Former first lady Jill Biden revealed that she noticed her husband's symptoms almost immediately during his last year in the White House. Joe Biden frequently needed to wake up and use the bathroom in the middle of the night. Doctors initially dismissed these symptoms as common in aging men, but they ultimately indicated Stage IV prostate cancer that had spread to his bones.
Jill Biden's Book Tour Revelations
Jill Biden, on a press tour for her new book "View from the East Wing," spoke with "Today" on Monday. She described her husband's condition as manageable but serious. "He's doing OK," she told host Craig Melvin. She noted that a diagnosis of "just" prostate cancer could be cured, but metastasis to the bones "makes it a whole different story." She added, "Joe will live with cancer till the rest of his life."
Diagnosis and Medical Context
Joe Biden was diagnosed in May 2025 after reporting urinary symptoms. His office confirmed the cancer had metastasized to his bones. Prostate cancer is the second most common cancer among U.S. men, with about 1 in 8 diagnosed in their lifetime, according to the National Cancer Institute. Dr. Herbert Levine, a professor at Northeastern University, explained that early-stage cancer confined to the prostate is treatable, but spread to bones complicates care.
Levine noted that if cancer becomes resistant to therapies, it becomes castration-resistant prostate cancer. Biden's cancer has an aggressive Gleason score of 9, but his office said it appears hormone-sensitive, allowing effective management through radiation and hormone therapy.
Why Was It Missed?
Jill Biden expressed confusion on MSNBC's "Morning Joe" about why the cancer wasn't caught earlier despite excellent White House healthcare. Doctors followed standard guidelines, which recommend discontinuing routine PSA screenings for men over 70. Biden's last reported PSA test was in 2014 when he was 72. Dr. Bill Dahut of the American Cancer Society explained that early prostate cancer often has no symptoms, and frequent urination is commonly due to benign prostatic hyperplasia (BPH), not cancer.
The U.S. Preventive Services Task Force (USPSTF) has recommended against PSA screening for men over 70 since 2008, citing potential harms like unnecessary biopsies. However, some groups, including the American Urological Association, argue this has led to increased advanced-stage diagnoses.
Impact on Screening Guidelines
Biden's case may influence future screening recommendations. A Cochrane review from May 2025 found that PSA testing likely reduces prostate cancer deaths. The ACS is updating its guidelines, and USPSTF's update has been delayed under Health and Human Services Secretary Robert F. Kennedy Jr. Experts advise healthy men to discuss PSA screening with their doctors regardless of age, as early detection can be crucial.
Dahut emphasized, "Old men die with prostate cancer, very few die of prostate cancer."
