Hunter Biden said recently he got into a 'little bit of trouble' for revealing that his father's cancer had spread to the bones. He was referring to his father's stage four prostate cancer, which has spread to the bones.

Biden, 83, was diagnosed with an aggressive form of prostate cancer in May 2025, shortly after leaving the White House. His office said at the time that the cancer had a Gleason score of 9, placing it in Grade Group 5, the most severe category.

Bone Spread and Biden's Own Account

Hunter Biden said in August that the cancer had metastasised into his father's bones 'and further'. He called it very painful and debilitating in many respects.

Biden wrote in a post on X on 8 September that the cancer had already spread to his bones by the time it was found. He said the radiation last autumn worked as intended and thanked the doctors and nurses who helped control it.

He added that more than 330,000 American men will receive a prostate cancer diagnosis this year. He urged Americans to get regular health checks.

Treatment Takes a Physical Toll

Hunter Biden said radiation and other treatment had helped control his father's prostate cancer, while hormone therapy is being used to treat the metastatic disease. He said things look good for now, but the treatment is painful and 'incredibly taxing on the body'.

He acknowledged that he complains about the illness more than his father does and worries about him all the time. The former president recently spent a week visiting his son in California.

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How Prostate Cancer Spreads to Bone

Aggressive prostate cancers are more likely to escape the prostate and spread to nearby tissue, according to Dr Gurkamal Chatta, chief of genitourinary oncology at Roswell Park Comprehensive Cancer Center. They usually reach the lymph nodes first.

From there, the cells can spread through the bloodstream or lymph vessels to other parts of the body. About 85 to 90 per cent of prostate cancer metastases are to bone, according to the Prostate Cancer Foundation.

Metastatic prostate cancer, also called stage four, does not always cause symptoms, according to the Mayo Clinic. As it advances, symptoms can include fatigue, unintended weight loss and pain in the back, hips, pelvic area or a bone.

Periodic X-rays, CT, MRI and prostate-specific PET scans help doctors keep tabs on the disease.

Managing Treatment and Side Effects

Hormone therapy remains the mainstay of advanced prostate cancer treatment because it targets testosterone, the main fuel for the disease. Other options include chemotherapy, immunotherapy and targeted therapy.

Hormone therapy is not chemotherapy, but it can cause hot flushes, weight gain, mood swings and higher blood pressure, cholesterol and blood sugar. The toll on quality of life is often underappreciated.

Once prostate cancer spreads beyond regional lymph nodes, the focus shifts to control rather than cure. People can live with advanced disease for a long time, five years or more.

Family Recalls Early Concerns

Former First Lady Jill Biden said the cancer was not found while her husband was in the White House. She said doctors cited American Urological Association guidance that men over 70 do not need a PSA blood test, and called the diagnosis 'shocking'.

She recalled first suspecting a problem when her husband needed the bathroom 'seven times a night'. She told the White House doctors about it, but said nothing came of the matter.

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