Concerns are growing among friends of former President Joe Biden as he continues to battle an aggressive form of prostate cancer, with reports surfacing of increased fatigue. Whereas aides maintain that the 83-year-old remains active and engaged, several individuals close to Biden have expressed worry about his well-being, attributing the tiredness to the strain of his cancer treatment. This development comes as Biden continues to maintain a public presence, including scheduled appearances and work on his memoir.
In 2025, Biden’s office publicly announced his diagnosis of stage 4 prostate cancer, which had metastasized to the bone. Medical experts consider this stage of the disease to be incurable. At the time of the announcement, his cancer was given a Gleason score of 9, on a scale of 6 to 10, indicating a particularly aggressive form of the disease with a higher likelihood of rapid spread, particularly to the spine. The former president began undergoing radiation therapy at Penn Medicine Radiation Oncology in Philadelphia on October 11, 2025, in addition to hormone therapy.
The reports of fatigue approach despite assurances from Biden’s team that he is responding positively to treatment. A fifth source indicated that Biden remains “encouraged and positive about his prognosis given his positive response to treatment.” He completed a course of radiation treatment on October 20, 2025, marking the occasion by ringing a ceremonial bell – a moment his daughter, Ashley, described as a minor celebration in his fight against the disease.
Prior to his cancer diagnosis, Biden underwent surgery in September 2025 to remove several skin cancer lesions from his head. Despite these health challenges, the former president has continued to participate in significant events, demonstrating a commitment to maintaining a public profile. In April 2025, he attended the funeral of Pope Francis, and in November of the same year, he attended the funeral of former Vice President Dick Cheney. He also made an appearance at Tatiana Schlossberg’s funeral in January.
Understanding Prostate Cancer and Metastasis
Prostate cancer is a common malignancy in men, with the American Cancer Society estimating about 299,000 new cases in the United States in 2024. While many cases are slow-growing and highly treatable, some are aggressive and can metastasize, meaning the cancer spreads to other parts of the body. When prostate cancer spreads to the bones, as in Biden’s case, it can cause pain and increase the risk of fractures.
A Gleason score is used to assess the aggressiveness of prostate cancer cells under a microscope. A higher score, like the 9 Biden received, indicates a more aggressive cancer. Treatment options for metastatic prostate cancer often include hormone therapy, chemotherapy, radiation therapy, and immunotherapy. The goal of treatment is to control the cancer’s growth, relieve symptoms, and improve quality of life.
Biden’s Continued Public Engagement
Despite his health challenges, Biden is scheduled to travel to South Carolina on February 27 to deliver remarks marking the sixth anniversary of his primary victory in the state. This planned appearance underscores his continued engagement in public life and his commitment to maintaining a visible presence.
The former president has also been working on his memoir, suggesting a continued dedication to his professional pursuits. The balance between managing his health and maintaining public commitments will likely remain a key focus as Biden navigates his cancer treatment.
As Biden continues his treatment and public engagements, the focus will remain on monitoring his response to therapy and managing any potential side effects. The coming months will be crucial in assessing the long-term impact of his cancer diagnosis and treatment on his overall health and well-being.
Disclaimer: This article provides informational content about medical topics and should not be considered a substitute for professional medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment of any health condition.
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