The Diagnosis Rocks the Public Sphere
If you’ve been following the news, you’ve probably heard by now that Joe Biden has been diagnosed with an aggressive form of prostate cancer. What stands out? The Gleason score attached to his case—a whopping 9 out of 10. For anyone unfamiliar with prostate cancer, that number is about as high as it gets, putting this diagnosis in the "very aggressive" category.
The Gleason score isn’t just a random label. Doctors get this score by analyzing prostate biopsy slides under a microscope. They look for how much the cancer cells differ from healthy tissue. In Biden’s case, the cancer cells are far from normal, earning the score from two combined patterns—grades 4 and 5, which are the highest in terms of abnormality. This tells us the cancer isn’t just there; it’s likely to grow and spread quickly.
By the time the medical team announced his diagnosis on May 18, 2025, they also confirmed something even more challenging: the cancer has spread to his bones. Metastatic prostate cancer is a whole different ball game, complicating the road ahead. But there’s a silver lining—Biden’s cancer is classified as hormone-sensitive.
Hormone Therapy: Hope in the Face of Aggression
When prostate cancer is labeled hormone-sensitive, it means drugs that suppress or block male hormones—mainly testosterone—can still help slow or stop cancer growth. This is big news for Biden, because hormone therapy, also called androgen deprivation therapy, often forms the core of treatment for metastatic prostate cancer. Some cancers become resistant to these drugs over time, but as long as there’s sensitivity, doctors still have a major tool to work with.
For patients with advanced prostate cancer like Biden, treatment usually isn’t just one drug or procedure. Doctors look at a combination: hormone therapy, chemotherapy, radiation therapy, and sometimes surgery if it makes sense. The choice depends on how far the cancer has spread and how a patient responds to each approach.
Modern medicine has changed the outlook for men with high Gleason scores. Not long ago, a score of 9 with bone metastases was seen as a grim diagnosis. These days? Newer treatments, clever hormone therapies, and focused radiation have pushed survival rates higher. Dr. Jason Efstathiou, a radiation oncologist, pointed out that advanced therapies can mean patients live longer and better quality lives, even with aggressive disease.
Biden’s medical team is taking a careful, personalized approach. They’re weighing which combination of treatments could control the cancer’s growth, manage symptoms, and let him maintain as much daily activity as possible. While no plan can guarantee a cure at this stage, staying hormone-sensitive gives their options some serious firepower.
This diagnosis puts a spotlight not only on Biden but on the realities faced by thousands of men dealing with advanced prostate cancer. The Gleason score acts as a warning system, but it’s not the full story. Each person’s journey is shaped by how the cancer behaves, whether it responds to hormone treatments, and how aggressively it’s managed by a skilled care team. And for now, Biden’s fight just got a lot more public—but also, potentially, a lot more hopeful.
