Eighteen months after leaving the White House, former President Joe Biden’s activities have become markedly constrained as he undergoes treatment for metastatic cancer. Diagnosed in May 2025 with an aggressive form of prostate cancer that has spread to his bones, Biden, 83, is reportedly responding to treatment, but friends and former aides familiar with his condition say the illness and its management have visibly affected his health.

Biden’s post-presidential life is largely centered around medical care, family, and efforts to solidify his legacy. Unlike some of his recent predecessors, he has maintained a relatively low public profile and has yet to establish a broad philanthropic or policy operation. His effort to raise funds for a presidential library in Delaware has also lagged, drawing significantly less financial support compared to similar projects by George W. Bush and Barack Obama in the early years after their presidencies.

The former president’s health became a focal point during his 2024 reelection campaign, particularly after a widely scrutinized debate performance in June 2024 against then-candidate Donald Trump. During that debate, Biden appeared frail and struggled with his composure, which intensified concerns about his physical and cognitive stamina. Despite initial resistance to calls for him to withdraw from the race, Biden ended his bid in July 2024 amid growing pressure from within the Democratic Party.

The coming months may see renewed attention to Biden’s health and public image as he prepares to promote a memoir scheduled for release in mid-November, shortly after the U.S. midterm elections. This has raised concerns among some Democrats who worry that his visible health challenges and personal narrative could reawaken divisions from the 2024 campaign at a politically sensitive time. Conservative voices, including Donald Trump, have frequently seized on Biden’s age and health to question his fitness for office and criticize his presidency.

Biden’s family has publicly expressed frustration with attacks that exploit his illness. Hunter Biden, the former president’s son, confronted such criticism in social media comments, defending his father’s privacy amid political attacks.

While Biden has occasionally appeared in public since leaving office — including at Democratic events and the dedication of the Obama Presidential Library — he largely remains at his Delaware home undergoing a combination of radiation, hormone therapy, and other treatments. Jill Biden, the former first lady, has described the cancer diagnosis as unexpected and advanced but has provided optimistic updates regarding his ongoing care.

The former president’s office has declined to provide detailed information about his daily routine or medical prognosis, though it has confirmed ongoing treatment and surgery to remove cancerous skin cells. Former aides suggest that the public focus on Biden’s health is unlikely to influence the midterm elections, given voters’ preoccupation with economic challenges.

The scrutiny of Biden’s health has also sparked broader political debates about transparency and leadership. His 2024 campaign exposed tensions within the Democratic Party and fueled Republican narratives alleging that Biden’s condition was concealed to protect his political standing. Meanwhile, critics have contrasted Biden’s struggles with President Donald Trump’s health, despite controversy over Trump’s own medical history and frequent hospital visits for various concerns.

Historically, health and age have greatly shaped former presidents’ post-office lives. Figures like Jimmy Carter, Bill Clinton, George W. Bush, and Barack Obama have navigated their retirements with varying degrees of engagement, balancing public service, philanthropy, and private pursuits. Biden’s ongoing battle with cancer adds a new dimension to his post-presidential years as he manages his health while seeking to maintain his legacy amid a politically divided environment.