At 82, many might expect to slow down, yet Joe Biden has entered a new and demanding chapter in his health journey. The former president is now undergoing radiation therapy alongside hormone treatment as part of his plan to combat an aggressive form of prostate cancer. The diagnosis shocked many, not least because the disease had already spread to his bones. What does that mean for his prognosis? Medical experts are watching closely.
The Cancer and the Silver Lining
Biden's team confirmed that his prostate cancer carries a Gleason score of 9, one of the highest and most aggressive ratings in the disease classification system. The Gleason score, which ranges from 6 to 10, assesses how abnormal the cancer cells appear under the microscope, higher scores indicate more aggressive tumours.
Even more concerning is that Biden's cancer is already metastatic: evidence shows the disease had spread to his bones by the time of diagnosis.
But there is a silver lining: the cancer is described as hormone-sensitive, meaning it may respond to therapies that block male hormones which fuel tumour growth.
What The Therapy Might Achieve
The current phase of Biden's treatment is expected to last five weeks, during which radiation will target prostate tissue while hormone suppression works systemically. He has already been taking hormone pills.
Doctors caution that because the cancer has reached the bones, a cure is unlikely. But the goal becomes long-term control, symptom relief, and maintaining quality of life.
Dr Benjamin Davies, a urologic oncologist not involved in Biden's case, has noted that recent advances in hormonal and chemotherapy options have significantly extended survival in metastatic prostate cancer patients.
Urologist Dr Jamin Brahmbhatt similarly remarks that older men with aggressive prostate cancer can still live with good quality of life when properly treated.
Still, the presence of bone metastases places Biden in a higher risk category. Some oncologists emphasise that the true prognosis hinges on how widely the cancer has spread, how well he tolerates treatment, and how long tumour response lasts.
Experts' Perspectives
Medical observers say several factors will shape Biden's trajectory. First, how aggressively the radiation plus hormone therapy shrinks tumour burden — and how durable that response is — will be crucial. Second, the management of side-effects, especially in someone in his 80s. Radiation and hormonal interventions can strain the body, affecting energy, bone health, and more.
Third, emerging therapies could play a role. In recent years, novel androgen receptor inhibitors, chemotherapy agents, bone-directed treatments, and combination regimens have extended survival for many with metastatic prostate cancer. Fourth, close monitoring via imaging, biomarkers like prostate specific antigen (PSA), and adjustments to therapy will guide any pivots in care.
Given Biden's age, some specialists stress that absolute longevity may take a back seat to quality, function, and symptom control. The degree to which he can maintain strength, cognition, and overall health will influence decisions on intensifying or adjusting therapy.
In sum, the news that Joe Biden is undergoing radiation and hormone therapy for an aggressive, bone-metastasised prostate cancer answers part of the headline: yes, he is in a serious fight. But the doctors' verdict is more cautious than bleak. Though a cure is unlikely given the spread, his cancer is hormone-sensitive, giving him a fighting chance.
