BBC News, Washington DC

Joe Biden expressed his gratitude for the words of support that flocked around the world, including a private letter from King Charles British, after the former American president announced his diagnosis of cancer on Sunday.
“Cancer touches us all,” Biden wrote on social networks on Monday morning. “Like many of you, Jill and I have learned that we are the strongest in broken places. Thank you for raising us with love and support.”
On Sunday, Biden’s office revealed that it had been diagnosed with an aggressive form of prostate cancer which has spread to its bones.
The news comes while new questions are raised about the health of the former president while he was in office.
“Friday, he received a diagnosis of prostate cancer, characterized by a Gleason score of 9 (Group 5 of grade 5) with metastases at the bone,” Biden’s office said in a statement.
“Although this represents a more aggressive form of the disease, cancer seems to be sensitive to hormones that allows effective management.”
A Gleason de nine score means that his disease is classified as “high” and that cancer cells could spread quickly, according to Cancer Research UK.
Questions have been raised on how long he could have had this cancer and if the disease affects him when he was still in office.
Biden said that his diagnosis was made on Friday after reporting urinary symptoms that led doctors to find a small nodule on his prostate.
Following the diagnosis of cancer, many offered Biden their support, notably President Donald Trump, former President Barack Obama and former vice-president Kamala Harris.
King Charles wrote in private to Biden offering his support and his best wishes, said Buckingham Palace.
The king, 76, who met Biden several times, also receives treatment for a type of cancer not specified after his diagnosis in 2024.
Biden had then sent his best wishes, saying, “I am concerned about him. I just heard about his diagnosis. I’m going to speak to him, God wants it.”
Vice-president JD Vance offered wishes, but wondered if the American people had a clear image of Biden’s health while the former president was in office.
“We must really be honest as to whether the former president was able to do the work,” said Vance on Monday. “And that’s it … You can separate the desire that he has the right result for health with recognition, whether doctors or if there were staff members around the former president, I don’t think he could have done good work for the American people.”
Vance also said he had blamed people around him more than Biden himself.
“It is not the child’s game, and we can pray for good health, but also recognize that if you are not in good health to do the work, you should not do the work,” he added.
The announcement comes as Biden prevents criticism from an upcoming book which claims that he and his advisers hid his deterioration in health while he was in the White House.
The details revealed last week from the book titled Original Sin: President Biden of the decline, his concealment and his disastrous choice to go again, include Biden who do not recognize the actor and the frequent democratic donor George Clooney during a fundraising last year and aid to discuss the former president in a rolling armchair.
The book will be released on Tuesday.
Almost a year ago, the former president was forced to abandon the American presidential election of 2024 due to concerns about his health and age.