Michael Blackstone, the Detroit Pistons' 54-year-old executive vice president of basketball operations, has been quietly fighting Stage 4 lung cancer since 2023 — and he's still showing up to work. What began as an ache in his right shoulder turned out to be cancer that had already spread from his lung into his shoulder and spine, and Blackstone only told the Pistons organization about his diagnosis last week, even though he's been managing it for years.
Blackstone was first diagnosed in 2023 while working in the New Orleans Pelicans front office, according to Hoops Rumors. He had to push for a PET scan before doctors confirmed that the pain in his shoulder was actually cancer that had metastasized from his lung, according to The Athletic. Since July 2023, he has been receiving treatment at the Mayo Clinic in Jacksonville, Florida, according to the Detroit Free Press. He is a lifelong nonsmoker, a detail worth noting given that nonsmokers account for only 10 to 20 percent of lung cancer cases, per the same report.
Blackstone takes a drug called osimertinib, marketed as Tagrisso, which targets an EGFR mutation driving his cancer by blocking a protein that causes cancer cells to grow and multiply. He has undergone one round of radiation on his lung, and the Free Press report notes he received an additional high-dose radiation treatment in August after doctors found cancerous activity in his spine. As of this week, he expects the fatigue from that most recent radiation to hit its peak.
A Diagnosis He Kept Largely Private
Blackstone has led the Pistons' basketball operations department since 2024, running the team's day-to-day front office work and coordinating between scouting, administration, coaching and ownership. It was Trajan Langdon who brought Blackstone to Detroit that year, continuing a working relationship that dates back to when Langdon became the Pelicans' general manager in 2019 and David Griffin — hired by New Orleans that same year — brought Blackstone into that front office. Within Detroit's organization, Dennis Lindsey runs the scouting department and George David leads administrative operations, working alongside Blackstone.
Blackstone's path to NBA front offices ran through Shapiro Negotiations Institute, the consulting firm founded by Ron Shapiro, where Blackstone began working in 2003 and where past clients included the San Antonio Spurs. He was later hired by Chris Grant, who became the Cleveland Cavaliers' general manager entering the 2010-11 season, and Blackstone went on to become the Cavaliers' executive director of basketball operations before his moves to New Orleans and then Detroit.
Despite his diagnosis and ongoing treatment, Blackstone still spends much of his time at the Pistons Performance Center and attends shootarounds, practices and games, according to the same Hoops Rumors report. The Free Press notes he received support through the ordeal from his wife, Julia, his parents, his sister and friends.
Why He Chose to Go Public
Blackstone decided to speak publicly about his disease to encourage others to take their own symptoms seriously and to advocate for their medical care, he said. He told reporters that the five-year survival rate for someone with late-stage or metastatic non-small cell lung cancer — the type he has — is 12 percent, according to the American Cancer Society figure he cited in his interview with The Athletic. He has reported some cancer progression despite treatment and said the drug he's on will eventually fail, but he hopes his cancer can become a manageable chronic disease rather than a terminal one.
He said he wants to live as long as doctors can keep him out of pain, and he plans to undergo new cancer scans every 90 days going forward. Blackstone hopes the radiation treatment will allow him to keep up his current routine at the Pistons Performance Center, and his message to others, per the Free Press, is straightforward: pay attention to unusual pain and get persistent concerns checked out. Lung cancer remains the leading cause of cancer death in the United States, and diagnoses among younger people have been rising even as smoking, according to the National Cancer Institute, causes most cases.
A Front Office Turnaround Playing Out in the Background
Blackstone's health battle has unfolded alongside one of the more dramatic front-office turnarounds in the league. The Pistons won just 14 games before Blackstone and Langdon took over, then jumped to 44 wins in their first season and 60 wins the following year — an Eastern Conference-best record that also delivered Detroit's first playoff series win since 2008, according to the Free Press report.
