Joe Biden prostate cancer: What it means for a man of his age?

Former US President Joe Biden's office publicly announced that he had been diagnosed with an aggressive form of prostate cancer. The diagnosis came after he sought medical attention for urinary symptoms, leading to the discovery of a prostate nodule. Further tests revealed that the cancer had metastasized to his bones, and a Gleason score of 9 indicated a high-grade, aggressive form of the disease. Despite the severity, the cancer is hormone-sensitive, allowing for effective treatment options .

Prostate cancer is the second most common cancer in men worldwide, and the vast majority of cases occur in men over 65. In fact, the average age at diagnosis in the U.S. is about 66. So for someone in their 80s—like Biden—the chances of having been diagnosed with prostate cancer, or at least living with slow-growing cancer cells in the prostate, are fairly high.

That sounds alarming, but here’s where it gets a bit more complicated and hopeful.

Age and prostate cancer
When people hear the word “cancer,” panic often follows. But prostate cancer behaves differently than many other types. It tends to grow slowly, especially in older men.

In practical terms, that means an 82-year-old man diagnosed today with low-risk prostate cancer might never need treatment at all. Instead, doctors often recommend “active surveillance,” which involves monitoring the cancer through regular checkups, PSA (prostate-specific antigen) blood tests, and occasional biopsies.

For younger men, doctors often lean toward treatments like surgery or radiation because the patient is young. The idea is to cure cancer before it can cause problems. But for someone of Biden's age, the equation changes.

At 82, most medical professionals are more concerned with preserving a patient’s quality of life than aggressively pursuing a cure especially when it is cancer. Treatments like prostate surgery or radiation can carry significant side effects: urinary incontinence, erectile dysfunction, fatigue. For a man in his early 80s, the potential downside of those treatments can outweigh the benefits.

So what does it mean for a man of Biden’s age?
It means being vigilant, not alarmed. Prostate cancer, for older men, isn’t necessarily a medical emergency. It’s something that’s often managed, not immediately battled. It means regular checkups, conversations with doctors, and balancing risks and benefits with care.

However, with aggressive forms of cancer the narration changes. Joe Biden's cancer has metastasized to the bones or in simple words it has spread to the bones. His doctors revealed that he had a Gleason score of 9, which is considered high-grade and indicates an aggressive form of the disease.

The Gleason score is how doctors grade prostate cancer based on how abnormal the cancer cells look under a microscope. It ranges from 6 to 10. A score of 6 is considered low-grade, 7 is intermediate, and 8 to 10 is high-grade, meaning the cancer is more likely to grow quickly and spread.

A Gleason score of 9 (which typically means a 4+5 or 5+4 pattern of abnormal cells) is about as serious as it gets in the prostate cancer world. It means the cancer cells look very different from normal prostate tissue, and they’re likely to behave aggressively. In Biden’s case, the fact that it has already metastasized reinforces this level of severity.

However, not all is doom and gloom. His doctors also stated that the cancer is hormone-sensitive—a key detail. That means it can still be treated effectively with hormone therapy, which works by blocking or lowering testosterone, the hormone that prostate cancer cells need to grow.

Prostate cancer is common—about 1 in 8 men will be diagnosed in their lifetime, and the risk increases sharply with age. By the time men reach their 80s, many will already have small amounts of prostate cancer, often undetected. But not all cases are aggressive. Some grow so slowly that they’re never life-threatening.

Biden’s case is different. A Gleason 9 score and metastasis are serious red flags. It highlights the importance of regular checkups and discussions with doctors, especially about PSA (Prostate-Specific Antigen) levels, which can help catch the disease early, before it spreads.

It also highlights the importance of preventive care. Men in their 70s and 80s should be encouraged to talk to their doctors about PSA testing—not necessarily to rush into treatment, but to make informed decisions based on their overall health, life expectancy, and personal values.

At the end of the day, what prostate cancer means for a man of Joe Biden’s age is what it means for many older men: it’s not a sentence, but a signal. A signal to stay engaged with your health. To ask questions. To consider not just how long you want to live, but how you want to live.

And if someone like Joe Biden can continue with his work, well into his 80s, it’s a powerful reminder that growing older doesn’t mean stepping back from life it just means stepping forward a little more thoughtfully.