Understanding Brain Tumors
- Singer-songwriter Michael Bolton has just turned 72 and took to social media to share he was celebrating his birthday with his family, just one year after announcing his brain tumor diagnosis, which he underwent surgery to remove.
- Bolton’s brain tumor surgery was a success— but he took time away from touring to focus on his recover. He did not reveal exactly what type of brain tumor he was diagnosed with.
- Brain tumors account for 85-90% of all primary central nervous system (CNS) tumors, according to the American Society of Clinical Oncology (ASCO).
- When it comes to brain tumors, as new treatment approaches are continually being explored through clinical trials, the standard of care for glioblastoma has remained largely consistent since 2005. It combines maximal safe surgical resection (surgery to remove as much of the cancer as possible) followed by chemotherapy and radiation.
Alongside a photo of himself sitting in between two of his daughters and in front of his granddaughters Amelia, Olivia and River, the “Go The Distance” singer, wrote, “Spending my birthday filled with love and gratitude. Wishing you all the same, today & everyday!”
Read MoreOne fan commented, “Have a wonderful birthday MB. Praying for oceans of blessings on you and your family today and always,” while another wrote, “Happy birthday Michael! Wishing you many blessings and an amazing day!”
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An additional person, listed as a “top fan” of his, shared some sweet words, “Happy birthday Mr. Bolton!! I wish there was a way to express how much your music has meant/still means to us.
“Hope today you find yourself surrounded by all those people who are important to you, those you love and certainly love you back and I hope they will give you all the happiness you deserve. My best wishes for you & your family today and always.”
A fourth fan commented, “Happy birthday Michael. I think my family probably adore you and your music as much as your family standing there beside you do! Get better soon Michael enjoy your day and hug them close xx.”
We’re delighted to see Bolton often enjoys quality time with his family, as he recently shared a photo of him with his three grandsons (he has six grandchildren in total).
He captioned the post, which was shared a few days after Christmas, “These are a few of my favorite things.”
Bolton has been healing since his surgery last year and offered fans an update a couple months ago telling them in another Facebook post, “Hi everyone, I’m so sad to have to cancel the upcoming shows but I’m just not quite 100% yet and I only want to give you my very best, so please bear with me as I continue my road to recovery.
“It is challenging and often times frustrating because I just want to be out there performing for you but I need a little more time to build back my full strength and stamina.”
He concluded, “My progress is good and I have been able to get a little work done on a couple exciting projects that you’ll be hearing about very soon. In the meantime, know I’m so grateful for your patience and support as I get back on my feet again!! Love always MB.”
It’s unclear how long it will take for Bolton to recover but we’re happy to see him receiving ongoing support from his family and keeping spirits high.
Bolton first announced his brain tumor diagnosis in an emotional post last January, revealing that “2023 ended up presenting me with some very unexpected challenges … just before the holidays, it was discovered that I had a brain tumor, which required immediate surgery.”
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He explained further, “Thanks to my incredible medical team, the surgery was a success. I am now recuperating at home and surrounded by the tremendous love and support of my family.
“For the next couple of months, I will be devoting my time and energy to my recovery which means I’ll have to take a temporary break from touring.”
Making Sense of a Brain Tumor Diagnosis
According to the American Society of Clinical Oncology (ASCO), brain tumors account for 85-90% of all primary central nervous system (CNS) tumors. They can either be cancerous (malignant) or non-cancerous (benign), and depending on where the tumor forms on the brain, doctors determine its type, potential symptoms, and potential treatment.
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Signs and Symptoms of Brain Tumors
Brain tumors impact a person’s brain function and overall health, depending on their size, type, and location within the brain. Tumors that grow big enough and disrupt normal central nervous system functioning can press on nearby nerves, blood vessels, or other tissues. The disrupted central nervous system can present in various ways, making walking or maintaining balance difficult.
However, it’s important to know that brain tumors do not always cause symptoms.
Other signs of brain tumors may include:
- Headaches
- Difficulty speaking or thinking
- Weakness
- Behavioral changes
- Vision changes
- Seizures
- Loss of hearing
- Confusion
- Memory loss
Treatments for Brain Tumors
Treatment options for brain cancer depend on a variety of factors, including the size and type of the tumor as well as the grade of the tumor.
Surgery, radiation, and chemotherapy are options doctors use to treat brain tumors. Cancer warriors are encouraged to talk to their doctor about their situation and the best treatment options.
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The prognosis for brain cancer, or how likely it is to be cured, depends on a few things, including:
- The type of brain tumor
- How fast the brain tumor is growing
- The tumor’s location
- If there are DNA changes in the cells of the brain tumor
- If the entire tumor can be removed with surgery
- Your overall health
Your doctor will be able to help you understand your specific and unique circumstances and how they relate to your prognosis.
Types of Cancerous and Non-Cancerous Brain Tumors
A brain tumor can affect you differently depending on its location and if it is cancerous. Some brain tumors are non-cancerous (or benign). According to the National Cancer Institute, some examples of these types of brain tumors include:
- Chordomas are primarily benign and slow-growing and are often found near the tailbone or where the spine meets the skull.
- Craniopharyngiomas are rare, slow-growing tumors that don’t spread to other parts of the brain or body. They form near the pituitary gland near the base of the brain.
- Gangliocytomas are rare tumors of the central nervous system that tend to form on the temporal lobe (the left or right side of the brain).
- Glomus jugulare are rare and slow-growing tumors.
- Meningiomas are rare brain tumors that usually form on the outer layer of tissue that covers the brain (dura mater).
- Pineocytomas are rare and slow-growing tumors located in the pineal gland near the middle of the brain.
- Pituitary adenomas are slow-growing brain tumors of the anterior pituitary located in the lower part of the brain.
- Schwannomas are rare tumors that grow on the cells that protect nerve cells. They are called Schwann cells.
- Acoustic neuromas (vestibular schwannoma) are slow-growing tumors that develop from the nerves that help balance and hearing.
Other brain tumors are malignant or cancerous. These kinds of tumors include:
- Gliomas are the most common form of cancerous and aggressive primary brain tumors.
- Astrocytoma (glioma) forms in astrocytes (star-shaped cells). Depending on how aggressive or fast they grow and impact brain tissue, these tumors are classified into four grades.
- Ependymomas are tumors classified into three grades depending on how aggressive or fast they grow.
- Oligodendroglioma tumors are classified into grades depending on their growth speed. Grade 2 oligodendroglioma tumors are slow-growing and can invade nearby tissue, but they may not present symptoms for many years before detection. Meanwhile, grade 3 oligodendroglioma tumors proliferate.
- Medulloblastoma tumors are classified into four different grades depending on their aggressive nature or how quickly they grow.
- Glioblastoma, which is considered a central nervous system (CNS) tumor, is the most common and aggressive brain tumor in adults.
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Understanding Gliomas and How They Are Graded
A glioma is a type of tumor that originates in the central nervous system, specifically in the brain or spinal cord. They originate in glial cells. Glial cells are supportive cells in the brain which serve to protect and maintain the neurons. They perform these tasks by maintaining the right chemical environment for electrical signaling, creating protective coverings for neurons, and removing debris and acting as scavengers. Neurons are the key cells in the brain and spinal cord which are responsible for transmitting messages in the brain. While the signals and messages that allow you to think, move, and speak are created by neurons, the glial cells are critical in maintaining brain function.
So essentially, a glioma is a tumor that comes from the brain’s own support cells.
“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. “So, they’re tumors that originate in the brain and very rarely spread outside the brain to other parts of the body.”
Those glial cells, like many other cells in the body, have the potential to grow abnormally and form a mass, and that is when a glioma is formed. Gliomas, as they arise from the brain or spinal cord, are considered a primary brain tumor. They do not spread from elsewhere in the body. Relative to other cancers such as breast, prostate, and lung, primary brain tumors are relatively uncommon with 80,000 diagnosed per year in the United States. Of the primary brain tumors diagnosed each year, gliomas comprise approximately 25%.
The Grading System of Gliomas
Gliomas are graded on a scale of I to IV, with higher grades indicating a more aggressive tumor. This grading is based on several factors including the type of glioma, the genetics of the cancer, as well as the appearance of the tumor cells under a microscope. The more abnormal the cells look, the higher the grade, and the faster the tumor is likely to grow and spread. Here’s a quick overview:
- Grade I-II gliomas – These are considered low-grade and tend to grow slowly. “The grade one is a very indolent, benign tumor that basically 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. Grade III gliomas are typically classified as malignant and typically 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 most feared tumor in the lay population and quite frankly, the medical population as well,” Dr. Friedman explains.
Although Grade IV gliomas are the most aggressive glioma and may require several types of treatment including surgery, radiation, and chemotherapy, there can be challenges in treating low grade gliomas as well. When making decisions on treatment, several factors are taken into consideration including location of the tumor, ease of surgery and ability to resect, neurologic deficits, patient age, tumor size, and overall health.
Avoiding Provider Bias – Is Your Doctor Understanding You?
While your doctor has undergone years of training and practice, they are still human, and may come with their own set of biases that can impact how they treat patients.
To combat these biases and really get the most out of your interactions with your doctor, you should provide her or him with plenty of information about your life and ask plenty of questions when things aren’t clear. To better understand how you should approach conversations with your doctor, we previously spoke with Dr. Dana Chase, gynecologic oncologist at Arizona Oncology.
According to Dr. Chase, physicians, like many of us, can be a bit biased when seeing patients. She made it clear that these biases are rarely sinister, but rather unconscious and more subtle.
She explained, “We have certain beliefs that we don’t know about. We might look, for example, at an older woman, and just by the way she looks we might make certain assumptions, and we might not even know that we’re making these assumptions.”
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Clearing up misconceptions is important, but so is understanding what your doctor is telling you, Dr. Chase noted. Overall, she advises women to speak up and ask questions when they don’t understand something.
“It’s never a bad thing to ask for something to be repeated, or to ask the doctors to explain it in different terms.”
So next time you go to your physician, speak up if you need clarity, so your doctor can understand you and you can understand them.
Additionally, a component of advocating for yourself in healthcare includes going back to the doctor multiple times and even getting multiple opinions.
Dr. Steven Rosenberg is the National Cancer Institute Chief of Surgery, and he previously told SurvivorNet about the advantages of getting input from multiple doctors.
Cancer research legend urges patients to get multiple opinions.
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care. Because finding a doctor who is up to the latest of information is important,” Dr. Rosenberg said.
Power of Support
A cancer diagnosis can certainly be a stressful experience. One way SurvivorNet experts encourage cancer patients to alleviate some of that stress by leaning on their support system.
A support system can be made up of loved ones like family and friends. It can also be comprised of strangers who have come together because of a shared cancer experience. Mental health professionals can also be critical parts of a support system.
“Some people don’t need to go outside of their family and friend’s circle. They feel like they have enough support there,” psychiatrist Dr. Lori Plutchik told SurvivorNet.
“But for people who feel like they need a little bit more, it’s important to reach out to a mental health professional,” Dr. Plutchik added.
Psychiatrist Dr. Lori Plutchik discusses how people respond to stressors in different ways.
Dr. Plutchik also stressed it is important for people supporting cancer warriors to understand their emotions can vary day-to-day.
“People can have a range of emotions, they can include fear, anger, and these emotions tend to be fluid. They can recede and return based on where someone is in the process,” Dr. Plutchik said.
Contributing: SurvivorNet Staff
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