Former President Joe Biden is facing an “aggressive” case of Stage 4 prostate cancer, his office announced over the weekend in a statement. “Cancer touches us all. Like so many of you, Jill and I have learned that we are strongest in the broken places. Thank you for lifting us up with love and support,” Biden posted on social media Monday morning.

It’s aggressive. The cells have an ugly, disordered appearance under a microscope. Pathologists gave them a Gleason score of 9 (out of 10) for their likelihood to advance quickly. The cancer has already moved from Biden’s prostate to his bones, which means it cannot be cured — only controlled with drugs.