Former President Joe Biden’s advanced prostate cancer diagnosis has stunned the medical and political communities alike, with Fox News senior medical analyst Dr. Marc Siegel calling the findings “very, very concerning” and expressing disbelief at how far the disease had progressed before it was detected. The diagnosis, disclosed in a Sunday statement from Biden’s personal office, reveals a Gleason score of 9, placing it at Grade Group 5—the most aggressive classification of prostate cancer. The cancer has also metastasized to the bone, an indication of Stage 4B disease, with a reported five-year survival rate of just 37%, according to the Mayo Clinic.
Dr. Siegel, speaking on Fox Report, underscored the advanced nature of Biden’s condition:
“Gleason nine… means that it’s a very aggressive form of cancer… [and] when it reaches the point where you’re already having urinary symptoms, that’s also a sign that it’s pretty far advanced.”
The revelation that the cancer was found not through routine PSA screening, but by physical prostate examination following the onset of symptoms, raised eyebrows. Given that Biden was still serving as president just months ago—and presumably had access to world-class medical care—Siegel questioned how such an aggressive cancer escaped earlier detection.
“He must’ve had the best possible care here,” Siegel said. “I’m just… a little taken aback that it’s this far advanced.”
Fox host Jon Scott echoed this sentiment:
“He’s supposed to be getting… the best medical care in the world and yet… just a few months after he leaves office, this prostate cancer is advanced enough that it has metastasized to the bone. That’s, well, that’s just not good.”
Despite the grim staging, there is still hope. Biden’s cancer is described as hormone-sensitive, meaning it may respond to treatments that suppress testosterone, which fuels the growth of many prostate cancers. Siegel noted:
“It may very well be that he’s hormone responsive… That’s what we’re all hoping and praying for here.”
Treatment options may include:
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Hormone therapy (e.g., Lupron or Casodex)
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Advanced radiation therapy, which has seen significant technological improvements
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Robotic prostatectomy, which offers less invasive surgical removal
However, Siegel emphasized that Biden’s team hasn’t yet specified which treatment combination he will pursue.
Dr. Herbert Lepore of NYU Langone told Reuters that even with bone metastasis, many patients can live five to ten years if the cancer is managed effectively. Dr. Chris George, a cancer specialist at Northwestern, added that while the disease is incurable at this stage, it is treatable, and the goal becomes disease control rather than eradication.
Adding to the concern is the backdrop of Biden’s prior medical history, which includes two brain aneurysm surgeries and a pulmonary embolism in 1988. With such a medical background, many observers, including Siegel, are perplexed that routine screening didn’t identify the cancer sooner. Siegel said he routinely screens men over 45 using the PSA test, which, although imperfect, often serves as an early indicator.
While it is medically possible for aggressive cancers to develop without elevated PSA levels, the absence of proactive detection has led to questions about whether Biden’s care team missed warning signs, or if PSA testing was deprioritized due to age guidelines—despite his high-profile status and clear risk factors.
