Former U.S. President Joe Biden has significantly reduced his public activities as he undergoes treatment for metastatic cancer, with those close to him saying the treatment appears to be working despite taking a visible physical toll.

Axar.az reports, citing The Washington Post, that eighteen months after leaving the White House, the 83-year-old former president moves within a narrowed circle of relatives, old friends and longtime aides as he undergoes treatment for metastatic cancer.

The treatment appears to be working, according to five former aides and others close to Biden, many of whom spoke on the condition of anonymity to candidly discuss his health and private life. But the disease — and the toll of treating it — has left him visibly frail.

Those around Biden describe a post-presidency constrained by illness with his days increasingly organized around treatment, family and efforts to shape his legacy.

Unlike some recent predecessors, Biden has maintained a limited public schedule, has yet to build a sprawling philanthropic or policy operation and has struggled to raise money for a presidential library, leaving him with fewer avenues to influence how his presidency is remembered.