Singer Michael Bolton, 72, On Living With The ‘Reality Of Morality’ After Brain Cancer Treatment

He now gets routine MRIs every two months to check that the tumor doesn’t come back.

In a recent interview with People, Bolton revealed for the first time that his diagnosis was glioblastoma, the most aggressive type of brain tumor. He explained that the experience has caused him to shift his priorities a bit, including to spending as much time as possible with his daughters and six grandchildren.

 

View this post on Instagram

 

A post shared by People Magazine (@people)

“How do I give things that they can take forward? Life lessons, love, any kind of validation that I can give [them] — I want to be on the right side of that so they feel great about who they are,” he said of the time he’s devoting to family.

“It’s a reality of mortality. Suddenly a new light has gone on that raises questions, including ‘Am I doing the best that I can do with my time?’”

But the singer also revealed that he has no plans to stop fighting.

“I want to keep going. I feel there’s still a lot to do on the fight side,” he explained.

Understanding Glioblastoma

Like Bolton, people who have been through treatment for a brain tumor often have to undergo regular testing to ensure that the cancer has not returned.

Glioblastoma (GBM) is the most aggressive form of primary brain tumor.

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).

Glioblastomas present doctors with a significant challenge for treatment due to their highly invasive nature, rapid growth, and resistance to most conventional therapies.

WATCH: Understanding Gliomas

Diagnosing gliomas involves a multi-step approach that could include clinical assessment, imaging studies, histopathological examination, and molecular testing.

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, told 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 between 1 and 4, which determines how aggressive it is.

Treatment For Glioblastoma

Dr. Randy Jensen, a neurosurgeon at Huntsman Cancer Institute in Salt Lake City, recently told SurvivorNet that the standard of care for glioblastoma is typically to start with surgery.

“The standard of care for glioblastoma is to start off with a maximal safe resection, and that means having your surgeon pull out all the stops of anything they can do to maximize resection [removal],” Dr. Jensen explained.

The treatment of glioblastoma requires a comprehensive approach involving multiple medical specialties. Your care team may include neurosurgeons, medical oncologists, radiation oncologists, neuro-oncologists, and supportive care specialists.

A Utah Brain Cancer Expert’s Quick Guide To The ‘Standard of Care’ Treatment Options For Glioblastoma

The treatment approach for glioblastoma may consist of the following steps.

1. Surgery: The first step in treatment is often surgical removal of the tumor, also known as resection. The goal of surgery is to remove as much of the tumor as possible while preserving neurological function. Complete removal is often difficult due to the tumor’s infiltrative nature, but reducing the tumor size can improve the effectiveness of subsequent treatments. In cases where surgery is not possible due to the tumor’s location, a biopsy may be performed to confirm the diagnosis.
2. Radiation Therapy: Following surgery, most patients undergo radiation therapy to target any remaining cancer cells. Radiation uses high-energy X-rays or protons to damage the DNA of tumor cells, preventing them from growing and dividing. It is typically administered five days a week over a period of six weeks. Radiation therapy is a crucial component in slowing tumor progression and improving survival rates.
3. Chemotherapy: Temozolomide (TMZ) is the standard chemotherapy drug used in glioblastoma treatment. It is taken orally and works by interfering with the tumor cells’ ability to replicate. TMZ is often used in combination with radiation therapy (concurrent chemoradiation) and then continued as maintenance therapy for several months.
4. Tumor Treating Fields (TTFs): TTFs are a newer, non-invasive treatment option that uses alternating electrical fields to disrupt cancer cell division. This therapy is known by the brand name Optune.

After surgery, the next step is to “present that case in a multidisciplinary tumor board where everybody is in the room and everybody can review the pathology together; everyone can review the images pro-operation and post-operation,” Dr. Jensen explained.

The purpose of the tumor board is to give brain cancer experts with different specialties the opportunity to discuss and decide on the best possible treatment approach.

Learn more about SurvivorNet's rigorous medical review process.