What is a Gleason score of 9 and how is it treated?
Former President Joe Biden, 82, was diagnosed with advanced prostate cancer with a Gleason score of 9 that has spread to his bones.
Joe Biden has been diagnosed with advanced prostate cancer that has spread to his bones. The 82-year-old former president confirmed the diagnosis on May 18, 2025, following worsening urinary symptoms that led to a medical evaluation.
The news comes after a recent hospital stay where Biden was initially treated for a "prostate nodule." At that time, further assessments were planned without much public insight into the potential seriousness of his health issues.
The announcement today took many by surprise as officials disclosed that Biden's condition is a grade 5 prostate cancer with a Gleason score of 9, indicating that the cancer has invaded his bones. Biden and his family are now considering treatment options.
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A statement regarding his health situation was made public that read, "Last week, President Joe Biden was seen for a new finding of a prostate nodule after experiencing increasing urinary symptoms. On Friday, he was diagnosed with prostate cancer, characterized by a Gleason score of 9 (Grade Group 5) with metastasis to the bone."
The statement explained that although this type of cancer is more aggressive, it is still hormone-sensitive, which allows for potential effective treatments. It noted that Biden is currently reviewing treatment possibilities with his medical team.
This poignant news comes just before the anniversary of the passing of Biden's son Beau, who lost his battle with brain cancer in 2015.
The Gleason scoring system is an essential tool used to gauge the severity of prostate cancer. Scores range from 6 to 10, with higher numbers indicating more aggressive forms of the disease.
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 have spread beyond the prostate. Treatment typically involves a more aggressive strategy, often including surgery, radiation therapy, hormone therapy and sometimes chemotherapy.
What causes prostate cancer?
The precise cause of prostate cancer remains unclear, but several factors can increase your risk of developing the disease. 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
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What are the symptoms?
Early detection of the disease is crucial as the early stages often do not present any noticeable symptoms.
These symptoms don't necessarily mean you have prostate cancer. Many men's prostates enlarge as they get older due to a non-cancerous condition known as benign prostate enlargement.
Symptoms of prostate cancer can include: changes in urination, blood in urine or semen, unexplained weight loss or fatigue.
Indications that the cancer may have spread can include bone and back pain, a diminished appetite, testicular discomfort and unanticipated weight loss.
What's next on the agenda?
Despite the serious nature of Biden's diagnosis, his medical team has suggested that the cancer is hormone-sensitive, which could open up avenues for effective treatment. Hormone therapy, often paired with other treatments such as radiation or surgery, can be successful in managing these cases.
Biden and his family are currently consulting with his healthcare providers to determine the most suitable course of action. This recent diagnosis comes after a health update in 2023, when a cancerous skin lesion was successfully excised without requiring additional treatment.
The effect of prostate cancer on an individual's life can vary based on the specific type. Prostate cancer often develops slowly, and it's possible to live with the disease for years without any symptoms manifesting.
During this time, treatment may not be necessary.
