My Bladder Cancer Fight

When The Diagnosis Of Bladder Cancer Is Made

When someone is diagnosed with cancer, the immediate reaction is panic and denial. For the patient it is ‘am I going to die‘?

This is natural for all humans hearing such devastating news. We have to go through the grieving process before we can accept what is going on within our bodies. We need to come to terms with having cancer. What am I going to do about it?

In talking to a few recently diagnosed bladder cancer patients, over the years, I found one common reluctance. They and their loved ones have a hard time accepting such a diagnosis and what this is going to involve. Again, this is natural.

We would all like a snip, snip by the Urologist and we are cured. Nothing more to worry about, the cancer is gone. Yes, that would be great in a perfect world but that certainly is not the case with cancer.

The earlier cancer is detected, the higher our rate of survival.

With a late diagnosis, the cancer is well established and we have a lower our rate of survival.

Common sense tells us that it is easier to remove a few hundred-cancer cells from the body than it is to remove a few million or even billions. By removal, I mean with either surgery, radiation, or chemotherapy or any other new method that may be available.

In extremely early detection, there is generally just the primary site. The place where the cancer first began to grow.

In late diagnosis, besides the primary site, there could be a secondary site, or third, or fourth. For example in bladder cancer, the primary site is generally within the bladder itself. However, if diagnosis was late, the secondary could be the prostrate, the third could be the kidneys, and the fourth could be the seminal vesicles and the testicles. Different tubes from one to the other connect all theses organs. This would be a Class IV Cancer.

In a class III, the cancer in the bladder is the primary. However, this primary has invaded the wall of the bladder. This is becoming serious. As long as the cancer stays within the bladder and even though it has invaded the bladder wall, it is easier to treat.

Having said that, a big, big question arises. Have ANY of the cancer cells breached the bladder wall? It is almost impossible for the Urologist to say with absolute certainty that the bladder wall has not been breached without operating and looking at the outside bladder wall where the tumor or tumors are located. Even then, it might take a microscopic examination of a section of the bladder wall, by a Pathologist, to give a definitive answer. This is called a Frozen Section. The Pathologist diagnosis of ‘no or yes to breaching’ is only as accurate as the Urologist skill in submitting the correct piece of tissue for him to examine and make his diagnosis. If he submits a sample for examination that is not right on, the button then a false result could be obtained. As a bladder cancer patient, the last the last thing we want to receive is a false result. A good Frozen Section is very accurate. Nevertheless, a better answer can come from tissue that goes to the Pathologist and is treated in a different manner from a Frozen Section. The Frozen Section is done while the patient is still on the operating table.

In my case, my bladder was full of tumors and many of the clusters had invaded the bladder wall. Therefore, it was a class III. My Urologist was concerned that some cells might have breached the bladder wall. Remember it will only take one escaped cell to invade a different organ and set up a secondary site.

One cell divides to produce two new cells
Two cells divide to produce four new cells
Four cells divide to produce 8 new cells

You can see that in not time flat one cell will become millions of cells.

In my case, the accurate diagnosis of ‘did the cancer breach the bladder wall’ came AFTER my surgery. In Canada, every organ or piece of tissue removed, during ANY operation, is submitted to the Pathology Department for gross and microscopic examination. This is where they found a few cancer cells in one of my lymph nodes, from the groin, that they had removed. To me, only a few cells had escaped invaded a lymph node and began to grow. If a 100 or a 1000 had escaped, I think that more than one node would have been invaded. I had what they call a Radical Cystectomy.

Had the Pathologist NOT found those few cancer cells in one of my lymph nodes, I probably would not have had Chemotherapy. I thank that Pathologist every day for his skill. There is a very good chance that I would not be alive today since my cancer was very aggressive. By the time, the tumors showed up on a CAT scan, my body could have been riddles with tumours. Then my prognosis would have been poor and any Chemotherapy would have had a hell of a lot more work to do in trying to kill off these tumors.

Let me give you a family example. One of my cousins, around 60 years old, was diagnosed with Pituitary cancer. The doctors used Radiation to attack the cancer cells. According to the Cat Scan it was working, the cancer tumors were shrinking. About a year later, Ken, took very sick and started to go down hill very fast. He was put in hospital and the Doctors tried to determine what was going on. Another Cat Scan showed that they tumors were still shrinking. Someone woke up to the fact than while doing all the different Cat Scans, they had never scanned Ken’s head. The result was that Ken’s brain was full of tumours. It was so far advanced that he was sent home to spend the rest of his life. This took place in the USA.

Another family member, who was a smoker, developed lung cancer in one of the lobes. The Surgeon decided that all she needed was to remove the lobe showing one cancer tumor. She was to start chemotherapy but before it was started, my sister-in-law was dead. In the autopsy, it was determined that the cancer had spread through out her body. This happened in Canada.

A SINGLE cell of cancer will not show up on an x-ray or CAT scan. I have had no experience with a MRI.

What I am trying to get at in this post is how much RISK is the patient willing to take regarding ‘breach or no breach’ of the bladder wall, in Stage III bladder cancer? Of course, this is an individual decision. However, in my opinion, it could be a very RISKY DECISION.

Let me put it this way, with what I know about cancer today compared to what I knew back in 2000 at my time of diagnosis, I would not take ANY risks. Life is too precious to me to be taking any level of risk. Any Surgeon can remove any organ or any part of me that he deems necessary to give me the very best prognosis and I will consent to it 100%.
This is like investing in the stock market, KNOW YOUR LEVEL OF RISK before you consent to anything. The stakes are just too high.

At the National Cancer Website, you will find almost every thing you need to know about bladder cancer. Do read the whole thing.

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