Beau Biden's Story and What Glioblastoma Means

What the family said publicly

Beau Biden, a former attorney general of Delaware and a major in the Delaware Army National Guard, had a brain lesion removed in 2013 and returned to work after treatment. His cancer came back in the spring of 2015, and he died on May 30 of that year at the age of 46.

His family did not name the tumor type at the time, though his father later spoke about it publicly and identified it as glioblastoma. Joe Biden has also raised the question of whether smoke from military burn pits played a role, while saying he knows of no direct scientific evidence linking those exposures to his son's tumor.

That is the whole of the public record, and this page stops there, because nothing further about his care was ever disclosed. The rest of this article is about the disease itself, which is where the useful information lives.

What glioblastoma is

Glioblastoma is a fast-growing cancer that starts in the brain, arising from glial cells, which are the support cells that surround and feed nerve cells. The World Health Organization grades brain tumors from I to IV based on how the cells look and how quickly they grow, and glioblastoma sits at grade IV, the highest grade.

Fred Hutchinson Cancer Center puts glioblastoma at roughly 15 percent of primary brain tumors. A primary tumor is one that begins in the brain rather than spreading there from elsewhere in the body. Surgeons face a hard problem with them, because the mass sends thin, finger-like extensions into nearby brain tissue, often close to regions that handle speech, movement, or balance.

Laboratories now test the tissue for a gene called IDH. The National Cancer Institute reports that people whose tumors are IDH wild-type, meaning the gene is unchanged, have the worst outlook regardless of which treatment they receive. Most glioblastomas are IDH wild-type.

How it shows up

Symptoms depend on where in the brain the tumor sits. NCI lists these signs in adults:

• Headaches in the morning, or headaches that ease after vomiting.
• Seizures.
• Trouble with speech, hearing, or vision.
• Nausea and loss of appetite.
• Changes in mood or personality.
• Weakness, poor balance, or unusual sleepiness.

Every one of these has many ordinary causes, so what sets a tumor apart is the pattern: the problem is new, it is steady, and it worsens over days or weeks rather than coming and going.

When to get checked

Seek care the same day, or go to an emergency department, if any of these happen:

• A first seizure, at any age.
• A headache that starts suddenly and reaches full force within about a minute.
• Weakness or numbness on one side of the body, a drooping face, or slurred speech.
• New double vision, or a blind patch in part of your field of view.
• Confusion, or a change in personality that people around you notice.

Book a regular appointment for a new headache pattern that wakes you from sleep, is worst on waking, or has been building for more than two weeks, and treat it as more pressing if nausea or vomiting comes with it.

NCI states plainly that it has no evidence-based information about preventing brain tumors, and none about screening for them, so there is no routine scan for healthy adults. Symptoms are what trigger testing.

Getting to a diagnosis

MRI, or magnetic resonance imaging, is the main test, and it uses a magnet and radio waves to build detailed pictures of the brain. A contrast agent called gadolinium is usually injected first so that the tumor stands out, and CT or PET scans may be added to answer specific questions.

Scans can point strongly toward glioblastoma, but a confirmed diagnosis requires tissue. A stereotactic biopsy uses computer guidance to reach a deep tumor through a small opening in the skull, while an open biopsy uses a craniotomy, a larger surgical opening, when the surgeon can reach the tumor directly. The sample then goes to the laboratory for gene testing.

What treatment involves

NCI describes a standard plan in three parts.

The first is surgery, and the goal is maximal safe resection, which means removing as much tumor as possible without damaging function. Complete removal is rarely possible at grade IV, because of those finger-like extensions into healthy tissue.

The second is radiation and chemotherapy delivered together: NCI describes 60 Gy of radiation given in 30 daily sessions over six weeks, with the drug temozolomide taken daily throughout.

The third is temozolomide on its own, for up to six cycles.

One laboratory result shapes what to expect from that drug, and it concerns a gene called MGMT, which helps cells repair the damage temozolomide does. When a chemical tag switches MGMT off, a process known as methylation, the drug works better. NCI reports median overall survival of about 18 months when MGMT is methylated, compared with about 12 months when it is not.

The survival picture

SEER, the federal cancer statistics program, counts brain and other nervous system cancers as a single group. It estimated 24,740 new cases and 18,350 deaths in the United States in 2026, about 1.2 percent of new cancer diagnoses. Five-year relative survival across that whole group is roughly 33 percent.

Two cautions come with that number: it blends slow-growing tumors with fast ones, so it sits well above what glioblastoma alone would show, and it describes a group of people diagnosed years ago. It is a group statistic, and it does not forecast what will happen to any one person.

Progress here has been slow, and specialists say so openly. In 2015, Dr. Adilia Hormigo, then director of neuro-oncology at Mount Sinai, said: "The progress has been very limited; we're kind of stuck with the same treatments."

Sources

• https://www.cancer.gov/types/brain/hp/adult-brain-treatment-pdq
• https://www.cancer.gov/types/brain/patient/adult-brain-treatment-pdq
• https://seer.cancer.gov/statfacts/html/brain.html
• https://medlineplus.gov/braintumors.html
• https://www.mountsinai.org/about/newsroom/2015/the-facts-about-beau-bidens-cancer
• https://www.fredhutch.org/en/news/center-news/2015/06/beau-biden-treating-brain-cancer.html
• https://www.pbs.org/newshour/health/biden-addresses-possible-link-between-sons-fatal-brain-cancer-and-toxic-military-burn-pits