21 May 2025

This is a rare week where former president Biden has successfully replaced President Trump in the headlines. Already in the news on the eve of the launch of the new book by CNN’s Jake Tapper and Axios’ Alex Thompson, Original Sin: President Biden’s Decline, Its Cover-Up, and His Disastrous Choice to Run Again, on Sunday Biden’s office announced that he has been diagnosed with an aggressive form of prostate cancer.

Global reactions were swift, from messages of support from President Trump and Biden’s Vice President Kamala Harris, to calls to either quiet or amplify the discussions of his health and decisions while in office. Former senior adviser to President Obama, David Axelrod, spoke critically about Democrats in revelations from the book last week, but now says these discussions should be “more muted and set aside” in light of Biden’s diagnosis. However, questions from both the right and the left quickly followed the news of the diagnosis.

While the former president’s diagnosis with a Gleason score of 9 is uncommon, it is not unheard of, and the high level of abnormalities in the cells aligns with a more rapid spread of the disease. President Biden was not tested for prostate cancer while in office (even though presidents Obama and Bush were), but the Centers for Disease Control do not recommend regular prostate screenings for men over 70 due to potential false positive results and subsequent harms from tests and treatment.

Many commentators have questioned the timing of the announcement, right before Original Sin launched and shortly after Axios published the full audio from the former president’s interviews with Special Counsel Robert Hur. However, given the renewed attention the diagnosis brought to key questions highlighted in the book, it is difficult to see this as opportune timing. Instead, this just adds to challenges facing Democrats as they look for answers while trying to find a path forward for their party.

Mari Koeck
Director, Engagement and Impact

Lead image: President Joe Biden in December 2024 (Photo by Kevin Dietsch for Getty Images)

"Cancer touches us all. Like so many of you, Jill and I have learned that we are strongest in the broken places."

Message from former president Joe Biden on X | 19 May 2025

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By the numbers

Prostate cancer and Biden's "Cancer Moonshot"

New US prostate cancer diagnoses
and deaths (1999–2023)

Source: US CDC, NIH National Cancer Institute

After his son, Beau, died of cancer in 2015, then-Vice President Joe Biden oversaw the cancer “moonshot” to “end cancer as we know it” and cut the death rate from cancer in half in 25 years. He reinvigorated the initiative as president, channelling tens of millions of dollars towards additional research and launching major databases for global information sharing to increase collaboration and accelerate new discoveries in cancer treatments.

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Prostate cancer rates by country

Age-standardised incident rate per 100,000 men

Source: US CDC, NIH National Cancer Institute

The United States currently has the 26^th highest incidence rate of prostate cancer in the world, with an age-standardised rate of 75.2 per 100,000 men. Nordic and northern European countries have some of the highest incidence rates in the world and Australia and Brazil also have higher incidence rates for prostate cancer with 77.2 and 76.3 cases per 100,000 men, respectively.

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