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Former US president Joe Biden's prostate cancer has metastasised. "The cancer has spread, metastasised into his bones and further. It's very painful, and it's very debilitating in many respects," his son Hunter Biden told BBC in an interview. In May 2025, Biden was diagnosed with an aggressive form of prostate cancer. Biden's cancer was found to have "a Gleason score of 9 (Grade Group 5)." According to the American Cancer Society, Grade 5 is assigned if the cancer looks very abnormal. The Gleason score and grade group are numbers that tell how quickly the cancer is growing. A Gleason score of 8-10 indicates that the cancer may spread from the prostate to other parts of the body.
"It's really, really hard, and it's really sad to watch," Hunter Biden added.
Bone metastasis: Consequences and treatment explained
Bone metastasis occurs when cancer cells spread from the primary site, in this case, the prostate, to the bones. Prostate cancer has a well-known tendency to metastasise, particularly affecting the spine, pelvis, hips, and ribs. Nearly all cancer types can spread to the bones. But some types of cancer are more likely to spread to bone. These include breast cancer and prostate cancer.
Prostate cancer cells break away from the primary tumour and travel through the bloodstream or lymphatic system to nest and grow inside the bones.
Consequences of bone metastasis
The presence of bone metastases can lead to several serious complications, including:
1. Severe bone pain
A constant, dull, or throbbing pain that worsens at night or during movement is one of the most common symptoms, as the cancer disrupts normal bone structure and can cause significant discomfort.
2. Fractures
Extreme structural weakness makes bones snap or break even from minor movements or minor falls.
3. Hypercalcemia
Bone metastases can lead to elevated calcium levels in the blood, causing nausea, dehydration, confusion, and other serious health issues.
4. Spinal cord compression
If metastases occur near the spine, they can compress the spinal cord, leading to weakness, sensory loss, or paralysis.
5. Decreased mobility
Pain and fractures can limit a patient's ability to move, impacting quality of life and independence.
6. Bone marrow suppression
Cancer that occupies the bone marrow can impair the body's ability to produce red and white blood cells, leading to fatigue and frequent infections.
Treatment options
While bone metastasis cannot typically be cured, there are several treatment options available to manage the disease and alleviate symptoms. These include hormone therapy, radiation therapy, Bisphosphonates, chemotherapy, targeted therapies, surgery and palliative care.
Bone metastasis is a sign of advanced cancer. It is officially classified as Stage IV advanced disease. This means the cancer is no longer localised to the prostate gland and has become a systemic illness that requires whole-body treatment rather than a localised cure.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.