By Brianna Abbott and Liz Essley Whyte

Former President Joe Biden's prostate-cancer diagnosis is one of the most aggressive forms of the disease and usually isn't curable. He could still live for years, according to cancer doctors.

Biden, age 82, was diagnosed Friday with an aggressive, late-stage prostate cancer that has spread to his bones, his representatives said Sunday. Biden is likely to fight prostate cancer for the remainder of his life, specialists said.

But men in advanced stages can live years or a decade longer, prostate-cancer specialists said. The overall chance that a person diagnosed with metastatic prostate cancer is alive after five years is around 37% , based on data from patients diagnosed between 2014 and 2020, according to the American Cancer Society. Biden's physicians didn't publicly address his diagnosis.

"Once it spreads to the bone, it's usually not curable, but it is very treatable," said Dr. Jason Efstathiou, a prostate-cancer radiation oncologist at Mass General Brigham. "Men are living longer than ever before with advanced prostate cancer."

Pathologists grade prostate cancers with something called a Gleason score, based on how abnormal or healthy the cancer cells look under a microscope. The scores range from 6 to 10, with 6 being low-grade and slower-growing and 10 being the most aggressive. Biden's cancer had a Gleason score of 9, his personal office said.

His cancer also appears to be hormone-sensitive, his team said, making it potentially vulnerable to the latest hormone-targeting drugs.

Some 300,000 men are diagnosed with prostate cancer in the U.S. each year, making it the most common cancer in men aside from skin cancer. It is often slow-growing and highly curable at earlier stages, but it remains the second-leading cause of cancer death in American men, behind lung cancer. About 1 in 44 men will die of prostate cancer, the American Cancer Society says.

Some men with an advanced diagnosis will die within a year, but there are also reported cases of men living another two decades, said American Cancer Society's chief scientific officer Dr. Bill Dahut. "There's a broad range of how long people live."

Biden was experiencing urinary symptoms last week, and doctors found a prostate nodule, his personal office disclosed. What isn't known: how widely the cancer has spread in his bones. That information will guide some of the advice his doctors give, prostate-cancer specialists said.

"Is it in one, two or three places in the bone or 30 places?" said Dr. Russell Pachynski, a medical oncologist and prostate-cancer specialist at Siteman Cancer Center in St. Louis, Missouri. "I've got metastatic patients that I've been treating for over a decade, so it really depends on the extent of the disease."

People with prostate cancer often don't develop symptoms, including difficulty urinating, blood in the urine or bone pain, until the disease is already more advanced.

The cancer can be caught in its earlier stages with a blood test that looks for prostate-specific antigen, called a PSA test. But medical groups offer different screening recommendations, and some recommend against screening older men, since the test could lead to false positives or overtreatment of a slow-growing cancer that might not harm them if left alone.

The U.S. Preventive Services Task Force, a government-backed panel that makes preventive service recommendations, advises against screening men without symptoms who are ages 70 and older. Other groups say that the decision on whether men above age 70 should be screened should be made on an individual basis, consulting with their doctor.

Biden is reviewing his treatment options, his representatives said. The former president is likely to receive hormone therapy right away, prostate-cancer specialists said.

Such therapy includes a shot to stop production of testosterone, as well other newer drugs that block testosterone from binding to certain parts of the body, such as prostate cells. These drugs include Johnson & Johnson's Zytiga and Pfizer and Astellas Pharma's Xtandi. Treatment for advanced prostate cancer has improved in the last 15 years, largely thanks to such therapies.

"There are often patients who are surprised at how quickly the treatment can work if they're having cancer symptoms, how quickly they can start to feel better," said Dr. Tanya Dorff, division chief of genitourinary cancers at City of Hope.

Hormone therapy for men is akin to menopause for women, Dorff said. Side effects can include hot flashes, mood swings, fatigue, weight gain, erectile dysfunction and diminished sex drive.

Some patients also get chemotherapy or radiation on top of the testosterone-reducing drugs. Because Biden is in his 80s and the cancer has already spread to his bone, he is unlikely to face surgery.

The prostate cancer death rate declined by about half from 1993 to 2022, the American Cancer Society said, likely due to early detection and newer treatment. But an increasing number of cancers are being found at a later stage, and the decline in death has stalled in recent years.

Write to Brianna Abbott at brianna.abbott@wsj.com and Liz Essley Whyte at liz.whyte@wsj.com

(END) Dow Jones Newswires

May 18, 2025 21:34 ET (01:34 GMT)

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