Raul Malo's Colon Cancer and Leptomeningeal Disease

What Raul Malo shared

Raul Malo sang lead for The Mavericks. In June 2024 he said publicly that he was being treated for colon cancer. In September 2025 he posted on Instagram that he was dealing with LMD, or leptomeningeal disease. That is a rare complication in which cancer reaches the membranes around the brain and spinal cord. He died on December 8, 2025, at the age of 60. His wife, Betty Malo, announced his death on his Facebook page.

He documented his treatment on social media across those 18 months. That is the extent of what is public, and this page stops there. What follows explains the two conditions he named.

Colon cancer usually starts in a polyp

The colon is the long final stretch of the digestive tract. Most colon cancers begin as a polyp, a small growth on the inner lining. Polyps are common, and most never become cancer. The ones that do usually take years to make the change.

That slow timeline is the reason colorectal cancer is one of the few cancers where screening can prevent the disease rather than only find it early. A polyp removed during a colonoscopy cannot turn into anything.

The American Cancer Society projects 158,850 new colorectal cancers in the United States in 2026 and 55,230 deaths, and SEER, the federal cancer statistics program, carries those projections. It is the fourth most commonly diagnosed cancer in the country. SEER's own data put the lifetime risk of a colorectal cancer diagnosis at about 3.9 percent.

The screening menu, and the ages

The US Preventive Services Task Force recommends screening for colorectal cancer in all adults aged 50 to 75. It also recommends it for adults aged 45 to 49. For adults 76 to 85, it says clinicians should offer screening selectively. That choice weighs overall health, past screening and personal preference.

NCI describes the main tests:

• A fecal occult blood test checks stool for blood not visible to the eye. The immunochemical version, called FIT, uses antibodies to detect it.
• A stool DNA test looks for altered DNA in a stool sample.
• Sigmoidoscopy uses a lighted tube to look at the rectum and lower colon.
• Colonoscopy uses a longer tube to look at the whole colon and rectum, and can remove polyps during the same procedure.
• Virtual colonoscopy uses CT images to build a picture of the colon.

One rule matters more than the choice of test. A positive stool test is not the end of screening. It has to be followed by a colonoscopy, promptly, or the screening is not finished. Our guide to colorectal cancer screening compares the options in detail.

When to get checked

NCI says to check with a doctor about any of these:

• Blood in the stool, either bright red or very dark.
• A change in bowel habits, including diarrhea or constipation, lasting more than a few weeks.
• A feeling that the bowel does not empty completely.
• Stools that are narrower or a different shape than usual.
• Ongoing abdominal discomfort: gas pains, bloating, fullness or cramps.
• Weight loss you did not intend, fatigue, or vomiting.

Two points make this list more useful. Symptoms need their own workup. They should not wait for the next routine screening date. And low iron in the blood with no clear cause is a reason to look at the bowel, even when there is no visible bleeding. Our page on colorectal cancer symptoms covers what that check involves.

What leptomeningeal disease is

The brain and spinal cord are wrapped in thin membranes called the leptomeninges, with cerebrospinal fluid circulating between them. Leptomeningeal disease means cancer cells have reached that fluid and those membranes.

It is still the original cancer. Colon cancer cells in the spinal fluid are metastatic colon cancer, not a new brain cancer. That distinction determines which drugs might work.

NCI reports that leptomeningeal spread occurs in about 5 percent of all people with cancer. Breast tumors are the most common source, at about 35 percent of cases. Lung tumors account for about 24 percent and blood cancers about 16 percent. Colon cancer is an uncommon source.

The symptoms that need urgent attention

Because the fluid touches the whole nervous system, symptoms can appear anywhere. The list is long: new severe headache, nausea, confusion, weakness, numbness, poor balance, seizures, changes in vision or hearing, and new bladder or bowel problems.

For anyone with a cancer diagnosis, a new neurological symptom is a same-day call to the care team, not a wait-and-see. Ordinary headaches and balance problems almost always have ordinary causes. The reason to call quickly is that this particular cause is treated more effectively when it is found early.

How it is diagnosed and treated

Diagnosis combines imaging of the brain and spine, usually MRI with contrast, with cerebrospinal fluid cytology, in which fluid drawn by lumbar puncture is examined for cancer cells.

NCI lists four routes. One is chemotherapy given straight into the spinal fluid, called intrathecal chemotherapy. The others add either systemic drug treatment or radiation to that, or use supportive care alone. Steroids are often used as well, especially alongside radiation. Which route fits depends on the original cancer, its molecular features, past treatment, symptoms and a person's own goals. Our page on leptomeningeal disease goes further into what living with it involves.

The survival picture

For colorectal cancer overall, SEER reports five-year relative survival of 65.4 percent for people diagnosed from 2016 through 2022. About 34 percent of cases are found while confined to the bowel, 37 percent have reached nearby lymph nodes and 23 percent have spread to distant sites.

Leptomeningeal disease is far more serious. NCI puts median overall survival in the range of 10 to 12 weeks. That figure is a midpoint across a mixed group of people with many different underlying cancers, and it describes no individual.

Both numbers are group statistics about people diagnosed in the past. Neither predicts what will happen to any one person.

What this story cannot tell you

• Malo's course does not predict anyone else's colon cancer or leptomeningeal disease.
• Screening lowers risk substantially, but it cannot guarantee that a cancer will never appear or never spread.
• A headache or a balance problem is far more likely to have an everyday cause than to signal cancer spread.
• No symptom, on its own, establishes that cancer has reached the nervous system. Only imaging and spinal fluid testing can do that.

Our overview of colorectal cancer covers the stages and treatment routes in full.

Sources

• https://www.pbs.org/newshour/arts/raul-malo-soulful-tenor-and-frontman-of-the-mavericks-dies-at-60
• https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq
• https://www.cancer.gov/types/colorectal/patient/colorectal-screening-pdq
• https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
• https://www.cancer.gov/types/brain/hp/adult-brain-treatment-pdq
• https://seer.cancer.gov/statfacts/html/colorect.html

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

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