Laura ClarkFormer U.S. President Joe Biden, 82, was diagnosed with aggressive metastatic prostate cancer (Gleason score 9) in May 2025, with the disease having spread to his bones. As his treatment continues into April 2026, his case has renewed global attention to prostate cancer screening — particularly among men over 70.
What Happened: Biden's Prostate Cancer Diagnosis
Biden's cancer was discovered during a routine check in May 2025. Doctors identified a Gleason score of 9 — one of the most aggressive classifications on the prostate cancer grading scale — with metastasis already confirmed in his bones. He subsequently underwent radiation therapy, hormone therapy, and a separate Mohs surgery in September 2025 to remove skin cancer lesions.
First Lady Jill Biden publicly stated that doctors told him he would "live out his natural life" with the disease. As of April 2026, Biden remains in treatment, and media reports continue to circulate about his health status.
His case is notable not just because of his public profile, but because of what it reveals about a common and often silent disease: prostate cancer shows no symptoms in its early stages.
Why Prostate Cancer Is So Dangerous After 70
Prostate cancer is the second most common cancer in men worldwide, according to the World Health Organization. Each year, over 1.4 million new cases are diagnosed globally. Yet many cases — like Biden's — are discovered only when the disease has already advanced.
The challenge is biological: early-stage prostate cancer rarely causes pain, urinary problems, or any other noticeable warning sign. By the time symptoms appear — difficulty urinating, blood in urine, bone pain — the cancer has often spread beyond the prostate gland.
After age 70, the risk increases significantly. Studies show that roughly 1 in 3 men over 70 has some form of prostate cancer present in their body, though not all of it is clinically aggressive or requires immediate treatment.
Several factors raise the risk:
- Age — the leading risk factor, with most diagnoses occurring after 60
- Family history — a first-degree relative with prostate cancer doubles your risk
- Ethnicity — Black men face a significantly higher risk and are more likely to be diagnosed at an advanced stage
- High-fat diet and lack of physical activity are associated with more aggressive forms
The Gleason Score: What It Means
Biden's cancer was rated Gleason 9, which is near the top of the scale (max 10). This score reflects how abnormal the cancer cells look under a microscope — the higher the score, the more aggressive the cancer and the faster it tends to spread.
A Gleason score of 9–10 is classified as Grade Group 5, the highest risk category. Patients with this grade have a higher chance of cancer spread to lymph nodes, bones, and other organs. Bone metastasis — confirmed in Biden's case — causes pain and can make cancer harder to control.
Treatment for high-grade prostate cancer typically includes a combination of hormone therapy (androgen deprivation therapy), radiation, and sometimes chemotherapy or immunotherapy.
PSA Testing: Should Men Over 70 Be Screened?
The PSA (prostate-specific antigen) blood test is the primary screening tool for prostate cancer. A PSA level above 4 ng/mL typically prompts further investigation, though elevated PSA can also result from a benign enlarged prostate.
Screening guidelines differ by country and medical authority, and the question of whether men over 70 should be screened is genuinely debated. Some guidelines recommend against routine screening after 70, as slow-growing cancers detected late in life may never cause harm, while treatment side effects (incontinence, erectile dysfunction) can significantly impact quality of life.
However, Biden's case illustrates the other side: an aggressive Gleason 9 cancer, left undetected, can spread rapidly. For men with risk factors — family history, previous abnormal PSA, known genetic mutations like BRCA2 — screening discussion with a physician remains essential even after 70.
YMYL Notice: This article is for informational purposes only and does not constitute medical advice. Consult your physician for guidance on cancer screening appropriate to your age and medical history.
What to Do If You're Over 70 and Concerned
If you or a family member is over 70 and hasn't discussed prostate cancer screening recently, here are the concrete steps recommended by specialists:
- Request a PSA test at your next routine check-up — it's a simple blood draw
- Share your family history with your doctor, specifically mentioning any prostate cancer in first-degree relatives
- Ask specifically about your Gleason score if you've had a biopsy — grades 7–10 warrant urgent specialist referral
- Don't dismiss urinary symptoms as "just aging" — while many cases are benign prostate enlargement, only a physician can rule out cancer
Biden's high-profile diagnosis has made one thing clear: prostate cancer does not announce itself. The men who survive aggressive forms are those who act before symptoms appear.
A urologist or specialist in men's health can guide you through the appropriate screening decision for your specific risk profile. ExpertZoom connects you with qualified health specialists who can answer your questions in a private consultation.
