Gleason Score explained in full as Joe Biden's cancer labelled 'stage five' by Donald Trump Jr

Former US President Joe Biden has been diagnosed with a form of prostate cancer.

On Sunday (May 18), the office of the 82-year-old and former president released a statement, confirming Biden has been diagnosed with prostate cancer with a Gleason score of nine (Grade Group 5), which has spread to the bones.

Well-wishes have since been flooding in for Biden from most, including from President Donald Trump.

But his son, Donald Trump Jr, instead took to social media to suggest the news was a 'cover up'.

The 47-year-old trustee and executive vice president of the Trump Organization also agreed with a comment 'without question' that claimed Biden was 'running the country as a vegetable under the rug'.

What did Donald Trump Jr say about Joe Biden’s cancer?

Taking to X, formerly Twitter, Trump Jr shared a screenshot of a tweet from Dr Steven Quay, who, in part, claimed it is 'highly likely [Biden] was carrying a diagnosis of prostate cancer' while in the White House and that the 'American people were uninformed.'

Responding to this, Trump Jr wrote: "What I want to know is how did Dr. Jill Biden miss stage five metastatic cancer or is this yet another coverup???"

Firstly, Jill holds a doctorate in education, not medicine. But moreover - 'stage five' cancer doesn't even exist.

What I want to know is how did Dr. Jill Biden miss stage five metastatic cancer or is this yet another coverup??? pic.twitter.com/fSqtDmcX4p

— Donald Trump Jr. (@DonaldJTrumpJr) May 18, 2025

Is stage five cancer real?

No, stage five cancer - as Trump Jr called it - does not exist.

There are four stages when it comes to diagnosing certain cancers, as per Cancer Research UK.

Stage 1 usually means that a cancer is small and contained within the organ it started in.

Stage 2 usually means that the tumour is larger than in stage 1 but the cancer hasn't started to spread into the surrounding tissues. Sometimes it can mean that cancer cells have spread into lymph nodes close to the tumour, depending on the certain type of cancer.

Stage 3 usually means the cancer is larger. It may have started to spread into surrounding tissues and there are cancer cells in the lymph nodes nearby.

Stage 4 means the cancer has spread from where it started to another body organ. This is also called secondary or metastatic cancer.

What is the Gleason Score?

The Gleason Score - also known as the Grade Group - is the most common system doctors use to grade prostate cancer.

The grade of a cancer tells you how much the cancer cells look like normal cells, as Cancer Research UK explains.

This gives your doctor an idea of how the cancer might behave and what treatment you need.

A Gleason score 6 is 'Grade Group 1' - where the cells look similar to normal prostate cells and the cancer is likely to grow very slowly, if at all.

The highest of the Gleason scale is a score of nine or ten. Known as 'Grade Group 5,' this is when the cells look very abnormal and the cancer is likely to grow quickly.

Grade Group 2 Most cells still look similar to normal prostate cells. The cancer is likely to grow slowly

In between, you have Gleason score 7 - or Grade Group 3 T- where the cells look less like normal prostate cells and the cancer is growing at a 'moderate' rate.

Then there's Gleason score 8 - Grade Group 4. This is where some cells look abnormal, while the disease could be growing quickly or at a moderate rate.

So, Biden has Grade Group 5 cancer - not 'stage 5'.