Joe Biden's cancer diagnosis: What is a Gleason score of 9 and how is it treated?

Joe Biden has been diagnosed with a severe form of that has spread to his bones. The diagnosis was confirmed on 18 May 2025, following evaluations triggered by escalating urinary symptoms.

The shock diagnosis comes after the 82-year-old was admitted to last week for the investigation of a "prostate nodule", news which, at the time, raised few eyebrows as planned to conduct "further evaluation". Officials confirmed today that the anomaly was grade 5 with a Gleason score of 9 that had metastasised to the ex Commander-in-Chief's bones. He and his family, the statement added, are now considering treatment options

The statement read: "Last week, President was seen for a new finding of a prostate nodule after experiencing increasing urinary symptoms. On Friday, he was diagnosed with prostate cancer, characterised by a Gleason score of 9 (Grade Group 5) with metastasis to the bone.

READ MORE:

"While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive which allows for effective management. The President and his family are reviewing treatment options with his physicians."

The news comes just days before the anniversary of the death of Biden's son Beau, who tragically passed away from brain cancer in 2015. Here we expalin what a Gleason score of 9 means, the cause, the symptoms and the treatment options .

What does a Gleason score of 9 mean?

The Gleason scoring system is an essential tool used to assess the severity of prostate cancer. Scores range from 6 to 10, with higher numbers indicating more aggressive forms of cancer.

A Gleason score of 9 falls into Grade Group 5, the highest risk category, suggesting that the cancer cells are highly abnormal and likely to grow and spread rapidly.

A Gleason score of 9 is considered high-risk and advanced, implying it may extend beyond the prostate. Treatment is typically more aggressive, often involving surgery, radiation therapy, hormone therapy and occasionally chemotherapy.

What causes prostate cancer?

It's not known exactly what causes prostate cancer, although a number of things can increase your risk of developing the condition.

These include:

• age – the risk rises as you get older, and most cases are diagnosed in men over 50 years of age
• ethnic group – prostate cancer is more common in black men than in Asian men
• family history – having a brother or father who developed prostate cancer before age 60 seems to increase your risk of developing it; research also shows that having a close female relative who developed breast cancer may also increase your risk of developing prostate cancer
• obesity – recent research suggests there may be a link between obesity and prostate cancer, and a balanced diet and regular exercise may lower your risk of developing prostate cancer
• diet – research is ongoing into the links between diet and prostate cancer, and there is some evidence that a diet high in calcium is linked to an increased risk of developing prostate cancer

What are the symptoms?

Detecting the disease early is vital, as the initial stages often do not present any noticeable symptoms. Symptoms of prostate cancer can include:

• needing to pee more frequently, often during the night
• needing to rush to the toilet
• difficulty in starting to pee (hesitancy)
• straining or taking a long time while peeing
• weak flow
• feeling that your bladder has not emptied fully
• blood in urine or blood in semen

These symptoms do not always mean you have prostate cancer. Many men's prostates get larger as they get older because of a non-cancerous condition called benign prostate enlargement. Signs that the cancer may have spread include bone and back pain, a loss of appetite, pain in the testicles and unintentional weight loss.

What's the next step?

Despite the seriousness of the diagnosis, Biden's medical team has noted that the cancer is hormone-sensitive, which could open up effective treatment options. Hormone therapy, often combined with other treatments like radiation or surgery, can be successful in managing such cases.

Biden and his family are currently consulting with his healthcare team to determine the best course of action This latest diagnosis follows an earlier health update in 2023, when a cancerous skin lesion was successfully removed without requiring further treatment.

Depending on the type of prostate cancer you have, your life may be affected in different ways. Prostate cancer often gets worse slowly, and you may have it for years without symptoms. During this time, you may not need treatment.

As the former president navigates this difficult diagnosis, the nation watches anxiously, hoping for a positive outcome.

Follow our live blog for the latest updates by