Former President Joe Biden’s inner circle remains divided nearly a year into his Stage 4 prostate cancer battle, with close aides projecting confidence in his treatment while longtime allies quietly voice alarm over his visible decline and mounting fatigue.
Aggressive Diagnosis Revealed Last Spring
Biden received his Stage 4 prostate cancer diagnosis in early May 2025 after experiencing urinary symptoms that prompted medical evaluation. The biopsy revealed a Gleason score of 9, Grade Group 5 classification indicating highly aggressive disease that had already metastasized to his bones. Despite the severity, Biden’s medical team determined the cancer remained hormone-sensitive, opening pathways for treatment through androgen deprivation therapy combined with targeted radiation. The then-82-year-old former president publicly announced his condition on May 18, 2025, characterizing his prognosis as good and describing treatment as simply taking medication.
Treatment Expanded to Include Radiation Therapy
Biden’s treatment regimen evolved throughout 2025 as his medical team at Penn Medicine Radiation Oncology in Philadelphia implemented a comprehensive approach. Hormone therapy in pill form began during summer 2025, targeting the testosterone-fueled cancer growth characteristic of prostate malignancies. By October 11, 2025, radiation therapy commenced alongside the ongoing hormone treatment to directly target bone metastases. This dual-therapy approach aligns with standard protocols for aggressive, hormone-sensitive Stage 4 prostate cancer, offering patients extended management options even with metastatic disease. Separately, Biden underwent Mohs surgery in September 2025 to remove basal cell carcinoma lesions from his head, a common and highly treatable skin cancer unrelated to his prostate condition.
Divided Assessments Within Biden’s Circle
Close aides working directly with Biden throughout early 2026 describe him as engaged and productive, actively involved in writing his presidential memoir, planning his foundation initiatives, and developing his presidential library. These insiders characterize his condition as manageable under current treatments, emphasizing his continued public appearances and project commitments. However, longtime allies and friends who observe Biden from outside his immediate staff express growing concern over visible fatigue and what they perceive as health deterioration nearly twelve months post-diagnosis. These worries, though anecdotal and medically unverified, highlight tensions between the official narrative of stable management and private observations suggesting treatment side effects may be taking a toll on the former president’s energy levels and overall stamina.
Medical Context and Survival Outlook
Prostate cancer represents the most common cancer diagnosis among American men, with an estimated 313,780 new cases projected for 2025 accounting for 15.4 percent of all cancer diagnoses. Despite being the second-leading cause of cancer death in men, prostate cancer generally progresses slowly with a 98 percent five-year survival rate even in metastatic cases when detected early and treated appropriately. Biden’s Gleason 9 classification indicates rapid-growth potential with high metastasis risk, yet the hormone-sensitive nature of his specific cancer provides what medical experts describe as a viable treatment pathway. The National Cancer Institute confirms that androgen deprivation therapy remains effective for managing high-grade prostate cancers, offering extended disease control through testosterone suppression that starves cancer cells of growth signals.
Bipartisan Support and Public Transparency
Biden’s cancer diagnosis generated unusual bipartisan expressions of support, including well-wishes from President Trump and former First Lady Melania Trump, reflecting cross-aisle respect for the former president’s health challenges. This public transparency about an aggressive cancer diagnosis during post-presidency provides valuable awareness about prostate cancer realities for older American men, a demographic that faces elevated risk factors. The ongoing narrative underscores the complex reality of managing serious illness while maintaining public commitments, a balance that remains difficult regardless of medical optimism. For conservatives watching Biden’s situation unfold, the story serves as a reminder that health battles transcend political divisions, though questions about candor in public health communications remain relevant given past controversies surrounding Biden’s cognitive fitness during his presidency.
Sources:
ABC News – Joe Biden Undergoing Radiation Therapy for Prostate Cancer Treatment
OncoDaily – Joe Biden Skin Cancer Surgery
Fox News – Joe Biden Friends Concern Increased Fatigue Battles Cancer Report
Anadolu Agency – Aides Optimistic on Biden’s Cancer Battle, but Allies Voice Worry