Country Star Tim McGraw, 58, Says His No. 1 Hit Was a Tribute to His Father’s Advanced Brain Cancer Battle – and the Diagnosis Brought Their Family Closer

Gliomas are tumors that begin in the brain and can range from slow-growing to highly aggressive.

Tug McGraw was diagnosed with glioblastoma (GBM), the most severe form of brain cancer, in March 2003. According to ESPN, “The doctors found at least two tumors.”

A glioblastoma is known for its rapid growth and limited survival rates, averaging about 15 months with treatment, and often less than six months without it.

“To control the disease, we typically follow surgery with chemotherapy and radiation to target microscopic infiltration,” explains Dr. Ganish Shankar, a neurosurgeon at Massachusetts General Hospital.

WATCH: Understanding Types & Standard of Care for Gliomas

Standard care usually includes combined chemotherapy and radiation after surgery, followed by additional chemotherapy.

Chemotherapy remains central to glioma treatment, stopping cancer cells from multiplying. But it also affects healthy cells, leading to harsh side effects such as nausea, vomiting, hair loss, and profound fatigue.

“Fatigue is almost universal among patients,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington.

RELATED: A Neuro-Oncologist’s Three Tips For Newly Diagnosed Glioma Patients

While nausea can often be managed with medication, she notes that fatigue and neuropathy, which is nerve damage that causes tingling, pain, or weakness, can be far more difficult and may linger after treatment ends.

As McGraw watched his father navigate the disease, the lyrics that would become “Live Like You Were Dying” surfaced during some of their final moments together.

“He stayed at my cabin out at the farm,” McGraw recalled.

“We were spending a lot of nights out there with my uncle and my brother hanging out, listening to music, watching football. We spent a couple of weeks there before he passed away in the bedroom at the cabin,” McGraw added.

McGraw had already cemented himself as a 1990s and early‑2000s country powerhouse with hits like “I Like It, I Love It,” “My Best Friend,” and “Better Than I Used to Be.” But in 2004, it was the song inspired by his father’s final chapter that soared to the top of the charts.

Though he once questioned whether releasing such a personal song was the right choice, McGraw ultimately came to believe his father would be proud of the legacy it created.

“I think he would be somewhere, hopefully up in heaven, smiling down,” McGraw said.

Understanding a Glioblastoma Diagnosis

Diagnosing gliomas involves a multi-step approach that includes 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 Behavioral 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. 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?

“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 asymptomatic 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.

Better Understanding the Types of Brain Tumors

Brain tumors can impact a person’s cognitive function and overall well-being, depending largely on the tumor’s size, type, and specific location within the brain. When large enough, tumors may interfere with the central nervous system, pressing on nearby nerves, blood vessels, or tissues. This disruption may result in difficulties with coordination, balance, or mobility.

According to the American Society of Clinical Oncology (ASCO), brain tumors make up 85–90% of all primary central nervous system (CNS) tumors. They can be benign or malignant, with treatment and symptoms varying based on tumor type and location.

“The goal is to remove as much of the tumor as we can while keeping the patient well neurologically,” Dr. Reid Thompson, Chair of Neurosurgery at Vanderbilt University Medical Center, tells SurvivorNet. In other words, to remove as much of the tumor as possible without causing harm to the patient.

Even though surgery can remove a large part of the tumor, any remaining cancer cells can continue to grow over time, leading to the tumor’s return. For this reason, surgery is often followed by other treatments, like radiation or chemotherapy, to try to eliminate any remaining cells.

WATCH: Hope for Glioblastoma Research

While some brain tumors cause noticeable symptoms, others can go unnoticed for long periods. When symptoms do occur, they might include:

• Persistent headaches
• Difficulty speaking or processing thoughts
• Muscle weakness
• Behavioral or personality changes
• Vision disturbances
• Seizures
• Hearing loss
• Confusion
• Memory issues

Treatment Options for Brain Tumors

Treatment strategies for brain cancer depend on several variables, including the tumor’s size, type, grade, and location. Doctors may recommend:

• Surgery
• Radiation therapy
• Chemotherapy

Your medical team will help guide you based on your individual diagnosis. The prognosis—or outlook—depends on:

• Tumor type and growth rate
• Tumor location in the brain
• Presence of genetic mutations or abnormalities
• Whether the entire tumor can be removed
• The patient’s overall health

Questions for Your Doctor

SurvivorNet’s AI-powered tool, “My Health Questions,” is a resource designed with patients and clinicians in mind. For patients, My Health Questions can help answer spur-of-the-moment questions with doctor-supported information. It can also help patients and caregivers formulate questions to ask at the next appointment.

Below are some questions to kickstart your journey.

• What stage is my brain cancer?
• What are the treatment options for my brain cancer?
• Am I a good candidate for temozolomide?
• What are the risks and benefits of the recommended treatment?
• What are the side effects of the recommended treatment?
• How long will it take to recover from treatment, and will I be able to return to work and normal activities?
• What’s the likelihood that insurance will cover the recommended treatment?

Learn more about SurvivorNet's rigorous medical review process.

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