Joe Biden marked the completion of a course of radiation therapy for an aggressive form of prostate cancer by ringing a brass bell at Penn Medicine Radiation Oncology in Philadelphia, a milestone his family and spokesperson said capped several weeks of treatment that began earlier this month and followed months of hormone therapy begun after his diagnosis in May. “I can confirm that he has completed a course of radiation therapy today,” Biden spokesperson Kelly Scully said on Monday, adding that the former president “rang the bell” at the University of Pennsylvania clinic where he has received care. In a short video posted to Instagram Stories, his daughter Ashley Biden filmed him pulling the bell’s rope while staff and relatives applauded, adding the caption, “Rung the bell! Thank you to the incredible doctors, nurses, and staff at Penn Medicine. We are so grateful!” The family did not disclose whether additional radiation would be needed; Scully said it was too early to determine next steps beyond continued monitoring under his oncology team.
The ringing of a bell to mark the end of a treatment phase has become a familiar ritual across cancer centers in the United States over recent decades, a moment of encouragement for patients and staff that signals the completion of a planned regimen rather than the finish of medical care. Biden’s office first confirmed on October 11 that he had been undergoing several weeks of radiation therapy in Philadelphia in combination with ongoing hormone therapy; on Monday, it said the scheduled course was complete. The clinic did not release clinical metrics associated with the treatment, and Biden’s team declined to comment on whether physicians anticipate further radiation, chemotherapy, or targeted agents as part of his longer-term plan.
Biden, 82, received the diagnosis in May after experiencing urinary symptoms that prompted evaluation and imaging; his office said the cancer was a high-risk, hormone-sensitive prostate adenocarcinoma with a Gleason grade of 9 that had metastasized to bone, a profile that oncologists characterize as aggressive but potentially responsive to combinations of androgen deprivation therapy and radiation. The office indicated at the time that he had begun hormone therapy shortly after the diagnosis and that his case would be managed by a multidisciplinary team. Public updates since then have been limited to brief statements, with the most recent providing confirmation that the radiation course had concluded at the Penn Medicine facility.
Photographs and video of Biden leaving the clinic and of family gatherings around the bell were shared across social platforms on Monday and Tuesday, but the most substantive official detail remained the spokesperson’s statement and Ashley Biden’s short clip. News organizations that contacted Penn Medicine said the hospital would not discuss an individual patient’s care beyond what the family had shared. The former president did not issue a written statement of his own, and his schedule for public appearances remains light; aides have said routine commitments will be evaluated appointment by appointment.
Major outlets with access to Biden’s office reported that the completed radiation represents progress in a plan calibrated to a cancer that had spread beyond the prostate at diagnosis, while cautioning that the end of a radiation block does not itself define prognosis. CBS News said the several-week course had been anticipated as part of the treatment designed by his physicians and confirmed that he “rang the bell today,” underscoring a tradition widely used to mark milestones inside oncology units. The Washington Post noted that the therapy had been delivered over a period of weeks and that future steps were not yet public, an uncertainty typical of cases where response assessments depend on post-treatment imaging and laboratory markers to be collected over time.
In the months before beginning radiation, Biden underwent Mohs surgery in early September to remove skin cancer lesions on his forehead, a procedure that involves staged excision and margin analysis until all cancerous tissue is cleared. His office described that surgery as successful and unrelated to the prostate cancer diagnosis, noting that he previously had a basal-cell carcinoma removed in 2023. Those dermatologic procedures were disclosed separately from the genitourinary cancer updates; Monday’s announcement made no additional linkage beyond confirming that the skin lesions had been treated and that he had completed a planned course of radiation for the prostate cancer.
People familiar with his care said Biden’s radiation was delivered at Penn Medicine’s Radiation Oncology clinic, where patients with bone metastases often receive targeted external-beam therapy to control symptoms and reduce tumor burden while systemic hormone therapy addresses disease activity across the body. A common approach in hormone-sensitive metastatic prostate cancer pairs androgen deprivation with newer androgen receptor pathway inhibitors; clinicians may add focal radiation to sites of pain or risk as part of a broader regimen. Biden’s team has not enumerated the agents used or the schedule applied, but the description of “several weeks” of radiation is consistent with protocols that fractionate doses over multiple sessions.
The family’s decision to share the bell-ringing video framed the completion as a morale marker. “Rung the bell!” Ashley Biden wrote, echoing the words patients and caregivers often use when crossing off a planned block of care. The clip circulated quickly among supporters and critics alike, drawing messages of encouragement that emphasized Biden’s long public history with cancer through the Beau Biden Cancer Moonshot and his own prior dermatologic surgeries. In a separate note, a family spokesperson conveyed gratitude to staff at the University of Pennsylvania and said Biden would follow physician guidance on follow-up scans and visits.
News accounts traced the timeline from the initial disclosure in May through Monday’s milestone. The Associated Press reported last week that Biden had been receiving radiation and hormone therapy for an aggressive prostate cancer identified after he left office, writing that the tumor grade and spread to bone indicated a high-risk profile. ABC News, citing Scully, said Monday’s bell-ringing marked the end of the current radiation course while leaving open the possibility of additional treatment based on response. The Guardian similarly noted that he had completed a round of radiation at Penn Medicine and highlighted Ashley Biden’s video as the family’s public signal.
The clinical facts available publicly remain sparse by design. Prostate cancers that have metastasized to bone are commonly managed with systemic therapy aimed at suppressing testosterone-driven tumor growth, with radiation used to address specific lesions or, in some protocols, to treat the primary tumor and oligometastatic sites. Physicians monitor response through symptoms, prostate-specific antigen (PSA) levels, and imaging, adjusting therapy as the disease responds or progresses. Biden’s office has not released PSA values or scan results and has consistently framed updates in broad terms of treatment phase and tolerance. Monday’s statement continued that practice with the short confirmation that he had “completed a course of radiation therapy” and that he rang the bell at the clinic.
Public interest in Biden’s health has remained high since the diagnosis and has intersected periodically with appearances that drew attention to his stamina and gait. Outlets that covered Monday’s bell-ringing also revisited earlier footage of the former president out in Delaware in September after the Mohs procedure, when a bandage was visible on his forehead, and noted family members’ efforts to keep updates focused on clinical milestones rather than day-to-day speculation. The Daily Beast and Fox News, among others, carried the confirmation of the bell ceremony and the note that the family shared the video rather than holding a press conference.
The precise origin of the bell-ringing tradition varies by institution, but it has been widely adopted as a way to ritualize the conclusion of a planned block of radiation or chemotherapy. People magazine, in a broader explainer that accompanied its report on Biden’s milestone, traced one popular hospital bell to a naval tradition that migrated into oncology wards as clinicians looked for ways to mark progress tangibly. Biden’s video shows a small wall-mounted bell with a rope pull at the Philadelphia clinic; staff who appear with him in the clip applaud as he rings it twice. The family did not release the moment with a caption beyond Ashley Biden’s brief thanks to caregivers.
Treatment decisions for aggressive, hormone-sensitive prostate cancer often evolve in steps, particularly when disease is discovered at a stage that includes bone involvement. Oncologists commonly reassess after completing radiation to determine whether to continue current systemic therapy, intensify it, or pivot to other options depending on response and side effects. Biden’s office has emphasized that while the Monday ceremony was significant, it does not represent completion of all care, a point echoed by CBS News and ABC News in their reports. The next public update is likely to come from his spokesperson rather than from clinicians, in keeping with standard practice for high-profile patients who receive treatment at major academic centers.
The latest milestone arrived amid a quiet schedule that aides say reflects a balance between private medical needs and selected public commitments. The Guardian reported that Biden is slated to receive a lifetime achievement honor at the Edward M. Kennedy Institute in Boston, pending his physicians’ guidance, and that the family has kept focus on clinical progress rather than on extended appearances while treatment is active. Neither the institute nor Biden’s office elaborated on timing, which may depend on follow-up care.
For now, the facts confirmed by his office and family are straightforward: a diagnosis this spring of an aggressive, high-grade, hormone-sensitive prostate cancer with metastasis to bone; months of hormone therapy followed by several weeks of radiation delivered at Penn Medicine; the completion of that course on Monday; and a bell rung in a Philadelphia clinic to mark the passage from one phase of treatment to the next. Whether additional radiation will follow, and what combination of systemic therapies will define his regimen over the coming months, remain questions for his oncologists as they review post-treatment assessments. The family’s public note—short, specific, and centered on gratitude—aligns with the cautious cadence Biden’s team has maintained since May: confirm the phase, spare the metrics, and let the bell say the rest.