When Dan Koh won a seat in Congress last week, he received a voicemail from former President Joe Biden congratulating him on his victory. The incoming Massachusetts Democrat is among an extended network of ex-Biden aides and political allies who have been touching base with the former president as he battles cancer.
"I just check in and see how he's doing," said Koh, who served as a liaison between the White House and state and local governments. "Like anyone who loves someone with cancer, I'm sure it's not easy day-to-day. But I just want people to know that I'm thinking about them."
Biden said his health would force him to scale back the number of public appearances to promote his coming book about his presidency. His limited appearances during the fall election campaign season and curtailed book tour have put a spotlight on his health as he deals with an aggressive form of prostate cancer.
"Some days are better than others," Biden said Sunday in a social-media post. "It hasn't stopped me. But sometimes it slows me down. What that means is, unfortunately, I won't be able to do as many conversations about my book as I'd hoped."
Biden, who is 83 years old, was diagnosed in May 2025 with the aggressive prostate cancer that had spread to his bones. He underwent radiation therapy and is receiving hormone therapy. He also has been treated for skin-cancer lesions. His book, "Promise Me, America," chronicling his four years as president, is set to be released Tuesday.
The design of Biden's book rollout took into account his health situation, according to a person familiar with his thinking. The person said events weren't canceled as a result of his health status.
Book tours can be grueling. Authors are typically expected to devote a week or two to intensive promotion, though with high-profile authors the time might be negotiated down based on their schedule or other factors. Because most book sales happen in the first few weeks, continuing to promote the book through podcasts, TV shows and live events is crucial to keep buzz going after the initial excitement subsides.
"It's really not very different than running for office: they want to pound the pavement and get their message out," said literary publicist Paul Bogaards, who worked on the campaign for former President Bill Clinton's hit 2004 memoir "My Life."
Last year, The Wall Street Journal reported that Biden had sold his memoir to Hachette's Little Brown & Co. for around $10 million. His 2017 memoir "Promise Me, Dad: A Year of Hope, Hardship and Purpose," about his relationship with his oldest son Beau, was a No. 1 bestseller. CAA represented Biden in both deals.
Health concerns overshadowed Biden's final year in office
Biden's health was a central issue in the final months of his presidency and his 2024 re-election campaign. He ended his bid for a second term in July 2024 after a disastrous debate performance against Donald Trump intensified questions about his health and mental acuity. Trump went on to defeat former Vice President Kamala Harris, Biden's former running mate, to win a second term.
The former president has largely kept a low profile since leaving office, making only occasional appearances at Democratic Party events and other public gatherings. Last month, he spoke at the Philadelphia Democratic Party's fall fundraiser, and earlier in the year appeared at events for Democrats in South Carolina, Maryland and South Dakota.
On midterms election night and in the aftermath, Biden made calls to congratulate dozens of victorious Democrats, including Pennsylvania Gov. Josh Shapiro, Georgia Gov.-elect Keisha Lance Bottoms and Texas Sen.-elect James Talarico.
"We continue to be so proud to have a native son of Scranton who served as president," said Rep-elect Paige Cognetti, mayor of Scranton, Pa., and an incoming House member who spoke to Biden after her election.
On Monday, Biden attended an event at the University of Delaware, his alma mater, to mark the groundbreaking of a building that will serve as the new home of the Joseph R. Biden Jr. School of Public Policy and Administration.
Biden on Tuesday was in Ireland for a ceremony honoring his son, Hunter Biden, at Trinity College Dublin. Biden and his family were targeted by pro-Palestinian protesters who threw objects at them as they left the event.
Biden's son said in an August interview with the BBC that the former president's cancer was "very painful, and it's very debilitating in many respects." Those comments came after former first lady Jill Biden told NBC in June that her husband "will live with cancer 'til the rest of his life."
Biden has struck an optimistic tone on his prognosis. In an interview with People published Wednesday, he said the cancer has "not metastasized beyond what it already was."
"I'm not saying I'll live forever. But the point is that I have all my faculties, I have access to all the things I had before and I feel good," said Biden, who noted that many people who are diagnosed with prostate cancer "live long lives, who live for another 10, 20 years."
Biden says he didn't try to hide diagnosis
In the book, Biden pushes back against suggestions that he sought to hide his cancer diagnosis from the public near the end of his presidency. Biden's doctor wrote in February 2024 that Biden was "fit for duty" amid questions about his age and health. His cancer diagnosis was disclosed about four months after he left the White House.
In excerpts published Tuesday by MS NOW, Biden writes, "What did surprise me was the cynical twist the story took in the political press and among political commentators." He added, "Almost immediately, the reaction was: 'You hid it from us.' 'You must have known it.' 'You're lying.' Let me tell you something: There isn't anyone in this world with stage 4 cancer who doesn't wish it had been caught sooner."
Biden, in the People interview, added that had he known about his cancer in 2024, he wouldn't have gone forward with his re-election bid "because I don't think an 80-year-old man with cancer should be running" for president.
He writes in the book that he experienced urinary symptoms that prompted him to seek medical advice in May 2025. Doctors found a nodule on his prostate and diagnosed him with aggressive, stage 4 prostate cancer. Biden announced the diagnosis two days later and began receiving hormone and radiation therapy immediately.
"For anyone to think I would try to ignore or hide a cancer ravaging my body is absurd," Biden writes. "Here are the simple facts. Standard medical protocol is to stop testing men for prostate cancer after the age of seventy."
Before his diagnosis, Biden's last known prostate-cancer blood-screening test was performed in 2014, a spokeswoman for the former president said at the time. Prostate-cancer screening for men in their 80s isn't considered standard care.
Many prostate cancers in the U.S. are detected with a blood test that measures prostate-specific antigen, or PSA. The U.S. Preventive Services Task Force, a government-backed volunteer panel of experts that makes preventive-health recommendations, advises against PSA screening for men ages 70 and above, based on concerns about false positives and overtreating low-risk forms of the disease. Other groups advise older men to make the decision about whether to continue screening in consultation with their doctors.
"And as I sit here today, do I wish I had been tested sooner? Yes, I do. Do I wish the cancer had been caught before it spread to my bones? Yes, I do," Biden writes. "But I was treated no differently from any other eighty-two-year-old man in America. Maybe I should have been. But I wasn't."