Based on the details in the statement, here's a medically grounded estimate:

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### 📋 Key Clinical Info:

* **Gleason score 9 (Grade Group 5)** → This is **very high-grade**, aggressive prostate cancer.

* **Metastasis to the bone** → Stage **IV** disease, meaning it's spread beyond the prostate.

* **Hormone-sensitive** → Responds to **androgen deprivation therapy (ADT)**, which can control the cancer for some time.

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### ⏳ **Prognosis (Life Expectancy Estimates)**

For men diagnosed with **metastatic hormone-sensitive prostate cancer**:

| Factor | Average Survival |

| ------------------------------------------------------------------ | ---------------------------------------------------------------------------------------------- |

| Hormone-sensitive (like Biden’s) | **3 to 6 years**, depending on health, response to treatment, and access to advanced therapies |

| With modern treatments (e.g., ADT + chemotherapy + targeted drugs) | **Up to 7–9 years** in some cases |

| If cancer becomes **castration-resistant** later | Survival drops to **\~1.5–3 years** from that point |

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### 💡 Important Context:

* **Age & general health**: At age 81+, outcomes are generally **less favorable**, though Biden appears in relatively good overall condition.

* **Treatment options** may include:

* Hormone therapy (ADT)

* Chemotherapy (e.g., docetaxel)

* Novel agents (abiraterone, enzalutamide)

* Bone-targeting drugs (e.g., zoledronic acid)

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### 🧠 Bottom Line:

With current treatments and assuming good initial response, someone in this situation typically lives **3–5 years**, sometimes longer if managed aggressively — though quality of life may decline over time.

Let me know if you want a breakdown of treatment phases or how this compares to other cancers.

(http://www.autoadmit.com/thread.php?thread_id=5727122&forum_id=2).#48943204)