Former President Joe Biden has been diagnosed with an aggressive form of prostate cancer – but the fact that it is hormone sensitive may provide a ray of hope for his family.
A spokesperson for the former commander-in-chief announced Sunday that Biden had visited the doctor last week after ‘experiencing increasing urinary symptoms’ and finding a ‘small nodule’ on his prostate.
The 82-year-old was officially diagnosed on Friday, with the doctors giving his cancer a Gleason score of 9 and a Grade Group of 5.
They also noted that the cancer has already spread to Biden’s bones.
‘While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive which allows for effective management,’ the spokesperson said.
Biden and his family are now ‘reviewing treatment options with his physicians,’ the spokesperson added.
Below, DailyMail.com delves into what the diagnosis may mean for the former president.
A spokesperson for former President Joe Biden announced on Sunday that he has been diagnosed with prostate cancer
What is a Gleason score?
A Gleason score is a system physicians use to grade prostate cancer based on how abnormal the cancer cells look under a microscope. Generally, the higher the score, the more aggressive the cancer is.
To determine a Gleason score, doctors examine prostate tissue samples collected during a biopsy and assign a grade from one through five to the two most common patterns of cancer cells they find.
The physicians then add the two numbers up to determine the Gleason score.
Lower scores, those of six or below, suggest the cancer is spreading slowly; while a score of seven indicates an intermediate risk of an aggressive cancer.
Higher scores – those eight and above – suggest the cancer will spread rapidly and present more complications.
The scores help doctors determine the most appropriate treatment plan for each patient and can help predict the likelihood of survival.
However, doctors also take into account other factors – like the patient’s overall health.
In Biden’s case, a score of nine indicates doctors found two of the most aggressive cancer cells in his pancreas.
What does it mean that Biden’s cancer is a Grade Group of 5?
In recent years, some physicians have moved away from the Gleason score in favor of the Grade Group method.
Grade Groups range from one – meaning the cancer is the most likely going to grow and spread slowly throughout the body – to a five – meaning that it is the most likely to grow and spread quickly.
Biden’s cancer is categorized as having a Gleason score of 9 and a Grade Group of 5
That means the cancer spreads inside his prostate are likely to spread rapidly
What does it mean that the cancer has spread to his bones?
If prostate cancer has metastasized to the bones, it means that the cancer cells have detached from the original tumor and spread through the blood stream or lymphatic system to one’s bones.
There, the cancer cells form new tumors.
That can create its own set of problems – causing significant bone pain and weakening the bones, which would increase the risk of fractures, the Cleveland Clinic notes.
If the cancer winds up spreading to the spine, it can also compress the spinal cord – which can lead to nerve damage and potentially even paralysis.
Bone metastasis can also cause the release of calcium from the bones into the bloodstream, which can cause symptoms like nausea, vomiting and confusion.
Bone metastasis is considered an advanced form of prostate cancer.
So why does the fact that Biden’s cancer is hormone-sensitive provide some hope?
When prostate cancer is described as being ‘hormone-sensitive’ that means that the growth and spread of the cancer are being fueled by male hormones called androgens that are primarily testosterone and dihydrotestosterone.
The prostate cells possess androgen receptors, which the androgens bind to and promote the expression of genes that stimulate cell growth and proliferation. In patients with prostate cancer, though, the androgens promote cancerous cell growth.
Hormone-sensitive prostate cancers are therefore dependent on these androgens to grow and survive – which makes it a target for hormone therapy, also called androgen deprivation therapy.
The therapy aims to reduce androgen levels or block their action, effectively stopping the cancer cells from growing.
However, many prostate cancers eventually develop a resistance to the therapy and continue to grow despite the low androgen levels.
In that case, second-line therapies like chemotherapy, targeted treatments and radiopharmaceuticals may help keep the cancer at bay.
Prostate cancer is the most common cancer and the second leading cause of death among men in the United States
How common is prostate cancer?
Prostate cancer is the most common cancer and the second leading cause of death among men in the United States, according to the American Cancer Society.
The organization estimates one in eight men will be diagnosed with prostate cancer during their lifetimes, though the risk of developing the cancer may depend on their age, race, ethnicity and genetic predisposition to the disease.
Men over the age of 50 have a higher chance of being diagnosed, though the American Cancer Society says more than half of the diagnoses are found in men over the age of 65.
Smoking, diet and chemical exposures can also increase the chance that a male develops prostate cancer.
What are the symptoms of prostate cancer?
Early symptoms of prostate cancer include blood in the urine or the semen, and bladder problems like needing to urinate more frequently or having difficulty doing so.
In later stages, men may experience back and bone pain, erectile dysfunction, limb weakness and weight loss, the American Cancer Society says.
The overall prognosis for prostate cancer is among the best of all cancers thanks to modern treatments that can shrink or control the cancer
What is the prognosis?
The overall prognosis for prostate cancer is among the best of all cancers thanks to modern treatments that can shrink or control the cancer, relieve pain and prevent complications, according to Johns Hopkins Medicine.
In fact, five years after a diagnosis the average prostate cancer patient is as likely as someone without prostate cancer to still be alive.
Some men can even live more than 15 years after a diagnosis, particularly if the cancer responds well to the treatment, they are in good overall health and they start treatment early.
However, when the cancer has metastasized – like Biden’s has – the average five-year survival rate is 28 percent.
What can I do to catch the cancer early?
Doctors recommend men get prostate cancer screening tests beginning at the age of 50 – though those with increased risk factors are encouraged to get screened earlier.
Prostate exams can include prostate-specific androgen blood tests or rectal exams.
How are people reacting to Biden’s diagnosis?
The medical community has noted that the former president has an aggressive form of the cancer – which Dr. Houman David Hemmati said is a ‘sobering reminder of how aggressive this disease can be when caught late.
‘As a physician and former prostate cancer researcher, I know that while early-stage prostate cancer is often curable, high-grade cases like this require lifelong management,’ he said.
‘This is a moment to raise awareness: men over 50 (and earlier for those with risk factors) should talk to their doctors about PSA screening,’ Hemmati added, noting: ‘Early detection saves lives.’
Congressman Greg Murphy, a Republican from North Carolina who is also a doctor, meanwhile, questioned whether Biden had undergone routine screenings.
‘Makes me wonder why someone running for President of the United States, especially someone who is elderly, did not have these examinations,’ he wrote on X.
‘Screening is critical.’
But President Donald Trump – who has long questioned Biden’s health – offered more of an olive branch.
Dr. Houman David Hemmati said Biden’s diagnosis is a ‘sobering reminder of how aggressive this disease can be when caught late’
Congressman Greg Murphy, a Republican from North Carolina who is also a doctor questioned whether Biden had undergone routine screenings.
The president said he and first lady Melania Trump were ‘saddened to hear’ about the former president’s
Despite their bitter rivalry, the president put aside their differences to extend some warm words for his political foe.
‘We wish Joe a fast and successful recovery,’ Trump wrote on Truth Social Sunday.
His eldest son, Donald Trump Jr. also posted news of the grave prognosis to his Instagram story and wrote: ‘Politics aside, we wish him a speedy recovery.’
