Former US President Joe Biden’s prostate cancer has reportedly progressed, with his son Hunter Biden revealing in a recent BBC interview that the disease has spread and is causing his father significant pain.
Hunter Biden described his father’s condition as increasingly difficult to watch, saying that the cancer has become “very debilitating” and painful. The latest reports indicate that the prostate cancer has spread beyond the prostate, including to the bones.
The news has once again drawn attention to prostate cancer, cancer metastasis and what happens when prostate cancer spreads to other parts of the body.
Understanding metastatic prostate cancer and its impact on the body.
But what exactly does it mean when doctors say prostate cancer has “spread” or “metastasized”? Why does prostate cancer commonly spread to the bones? And can metastatic prostate cancer be treated?
Here is what you need to know.
What Is Prostate Cancer?
The prostate is a small gland in men located below the bladder and in front of the rectum. It surrounds part of the urethra, the tube that carries urine out of the body.
Prostate cancer develops when cells in the prostate begin growing abnormally and uncontrollably.
Many prostate cancers grow relatively slowly and may remain confined to the prostate for years. Others can be more aggressive and may grow or spread more quickly.
Prostate cancer is one of the most common cancers affecting men, particularly older men.
What Are the Symptoms of Prostate Cancer?
Early prostate cancer often causes no obvious symptoms. When symptoms do occur, they may include:
- Difficulty starting or stopping urination
- A weak or interrupted urine stream
- Frequent urination, particularly at night
- A feeling that the bladder has not completely emptied
- Blood in the urine or semen
- Painful urination
- Erectile difficulties
These symptoms do not necessarily mean that a man has prostate cancer. Benign prostate enlargement and other prostate or urinary conditions can cause similar symptoms.
This is why persistent urinary symptoms should be evaluated by a doctor rather than being automatically attributed to ageing.
What Does It Mean When Prostate Cancer Spreads?
Cancer that remains within the organ where it began is described as localized cancer.
Cancer cells can sometimes break away from the original tumour and travel to other parts of the body through the bloodstream or lymphatic system.
When cancer cells establish themselves in another part of the body and begin growing there, this is called metastasis.
In simple terms:
Prostate cancer starts in the prostate → cancer cells spread → they establish tumours elsewhere → this is metastatic prostate cancer.
How cancer cells travel from one location and settle elsewhere in the body.
Importantly, if prostate cancer spreads to the bones, it does not become bone cancer.
It remains prostate cancer that has metastasized to the bones.
What Is Metastatic Prostate Cancer?
Metastatic prostate cancer is prostate cancer that has spread beyond the prostate to distant parts of the body.
It is also commonly referred to as advanced prostate cancer or, when appropriate, Stage IV prostate cancer.
Stage IV prostate cancer can include cancer that has spread to nearby lymph nodes or, in more advanced cases, to distant organs such as the bones, liver or lungs.
Prostate cancer has a particular tendency to spread to the bones.
The spine, pelvis, ribs and other bones can be affected.
Bone metastases can affect the spine, pelvis, and ribs in advanced prostate cancer.
Why Does Prostate Cancer Spread to the Bones?
Cancer cells can travel from the prostate through the bloodstream and reach the bone.
The exact biological process is complex, but prostate cancer cells can interact with the bone environment in ways that allow them to survive and multiply.
Once prostate cancer has established itself in the bones, it can cause several complications.
These may include:
- Bone pain
- Weakening of the bones
- Fractures
- Spinal cord compression
- High calcium levels in the blood
Bone metastases are therefore an important cause of pain and disability in people with advanced prostate cancer.
Why Can Metastatic Prostate Cancer Cause Severe Pain?
Cancer in the bones can cause pain because the tumour affects the normal structure and activity of bone.
As metastatic deposits grow, they can weaken or damage the affected bone and irritate surrounding tissues.
If the spine is involved, the tumour can also put pressure on nerves or the spinal cord. This can cause severe pain and, in serious cases, neurological problems.
This helps explain why advanced prostate cancer involving the bones can become extremely painful for some patients.
However, not every person with metastatic prostate cancer experiences the same symptoms or degree of pain.
Pain can also be managed using a combination of cancer treatment, pain-relieving medicines and treatments directed specifically at bone metastases.
Supportive care and treatment can help manage pain and maintain quality of life.
Does Metastasis Mean That Prostate Cancer Is Incurable?
This is one of the most important distinctions to understand.
When prostate cancer has spread to distant parts of the body, it is generally not considered curable with current standard treatments.
However, that does not mean that nothing can be done.
Metastatic prostate cancer can often be treated and controlled for significant periods of time. The objectives of treatment may include:
- Slowing or stopping cancer growth
- Reducing the amount of cancer in the body
- Relieving symptoms such as pain
- Preventing complications
- Maintaining quality of life
- Extending survival
The outlook varies considerably from one patient to another and depends on factors such as the extent and location of the cancer, tumour characteristics, response to treatment, overall health and other medical conditions.
How Is Metastatic Prostate Cancer Treated?
Treatment depends on the individual's cancer and overall health.
Because many prostate cancers depend on male hormones called androgens, particularly testosterone, an important component of treatment is often androgen deprivation therapy (ADT) or other forms of hormone therapy.
Treatment may also involve combinations of:
- Hormone therapy
- Chemotherapy
- Radiation therapy
- Targeted medicines
- Immunotherapy in selected situations
- Radiopharmaceutical treatments in appropriate patients
- Medicines to protect or strengthen bones
- Pain management and palliative care
Radiation therapy can sometimes be directed at painful bone metastases to help relieve pain.
Doctors may combine several approaches depending on how the cancer is behaving and how the patient responds to treatment.
What Does Joe Biden’s Cancer Diagnosis Tell Us?
Joe Biden’s situation illustrates an important point about prostate cancer: the disease can behave very differently from one person to another.
Some prostate cancers are slow-growing and remain confined to the prostate. Others can be aggressive and spread to distant parts of the body.
The latest reports about Biden’s condition should therefore not be interpreted as representative of every man diagnosed with prostate cancer.
His specific medical condition, treatment response and prognosis can only be assessed by his treating medical team.
What is publicly known is that Biden was diagnosed with prostate cancer in 2025, and his son has now said that the disease has spread and is causing significant pain.
Can Prostate Cancer Be Detected Early?
Yes. Prostate cancer can sometimes be detected before symptoms develop.
Doctors may use tests such as:
- PSA blood testing
- Digital rectal examination in appropriate circumstances
- Prostate MRI
- Prostate biopsy when indicated
The decision about whether and when to undergo PSA testing is not identical for every man. Age, family history, risk factors and individual preferences all need to be considered when discussing screening with a doctor.
If prostate cancer is detected while it is still localized, treatment may have a much greater chance of eliminating the disease.
When Should Men See a Doctor?
Men should speak with a healthcare professional if they experience persistent urinary symptoms, blood in the urine or semen, unexplained bone pain, or other concerning changes.
It is particularly important not to dismiss persistent urinary problems simply as a normal part of ageing.
At the same time, urinary symptoms alone do not mean that someone has prostate cancer. A proper medical evaluation is needed to determine the cause.
Prostate Cancer: Key Medical Terms Explained
- Prostate cancer: Cancer that begins in the prostate gland.
- Metastasis: The spread of cancer cells from their original location to another part of the body.
- Metastatic prostate cancer: Prostate cancer that has spread beyond the prostate to distant parts of the body.
- Bone metastasis: Prostate cancer that has spread to the bones. It remains prostate cancer, not bone cancer.
- Stage IV: Advanced cancer that has spread beyond the prostate and/or nearby tissues, depending on the specific stage classification.
The Bottom Line
The reports about Joe Biden’s worsening prostate cancer have brought renewed attention to an important medical issue.
Prostate cancer begins in the prostate gland. When cancer cells travel beyond the prostate and establish tumours elsewhere, the process is called metastasis. When prostate cancer spreads to distant organs—particularly the bones—it is considered advanced or metastatic prostate cancer.
Bone metastases can cause significant pain and other complications, but treatment can often slow the disease, control symptoms and improve quality of life.
For men diagnosed with prostate cancer, understanding the stage and characteristics of the disease is essential because treatment and prognosis can vary enormously between individuals.
This article is intended for general educational purposes and should not be considered a substitute for medical advice, diagnosis or treatment.
Early detection through regular health checks can significantly improve outcomes.
