This is Part 1 of a series on men’s health and prostate cancer
When news first broke about former President Joe Biden’s diagnosis of stage 4 prostate cancer, there was an outpouring of empathy, well wishes and concern. At the same time, there was also a flood of misinformation, assumptions and even cruel accusations.
Seemingly driven by political foes’ unfounded claims that Biden’s diagnosis was “hidden” and “covered up” during his presidency, it was also speculated that if he had properly received medical exams, he would have never reached stage 4.
This is cause for concern for doctors, as such claims and presumptions unfairly blame the patient and fail to provide the public with accurate information, which is what is needed most.
Prostate Cancers Vary
“From what has been publicly disclosed, it appears that former President Biden has what we would call De Novo metastatic prostate cancer,” said Dr. Edwin M. Posadas, the medical director of the Center for Uro-Oncology Research Excellence / Group at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center.
Posadas, a cancer researcher and a noted specialist in treating advanced prostate cancer, explained when first detected, De Novo metastatic prostate cancer has already spread to other parts of the body. It can spread first to the bones and also to the lymph nodes or other organs.
Chris Meagher, spokesman for Biden, confirmed the former president had received the advanced prostate cancer diagnosis earlier this month, not when he was serving as president.
Biden’s office released more details in a statement: “President Joe Biden was seen for a new finding of a prostate nodule after experiencing increasing urinary symptoms. He was diagnosed with prostate cancer, characterized by a Gleason score of 9 (Grade Group 5) with metastasis to the bone. While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive, which allows for effective management. The president and his family are reviewing treatment options with his physicians.”
Challenges in Early Detection Among Seniors
Prostate cancer screening in men over 70 is not recommended and Biden, now 82, would not typically be screened for the disease. It’s believed that screening for very senior men with the use of the PSA test can cause false positives and invite more harm than benefit with biopsies and overtreatment, which can cause side effects, including incontinence and erectile dysfunction.
Because prostate cancer often grows slowly, senior men are more likely to lose their lives to another affliction, which has been a factor in the medical decision to refrain from screening seniors.
Advanced Prostate Cancer Isn’t an Immediate Death Sentence
While it is a very serious disease, Posadas is quick to confirm that, with treatment, there is positive news – men even with stage 4 prostate cancer can now live years after their initial diagnosis and have a good quality of life.
“Prostate cancer is still the most common cancer that affects men in the United States, followed by lung and pancreatic cancer,” Posadas explained. “One out of every seven to eight men in the U.S. will be diagnosed with prostate cancer in their lifetime, and that equates to more than 200,000 cases diagnosed each year. One in every 10 of those cases has the ability to spread and then eventually can become resistant to treatment.
“It’s well recognized that this is a disease of elderly men, and that many men will die with it, and not from it,” he explained.
Thanks to cancer research, advances in treatment and imaging, the life expectancy is now much longer in comparison to decades ago, when men diagnosed with advanced stage 4 prostate cancer were told they only had months to live.
“With treatment plans tailored to each person’s specific case, an individual with metastatic prostate cancer can live for years and not just be alive, but can actively contribute to their family and society.
“It’s a disease that isn’t curable, but manageable,” Posadas described.
“Our standard of care in 2025 [with new treatment strategies] has improved survival and the quality of life for men with this disease.
“Getting good care, getting an accurate and timely diagnosis is still of ultimate importance, and having the right kind of team managing the disease leads to extremely good outcomes for men,” said Posadas.
“Even those who experience some side effects from their therapy, with the right kind of interaction with their healthcare team they can still be very productive, very healthy and still contribute quite a bit to their family, friends and society at large.”
Part 2 of this series covers the importance of continued prostate cancer research.
Alejandro JSM Chavez contributed to this article.