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By Lars Hanson
Associate News Editor
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Former President Joe Biden has always talked about his life through grief and getting back up. His newest message about his health Sunday used similar language, but was one of the plainest admissions he has made of what the past 18 months have cost him.
"Some days are better than others," Biden wrote in a post on X Sunday. "It hasn’t stopped me. But sometimes it slows me down."
The message was mostly about his book. Biden wrote that his presidential memoir, Promise Me, America, "is coming out on November 17th," and that it covers "the challenges we faced, the decisions I made, and why I made them." But the news was in the fourth paragraph.
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Because of the cancer, he wrote, "unfortunately, I won’t be able to do as many conversations about my book as I’d hoped. However, I’m hopeful the words on the page speak for themselves."
It is an unusual thing for a politician to say. Biden built a fifty-year career on talking: rope lines, long Senate speeches, conversations that ran past schedule. Now, days before his account of his presidency comes out, he is saying the book will mostly have to speak without him.
A Diagnosis That Came After the Presidency
The cancer was found about four months after he left office. In May 2025, after experiencing worsening urinary symptoms, Biden was seen by doctors, who found a nodule on his prostate. On Friday May 16, 2025, he was diagnosed with prostate cancer that had already spread to his bones. His office announced it two days later, on Sunday, May 18, describing it as "prostate cancer, characterized by a Gleason score of 9 (Grade Group 5) with metastasis to the bone."
That score is serious. When pathologists grade prostate cancer, they score the cells under a microscope by how far they have strayed from healthy tissue, from grade 3 (the least serious) to grade 5 (the most). They add the two grades to get the Gleason score. In practice the score runs from 6 to 10.
Mayo Clinic says a 6 means the cancer is growing slowly and is unlikely to spread, and a 10 means it is growing quickly and likely to spread. Biden’s 9 is the second-highest score. Under the newer international system, scores of 9 and 10 are both in Grade Group 5, the most aggressive of the five groups. The same statement included some hope: "the cancer appears to be hormone-sensitive which allows for effective management."
At the time, the Bidens answered with a line that read like a family motto: "Like so many of you, Jill and I have learned that we are strongest in the broken places," they posted on Facebook.
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Radiation, a Bell and What Came After
The rest of 2025 was spent in treatment. In early September 2025, after video emerged showing a healing wound on his forehead, Biden spokesperson Kelly Scully confirmed that he had Mohs surgery to remove skin cancer. On October 11, 2025, she said Biden was "currently undergoing radiation therapy and hormone treatment."
On Monday, October 20, 2025, Scully confirmed the next step: "I can confirm that he has completed a course of radiation therapy today." She added that Biden "rang the bell" at Penn Medicine Radiation Oncology in Philadelphia, where he had been treated for several weeks. Patients ring that bell to mark the end of a course of treatment. It does not mean the disease is gone. Scully would not say what treatment might come next.
Since then, Biden and his family have offered occasional updates. In August 2026, Jill Biden said on SiriusXM’s Let’s Talk Off Camera with Kelly Ripa that her husband is "doing okay," but that "he will forever live with cancer, and we have to be mindful of it every three months, testing and medicines." Days later, Hunter Biden told the BBC’s Newsnight: "The cancer has spread, metastasized into his bones and further. It’s very painful and it’s very debilitating in many respects." In September, Biden wrote on X that "the radiation treatment from last fall worked as intended."
His new message says that his doctors "continue to be encouraged by how I’ve responded to treatment."
From "Really Well" to "Slows Me Down"
The tone has changed since summer. On July 15, 2026, Little, Brown announced that Promise Me, America would go on sale on November 17. That same day, Biden posted a video on X saying the book was "coming out November 17th and is available for preorder now." In the video, he described his cancer treatment as "going really well." A spokesperson for Little, Brown told the AP that Biden planned a book tour and interviews.
The new message describes good days and bad days, and a promotional schedule cut down to fit them.
In his July video, Biden said the book would explain "why I chose to run for reelection, and why I chose to step aside." Critics from both parties have questioned whether Biden and those around him were candid about his health while he was in office. Biden’s team has denied any cover-up.
The memoir comes out two weeks after the November 3 midterm elections.
Champ, When You Get Knocked Down, Get Up
Biden ended his Sunday message with his father, as so many of his speeches have.
"Looking forward, I’m going to keep following what my father told me a long time ago: ‘Champ, when you get knocked down, get up,’" he wrote. "It’s a good lesson for me. And for America."
The book’s title echoes two earlier memoirs: Promises to Keep (2007) and Promise Me, Dad (2017), his account of the final year of his son Beau. Beau Biden died of brain cancer in 2015 at age 46.
Biden turns 84 on November 20, three days after the book comes out. He closed his message by writing about the country rather than himself, describing a nation "built on an idea. An idea bigger than any ocean. More powerful than any army. Stronger than any tyrant or dictator."
"That idea?" he wrote. "All of us are created equal."
Contact Newsweek editors on this story: Steve Mollman and Dan Gooding.
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