Friends of former President Joe Biden have voiced concern about increased fatigue as he battles stage 4 prostate cancer, according to a report from The Washington Post.

The outlet reported that four individuals who have spoken with Biden in recent months said they had not received detailed updates on his condition but observed that he has appeared more tired in recent weeks. They attributed the fatigue to the strain of the disease and its treatment. A fifth person described Biden as active and engaged, saying he remains encouraged about his prognosis due to what aides have characterized as a positive response to therapy.

Biden, 83, was diagnosed in 2025 with prostate cancer that has metastasized to the bone, a condition widely considered incurable. His cancer was assigned a Gleason score of 9, indicating an aggressive form more likely to spread. His office previously announced he was undergoing radiation therapy at Penn Medicine Radiation Oncology in Philadelphia and had been receiving hormone therapy.

In October 2025, Biden marked the completion of his radiation treatment by ringing a ceremonial bell. In September of that year, he also underwent surgery to remove multiple skin cancer lesions.

Despite the diagnosis, Biden has continued to make public appearances and is scheduled to travel to South Carolina on February 27 to commemorate the anniversary of his primary victory there. Aides have said he remains focused on writing his memoir and maintaining a public schedule while managing his treatment.