Focusing on the Positive While Living With a Glioblastoma Brain Tumor
‘Antique Roadshow’ star Theo Burrell, 38, who is living with a glioblastoma brain tumor, is anxiously awaiting brain scans to learn how much or little her cancerous brain tumor has progressed. She’s focused on the positive parts of her daily life to ease her scan anxiety.
Burrell was diagnosed with grade 4 glioblastoma (GBM), which is an aggressive form of brain cancer. She’s undergone surgery, radiation, and chemotherapy for treatment so far and receives regular scans to monitor her progress.
Glioblastomas grow and spread very quickly. Patients typically have an average survival rate of 15 months with treatment and less than six if left untreated.
Surgery for gliomas strives to remove as much of the tumor as possible while preserving normal brain function. However, some tumors are located in delicate areas, like the brainstem, where removing the whole tumor entirely might not be safe for the patient.
After surgery, additional treatments like chemotherapy or radiation are often needed. These treatments help get additional tumor tissue left behind after surgery. Maintenance therapies may be necessary since gliomas tend to experience recurrence after initial treatment.
“Scanxiety” is a feeling of anxiousness patients tend to experience leading up to or following a cancer scan or test. Psychiatrist Dr. Samantha Boardman suggests exercise, participating in some form of art, listening to music, or doing an activity to take your mind away from potential scan results.
“Antiques Roadshow” star Theo Burrell, 38, admits she’s quite anxious about her upcoming scan to learn how much progression her glioblastoma brain tumor experienced. In the meantime, she’s trying to ground herself with everyday happenings such as caring for her family, running errands, and attending parties because it reminds her of a ‘normal’ life despite living with brain cancer.
“It continues to be a bit of a difficult time as I wait to find out what my scan in December shows. My paranoia about every ache and pain being cancer progression is pretty exhausting, but it’s a reality of living with brain cancer,” Burrell said in an Instagram post.
A glioma is a tumor originating in the central nervous system (CNS), specifically in the brain or spinal cord. A glioma originates in glial cells. Glial cells are supportive cells in the brain that protect and maintain the neurons. These types of tumors can either be benign (non-cancerous) or malignant (cancerous).
“Glioma is a broad term that refers to a whole range of different types of primary brain tumors,” Dr. Alexandra Miller, Director of the Neuro-Oncologist Division at NYU Langone Health, tells SurvivorNet.
“They’re tumors that originate in the brain and very rarely spread outside the brain to other parts of the body,” Dr. Miller continued.
Glioblastoma (GBM) is the most aggressive and lethal form of primary brain tumor. Classified as a Grade 4 glioma by the World Health Organization (WHO), glioblastoma presents significant challenges for treatment due to its highly invasive nature, rapid growth, and resistance to most conventional therapies.
WATCH: Understanding Gliomas
Burrell’s cancer journey began in 2022 when she was diagnosed with glioblastoma.
“Receiving my diagnosis, at the age of 35, when my son was one year old, was devastating,” Burrell previously told U.K.-based news outlet The Sun.
Burrell is among the team of experts that appeared on the popular television show that comes from auction houses. She appeared on the British version of the show, which tours throughout the U.K., valuing various treasures and trinkets. She has been a part of the show since 2018.
Theo Burrell and her dog Pippy when she first got her in 2017. Courtesy of Instagram/@theo.burrell
However, she says things changed seemingly in a flash after her diagnosis.
“Overnight, everything had changed. Suddenly, I’d gone from being a healthy person in the middle of my life with a new baby to having incurable cancer with maybe only a year or two left to live,” Burrell said.
After being diagnosed, Burrell said she immediately underwent surgery to remove the tumor. She also had chemotherapy and radiation. She said in a recent interview since her diagnosis, she’s gone through the rigors of treatment.
“I’ve lost my hair, I’m no longer allowed to drive, and no longer able to work,” she said.
“What followed was months of surgery and treatment to try and prolong my life, and … I continue to make the best of each day,” Burrell added, saying she’s “doing quite well.”
Since her diagnosis, Burrell has become a brain cancer advocate and is focusing on the positive.
“In the spirit of positivity, since my last medical appointments, I’ve celebrated Jonah’s birthday, held a whisky fundraiser, been to a wedding, and attended three birthday parties,” Burrell said.
The former reality TV star says doing “normal” things has become even more important to her since her brain cancer diagnosis.
“They’re the ‘normal’ things that I’m grateful I’m still able to do. There’s nothing like incurable cancer to make you really appreciate every aspect of life!” Burrell said.
Diagnosing gliomas involves a multi-step approach that involves clinical assessment, imaging studies, histopathological examination, and molecular testing.
As patients are diagnosed, they’re observed for typical glioma symptoms. These may include:
Headaches
Seizures
Cognitive or Behavior Changes
Visual or Speech Changes and Impairments
Loss of Body Weight and Deconditioning
Changes in mental function, mood, or personality
Changes in speech
Sensory changes in hearing, smell, and sight
Loss of balance
Changes in your pulse and breathing rate
During the clinical assessment, the physician will take a detailed history, focusing on the onset and progression of symptoms. Since gliomas can present with non-specific symptoms that overlap with other neurological conditions, ruling out conditions like stroke, infections, or inflammatory disorders is essential during the initial clinical evaluation.
Patients then undergo a neurological exam that tests cranial nerve function, motor strength and coordination, sensory function, and cognitive abilities.
Next, patients undergo an MRI, which provides doctors with a visualization of the tumor.
“If you’re suspected of having a tumor on imaging and our neurosurgeons think that tumor can come out, they will take a piece of that tumor out first and confirm in the operating room and with our pathologists that, in fact, what they are looking at is a tumor,” Dr. Alexandra Miller, Director of the Neuro-Oncologist Division at NYU Langone Health, tells SurvivorNet. “And if it is, they resect it at that time. It’s not usually a two-step procedure.”
If surgery cannot be performed due to tumor location or patient-specific factors, a less invasive stereotactic biopsy can be obtained. Once the tissue sample is obtained, it’s examined under a microscope for molecular testing. It’s at this stage, the tumor is given a grade which determines how aggressive it is.
WATCH: Molecular testing for glioma patients
Grade I-II gliomas – These are considered low-grade and tend to grow slowly. “The grade one is a very indolent, benign tumor that can be cured with surgery alone,” Dr. Henry Friedman, Deputy Director of the Preston Robert Tisch Brain Tumor Center at Duke, tells SurvivorNet.
Grade III gliomas—These are considered high-grade and tend to grow more rapidly. They are typically classified as malignant and require more aggressive treatment, which can include surgery, radiation, and chemotherapy.
Grade IV gliomas – These are the most aggressive gliomas, which are locally aggressive and require treatment intensification. Glioblastomas are the most common grade IV glioma, “which is by far the most well-known and feared tumor in the lay population and, quite frankly, the medical population,” Dr. Friedman explains.
How Are Gliomas Treated?
Burrell has already undergone surgery to remove her tumor, followed by chemotherapy and radiation, which helped extract the remaining bits of the cancer that surgery could not remove. Specific details of her ongoing treatment remain unclear at this time. However, the route she took early on is typical for glioblastoma treatment.
“The first step is always the neurosurgery. How much can you take out? Is it safe to do surgery? Do you have to rely on a biopsy? Can you even do a biopsy?” Dr. Friedman, tells SurvivorNet.
The main treatment options are:
Observation—Some benign, small, and without symptoms of gliomas or tumors located in inoperable locations can be recommended for observation.
Surgery is often the first-line treatment for gliomas, with the goal of achieving maximal safe resection, where the largest amount of tumor is removed without causing significant neurologic deficits. For low-grade gliomas, surgery alone can sometimes be curative.
After surgery, pathologists examine the tumor tissue to understand its features and molecular makeup. This added step helps doctors outline an appropriate treatment.
“We go through a very elaborate process of diagnostics, which includes looking at it under the microscope through our pathology team,” Dr. Friedman explained to SurvivorNet.
WATCH: The Role of Surgery in Treating Gliomas
Radiation and chemotherapy are often needed after surgery because removing the tumor completely is usually not possible due to the tumor’s ability to spread into surrounding brain tissue.
Radiation therapy uses high–energy X–rays to target and kill tumor cells. It is often used after surgery to target residual tumor cells.
Chemotherapy – These medications kill or slow the growth of cancer cells. Chemotherapy can be used alongside radiation or following radiation and is often used in higher-grade tumors.
The Food and Drug Administration (FDA) has approved some drug treatments, including temozolomide (Temodar), to help patients with this aggressive disease. Temozolomide is a chemotherapy drug patients can take after surgery and radiation therapy.
Targeted therapy and immunotherapy are newer treatments designed to target specific genetic mutations in the tumor or to stimulate the immune system to fight the cancer. Their role in the treatment of gliomas is continuing to evolve.
Other FDA-approved drugs for treating glioblastoma include lomustine (Gleostine), intravenous carmustine (Bicnu), carmustine wafer implants, and Avastin (bevacizumab).
Avastin is a targeted drug therapy that blocks glioblastoma cells from requesting new blood vessels that feed and allow the tumor to grow.
The FDA approved Vorasidenib, an IDH inhibitor. It works by blocking the mutated enzyme, slowing tumor growth, and extending the time before disease progression. IDH mutant gliomas tend to grow more slowly and have a better prognosis than IDH wild-type gliomas.
Dr. Alexandra Miller tells SurvivorNet that Vorasidenib is a “huge breakthrough for people with IDH mutant tumors.”
“What I tell my patients is that we have these effective treatments, but what they do is they delay the time to when this tumor comes back. Only in exceptional circumstances would we ever talk about getting rid of one of these cancers a few,” Dr. Daniel Wahl, professor of radiation and oncology at the University of Michigan, tells SurvivorNet.
Research Offers Hope to Glioma Patients
Research is ongoing to improve the prognosis for people battling glioblastoma. One area of promise is tumor-treating fields, which can help extend patients’ lives by two years on average, giving them hope.
Optune, the brand name for the tumor-treating field delivery device, was launched in 2011 and approved by the FDA in 2015. It is a wearable and portable device for glioblastoma treatment for adult patients aged 22 years or older.
“There’s been a very exciting development of tumor treating fields, which are electrical fields that have been applied to the brain,” Dr. Suriya Jeyapalan, a neurologist at Tufts Medical Center, previously told Survivor Net.
TTFields use low-intensity electric fields to disrupt the cell division process, making it harder for cancerous cells to multiply.
Despite Optune’s hope, not all cancer experts agree with its approach, including Dr. Friedman.
“Although the National Comprehensive Cancer Network (NCCN) recognizes Optune within its guidelines as a therapy for glioblastoma, many people don’t believe it adds value. At Duke, for example, we don’t consider it a mainstay of therapy,” Dr. Friedman said.
How to Cope with Anxiety Around Scans
Burrell admits she’s anxious about her upcoming brain scan to learn the status of her tumor. What she’s experiencing is a version of scan anxiety or “scanxiety” which is something many cancer patients experience.
“Scan anxiety is unbelievably stressful,” Dr. Samantha Boardman, an assistant professor of psychiatry at Weill Cornell Medicine, told SurvivorNet.
“Probably one of the best antidotes that I think psychology can offer patients is to experience flow,” Boardman explained, which involves losing time.
Her advice to help manage your anxiety is to exercise, participate in some form of art, listen to music, or do an activity you enjoy that takes your mind away from potential scan results.
A straightforward exercise starts with drawing four columns on a piece of paper. “I’ll ask patients to write down what I don’t know, what I do know, what I can’t control, and what I can control,” she said. From there, “a helpful way to dial down their anxiety” involves “trying to move as many items as possible into what they know and can control.”
Visually mapping this process out on paper can also help patients feel more in control of their circumstances. By putting down the anxieties bouncing around in a person’s brain, patients are encouraged to feel like they have power over the challenges they’re facing.
“How can we experience flow in our daily lives? It’s usually in some form of a hobby, something we just do because we love doing it,” Dr. Boardman said. “I really encourage patients to find and experience something that they can do that gives them flow. It might be baking, it might be gardening, it might even be doing some housework. They are so immersed in that experience that they’re not thinking about anything else.”
