small gland in men that produces seminal fluid. It’s one of the most common cancers affecting men globally.

• In 2022, there were over 1.4 million new cases of prostate cancer worldwide.

• It is the second most common cancer in men after lung cancer.

• The disease is generally slow-growing but can become aggressive in some cases, as seen with President Biden.

What Does a Gleason Score of 9 Mean?

The Gleason score is a grading system used to evaluate the aggressiveness of prostate cancer:

• Scores range from 6 (least aggressive) to 10 (most aggressive).

• A Gleason score of 9 indicates high-grade cancer, meaning the tumor cells look very different from normal prostate cells and are likely to grow and spread rapidly.

• Biden’s score of 9 implies Grade Group 5, associated with poor differentiation and high metastatic potential.

Biden’s Cancer Stage and Metastasis

Reports indicate that President Biden’s prostate cancer has metastasized to the bone, which classifies it as Stage IV. In prostate cancer staging:

• Stage I-III generally involve localized or regional spread.

• Stage IV means cancer has spread to distant organs—commonly the bones, lymph nodes, or other parts of the body.

Global Statistics on Prostate Cancer

Understanding the worldwide burden of prostate cancer underscores its public health impact:

• 5-year survival rates vary by country:

  • USA: ~97% (localized), ~31% (metastatic).

  • Europe: Varies between 70–90% depending on country.

  • Africa and developing countries: Often diagnosed late, with survival rates below 50%.

• Risk factors: Age (men over 65), African ancestry, family history, and lifestyle.

Treatment Options for Advanced Prostate Cancer

President Biden’s cancer is described as hormone-sensitive, meaning treatments that reduce testosterone (which fuels cancer growth) can be effective. Treatment options include:

1. Hormone Therapy (Androgen Deprivation Therapy – ADT)

• Standard for hormone-sensitive metastatic prostate cancer.

• Involves medications like LHRH agonists or antagonists.

• Often combined with radiation or chemotherapy.

2. Chemotherapy

• Common drugs: Docetaxel and Cabazitaxel.

• Often used when the cancer becomes castration-resistant or highly symptomatic.

3. Radiation Therapy

• External Beam Radiation Therapy (EBRT) or radiopharmaceuticals like Radium-223.

• May be used to control pain and manage metastases.

4. Surgery

• Rarely used in Stage IV but may involve cytoreductive prostatectomy in select cases.

5. Cutting-Edge Treatments

a. PARP Inhibitors

• For patients with BRCA mutations (common in prostate cancer).

• Examples: Olaparib, Rucaparib.

b. Immunotherapy

• PD-1 inhibitors and cancer vaccines (Sipuleucel-T).

c. Targeted Radioligand Therapy

• Lutetium-177–PSMA, a new therapy that delivers radiation directly to cancer cells expressing the PSMA protein.

d. Genomic Profiling

• Identifies actionable mutations for precision medicine.

Prognosis and Quality of Life

While Stage IV prostate cancer with Gleason score 9 has a lower survival rate, recent advances in therapy offer hope for longer life expectancy and quality of life:

• Median survival can range from 2 to 5 years, depending on response to therapy and overall health.

• Hormone-sensitive status, as in Biden’s case, is a positive prognostic factor.

• Ongoing research and clinical trials continue to improve outcomes.

Final Thoughts

Joe Biden’s diagnosis is a sobering reminder of the importance of routine screening, early detection, and ongoing research. It also highlights the potential for survival—even in advanced stages—thanks to advances in modern oncology.