How is prostate cancer diagnosed and treated? Understanding Joe Biden’s illness.
Former President Joe Biden’s diagnosis of what his office called an “aggressive” form of prostate cancer on Sunday, May 18, is calling attention to a disease that is diagnosed in hundreds of thousands of American men each year.
Doctors found a “small nodule” on Biden’s prostate during a routine exam last week, and the 82-year-old was diagnosed Friday, May 16, according to the statement. The cancer is described as having a Gleason score of 9, denoting its aggressiveness, and has spread to the bone.
The former Democratic president and two-term vice president is reviewing his treatment options with family and physicians, the statement says. The cancer's Gleason score of 9, grade group 5, is described by the American Cancer Society as a type "most likely to grow and spread quickly."
Prostate cancer is the second most common cancer in men, affecting 1 in 8 men in the U.S., according to the American Cancer Society.
Here's what we know about prostate cancer, including early signs, testing, risk factors and survival rates.
What are the signs of prostate cancer in men?
The announcement said that Biden had been experiencing "increasing urinary symptoms," prior to the diagnosis, which is consistent with the symptoms the Cleveland Clinic lists for prostate cancer. Those symptoms include:
- Frequent, sometimes urgent, need to pee, especially at night
- Weak urine flow or flow that starts and stops
- Pain or burning during urination
- Loss of bladder control
- Loss of bowel control
- Painful ejaculation and erectile dysfunction
- Blood in semen or urination
- Pain in lower back, hip or chest
How to test for prostate cancer: Explaining the DRE, PSA, MRI methods
A digital rectal exam, or DRE, is the most common screening test for prostate cancer, according to the Dana-Farber Cancer Institute. It involved a doctor inserting a gloved finger into the rectum to determine if the prostate is enlarged or has lumps, though it is not a definitive test.
The prostate-specific antigen (PSA) test, is a blood test that measures levels of the antigen, which is produced by the prostate. Higher levels of PSA in the blood may indicate prostate cancer, according to the Harvard Medical School-affiliated institute, calling it a helpful screening tool for doctors also used in planning treatment, judging treatment effectiveness, and monitoring the prostate for growth. Levels of the antigen can fluctuate, however, and can sometimes be elevated as a result of infection, inflammation, an enlarged prostate, aging, or ejaculation. Conversely, the institute adds, certain conditions may make PSA levels low, such as certain herbal medicines, supplements or obesity.
Other screening methods include an MRI, transrectal ultrasound and a transrectal or transurethral biopsy.
What are the risk factors for prostate cancer?
Approximately 12.9% of men will be diagnosed with prostate cancer at some point during their lifetime, according to the National Cancer Institute. The Institute also says that there were an estimated 3,518,978 men living with prostate cancer in the United States in 2022.
All men are at at risk, according to the CDC, but the most common risk factor is age. "The older a man is, the greater the chance of getting prostate cancer," the CDC says.
Out of every 100 American men, about 13 will get prostate cancer during their lifetime, and about 2 to 3 men will die from prostate cancer. Men who have a family history of prostate cancer are also at increased risk, the center says, while Black or African American men are more than twice as likely to die from prostate cancer and get the disease at a younger age than other men, often diagnosed with more advanced stages of the cancer when it is found.
How quickly does prostate cancer spread?
As with all medical diagnoses, treatments and survivability can differ significantly from person to person.
If prostate cancer spreads, or metastasizes, to other parts of the body, it nearly always goes to the bones first, the American Cancer Society says, as is the case for the former president.
While non-metastasized prostate cancer has a 97.9% 5-year relative survival rate, according to the National Cancer Institute, prostate cancer that has metastasized and spread to other parts of the body has a survival rate of about 37%, according to the Mayo Clinic.
“Bone metastasis can be painful and can cause other problems, such as fractures (breaks), spinal cord compression (when a tumor presses on the spinal cord), or high blood calcium levels, which can be dangerous or even life threatening,” the society said in a 2023 fact sheet.
What are prostate cancer treatments? Hormone therapy an option for some.
While about 1 in 44 men will die of prostate cancer, according to the American Cancer Society, most men diagnosed with the illness do not die from it. More than 3.3 million men in the U.S. who have been diagnosed with prostate cancer at some point are still alive today, according to a January 2025 fact sheet from the cancer research organization.
Management of the disease may include surgery, radiation therapies, hormone therapy, chemotherapy, and immunotherapy, among other treatment options, according to the Cleveland Clinic.
Contributing: Zac Anderson, Joey Garrison, James Powel, Thao Nguyen; Paste BN
Kathryn Palmer is a national trending news reporter for Paste BN. You can reach her at kapalmer@usatoday.com and on X @KathrynPlmr.