Beau Biden Dies at 46 From Brain Cancer: Why the Disease Is So Hard to Beat

Beau Biden had spent the last week before he died receiving treatment at Walter Reed National Military Medical Center in Washington. (Photo: Chip Somodevilla/Getty Images)

Joseph “Beau” Biden III, the son of Vice President Joe Biden and the former attorney general of Delaware, died on Saturday at age 46 from brain cancer.

Details about Biden’s health prior to his death are scarce. What is known is that he was hospitalized the week up until his death at Walter Reed National Military Medical Center, and that he did have a small lesion removed from his brain in 2013 at University of Texas M.D. Anderson Cancer Center, but was given a clean bill of health after the procedure.

To be clear, it’s not known the details of Biden’s lesion in 2013, nor whether his brain cancer that ultimately took his life was a primary brain tumor — meaning it originated in the brain — or a secondary brain tumor — meaning it spread from another part of the body.

But if it was indeed a primary brain tumor, and if he had one of the more common kinds of brain tumors — called a glioma — then that kind of brain tumor is known to have a high propensity for returning, even after being successfully removed, says Stephanie E. Weiss, MD, an associate professor of radiation oncology at Fox Chase Cancer Center in Philadelphia, who has not treated Biden.

“No matter what, almost all the time you’re talking about a kind of tumor that is going to come back and become more resistant to therapies,” Weiss, who specializes in treating adult malignant and benign brain tumors, tells Yahoo Health. “That’s why you hear these patients have a brain tumor, a primary brain tumor, and they’ve been given a clean bill of health. But they’re never really in a position” to have a clean bill of health for the rest of their lives, she says.  

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In fact, even benign (non-cancerous) brain tumors can be dangerous. “If you have a benign tumor elsewhere in the body, it won’t hurt you,” she says. But the brain “is precious real estate and it’s enclosed in a confined space.”

There will be an estimated 22,850 new cases of brain and nervous system cancers diagnosed this year, according to the American Association for Cancer Research. Of those, nearly 3,000 will be diagnosed in people under the age of 20. Today, the overall five-year survival rate for brain and nervous system cancers is 33 percent, a dramatic improvement over the last 40 years. In 1975, it was 22.8 percent.

The causes of brain tumors, both benign and malignant, are still largely a mystery to scientists. “For the vast majority [of cases], there’s no known specific cause. There can be familial clustering, where there seems to be some genetic propensity, but we really don’t know enough about how to identify that in a way [that’s] comparable” to how we might analyze genetic risk for ovarian or breast cancers, Weiss says. “And of course, even if you did, at least for breast cancer, there’s prophylactic mastectomy [breast removal-surgery]. But that’s not exactly an option for the brain.”

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Right now, treatment for brain cancer depends on the type, size, and location of the tumor in the brain. Sometimes watchful waiting is employed — where doctors monitor the tumor — and other times, surgery, radiation therapy, and/or chemotherapy are used. But newer, more personalized treatment options may soon be on the horizon, Weiss says.

“We are moving into an era where we appreciate that our traditional form of assessing the risk of these tumors — which has been the World Health Organization tumor grade – is going to be trumped by molecular profiling of these tumors,” she says. “There are going to be certain molecular signatures we’re increasingly identifying as being prognostic — meaning they tell you how the patient is going to do — and predictive, [which] will tell you if the patient will respond to a certain therapy.”

“We’re still in infancy in our understanding and ability to treat [brain cancer], but there’s a hopeful future,” Weiss adds. “Just maybe not as soon as we’d like it.”

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